首页 > 最新文献

Journal of the American Association of Nurse Practitioners最新文献

英文 中文
Integration of a nurse practitioner and physician associate leadership structure within an academic cancer center. 在学术癌症中心内整合执业护士和助理医师领导结构。
IF 1.2 4区 医学 Pub Date : 2024-06-01 DOI: 10.1097/JXX.0000000000001010
Heather J Jackson, Olivia West, Shelton Harrell, Emily Skotte, Karen Hande

Background: Nurse practitioners and physician associates are an essential part of the multidisciplinary cancer care team with expanding and evolving roles within cancer specialties.

Local problem: As these clinicians flourish, a parallel need for leadership rises to optimize scope of practice, mentor, and retain this crucial workforce. The purpose of this quality improvement project was to development a nurse practitioner and physician associate leadership structure within an academic cancer center.

Methods: Development of this nurse practitioner and physician associate leadership structure was guided by transformational leadership theory. In collaboration with nursing, business, and physician leadership, a quad structure was supported.

Interventions: Implementation of a leadership structure included the establishment of eight team leaders and two managers. These leaders identified multiple opportunities for improvement including improved communications, offload of nonbillable work, development of incentive programs, provision of equipment, specialty practice alignment, hematology/oncology fellowship, and professional development.

Results: Overall, a nurse practitioner and physician associate leadership structure allowed for representation across the cancer center. Such inclusion supported multiple quality improvement projects developed in partnership with nursing, business, and physician leaders. Cumulatively, these interventions yielded efficient workflows and expansion of services. Consistent with reported evidence, these efforts contributed to nurse practitioner and physician associate retention as well as improved job satisfaction.

Conclusions: Advanced practice leadership is essential to recruiting, developing, supporting, and retaining nurse practitioner and physician assistant colleagues in cancer care.

背景:当地问题:随着这些临床医生的蓬勃发展,对领导力的需求也随之上升,以优化执业范围、指导并留住这支至关重要的队伍。本质量改进项目的目的是在一家学术性癌症中心建立执业护士和助理医师领导结构:方法:在变革型领导力理论的指导下,制定了执业护士和助理医师领导力结构。通过与护理、业务和医生领导层的合作,支持建立一个四级结构:领导结构的实施包括设立八名团队领导和两名管理人员。这些领导者确定了多种改进机会,包括改善沟通、卸载非计费工作、制定激励计划、提供设备、专科实践调整、血液学/肿瘤学奖学金和专业发展:总的来说,执业护士和助理医师的领导结构使整个癌症中心都有了代表。这种包容性支持了与护理、业务和医生领导合作开发的多个质量改进项目。这些干预措施累积起来,产生了高效的工作流程并扩大了服务范围。与报告的证据一致,这些努力有助于留住执业护士和助理医师,并提高工作满意度:高级实践领导对于招聘、培养、支持和留住癌症护理领域的执业护士和助理医师同事至关重要。
{"title":"Integration of a nurse practitioner and physician associate leadership structure within an academic cancer center.","authors":"Heather J Jackson, Olivia West, Shelton Harrell, Emily Skotte, Karen Hande","doi":"10.1097/JXX.0000000000001010","DOIUrl":"10.1097/JXX.0000000000001010","url":null,"abstract":"<p><strong>Background: </strong>Nurse practitioners and physician associates are an essential part of the multidisciplinary cancer care team with expanding and evolving roles within cancer specialties.</p><p><strong>Local problem: </strong>As these clinicians flourish, a parallel need for leadership rises to optimize scope of practice, mentor, and retain this crucial workforce. The purpose of this quality improvement project was to development a nurse practitioner and physician associate leadership structure within an academic cancer center.</p><p><strong>Methods: </strong>Development of this nurse practitioner and physician associate leadership structure was guided by transformational leadership theory. In collaboration with nursing, business, and physician leadership, a quad structure was supported.</p><p><strong>Interventions: </strong>Implementation of a leadership structure included the establishment of eight team leaders and two managers. These leaders identified multiple opportunities for improvement including improved communications, offload of nonbillable work, development of incentive programs, provision of equipment, specialty practice alignment, hematology/oncology fellowship, and professional development.</p><p><strong>Results: </strong>Overall, a nurse practitioner and physician associate leadership structure allowed for representation across the cancer center. Such inclusion supported multiple quality improvement projects developed in partnership with nursing, business, and physician leaders. Cumulatively, these interventions yielded efficient workflows and expansion of services. Consistent with reported evidence, these efforts contributed to nurse practitioner and physician associate retention as well as improved job satisfaction.</p><p><strong>Conclusions: </strong>Advanced practice leadership is essential to recruiting, developing, supporting, and retaining nurse practitioner and physician assistant colleagues in cancer care.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
To choose or not to choose a nurse practitioner fellowship: An opinion piece on why to choose. 选择还是不选择执业护士奖学金:关于为何选择的评论文章。
IF 1.2 4区 医学 Pub Date : 2024-06-01 DOI: 10.1097/JXX.0000000000001014
Nicole Kuhnly

Abstract: New graduate nurse practitioners (NPs) often face a challenging learning curve, especially in specialized fields. The quality of clinical experiences and education varies widely across NP programs, and NP Fellowships offer an extension of formal education and clinical experiences. This editorial offers a personal perspective into the NP Fellowship experience and affirms their value to improve the standard of patient care and equip novice NPs for a sustainable career.

摘要:新毕业的执业护士(NPs)往往面临着充满挑战的学习曲线,尤其是在专业领域。不同 NP 项目的临床经验和教育质量差别很大,而 NP 研究金则是正规教育和临床经验的延伸。这篇社论从个人角度阐述了 NP 研究金的经验,并肯定了其在提高患者护理标准和帮助新手 NPs 获得可持续职业发展方面的价值。
{"title":"To choose or not to choose a nurse practitioner fellowship: An opinion piece on why to choose.","authors":"Nicole Kuhnly","doi":"10.1097/JXX.0000000000001014","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001014","url":null,"abstract":"<p><strong>Abstract: </strong>New graduate nurse practitioners (NPs) often face a challenging learning curve, especially in specialized fields. The quality of clinical experiences and education varies widely across NP programs, and NP Fellowships offer an extension of formal education and clinical experiences. This editorial offers a personal perspective into the NP Fellowship experience and affirms their value to improve the standard of patient care and equip novice NPs for a sustainable career.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characteristics of late preterm infant readmissions: A systematic review. 晚期早产儿再入院的特征:系统回顾。
IF 1.2 4区 医学 Pub Date : 2024-06-01 DOI: 10.1097/JXX.0000000000000986
Jennifer A Joyner, Amy E Papermaster, Jane Dimmitt Champion

Background: Prematurity represents a critical health disparity. It is important to note that late preterm (LPT) infants comprise the majority of preterm births, yet they are the least studied within the premature population. Evidence-based practice guidelines are now a decade old, indicating the potential need for review and revision.

Objectives: This systematic review proposed the assessment of sociodemographic characteristics of LPT infants, clinical practice standards, and associated hospital readmission rates, mortality, and morbidity to determine the need for revision of evidence-based practice guidelines for these infants.

Data sources: The Preferred Reporting System Items for Systematic Reviews and Meta Analysis methodology provided the framework for the completion of this review. Literature searches of PubMed/Medline (Ovid), Web of Science, Cumulative Index of Nursing, and Allied Health Literature Plus databases and citation searches included articles published after 2012 using the search terms "late preterm infants," "readmissions," and "readmission rates."

Conclusions: The literature search identified 11 studies meeting search criteria. These studies included quasi experimental, retrospective, and prospective cohort studies. These studies highlighted the characteristics of LPT infants that potentially contribute to increased readmission rates, morbidity and mortality rates, health care costs, and long-term health inequities. Overall findings indicate the need for review and revision of evidence-based practice guidelines for these infants.

Implications for practice: This systematic review manifests the vulnerability of LPT infants and the accompanying need for up-to-date clinical practice guidelines to effectively reduce their morbidity and mortality rates, hospital readmissions rates, and burden of health care costs.

背景:早产是一个严重的健康问题。值得注意的是,晚期早产儿(LPT)占早产儿的大多数,但在早产儿群体中对他们的研究却最少。以证据为基础的实践指南已有十年之久,这表明有必要对其进行审查和修订:本系统综述建议对早产儿的社会人口学特征、临床实践标准以及相关的再入院率、死亡率和发病率进行评估,以确定是否有必要修订针对这些早产儿的循证实践指南:数据来源:系统综述和元分析方法的首选报告系统项目为本综述的完成提供了框架。在PubMed/Medline (Ovid)、Web of Science、Cumulative Index of Nursing和Allied Health Literature Plus数据库中进行文献检索,并使用 "晚期早产儿"、"再入院 "和 "再入院率 "等检索词对2012年以后发表的文章进行引文检索:文献检索发现了 11 项符合检索标准的研究。这些研究包括准实验研究、回顾性研究和前瞻性队列研究。这些研究强调了 LPT 婴儿的特点,这些特点可能会导致再入院率、发病率和死亡率、医疗成本以及长期的健康不公平现象增加。总体研究结果表明,有必要审查和修订针对这些婴儿的循证实践指南:本系统性综述表明了 LPT 婴儿的脆弱性以及对最新临床实践指南的需求,以有效降低他们的发病率和死亡率、再入院率和医疗费用负担。
{"title":"Characteristics of late preterm infant readmissions: A systematic review.","authors":"Jennifer A Joyner, Amy E Papermaster, Jane Dimmitt Champion","doi":"10.1097/JXX.0000000000000986","DOIUrl":"10.1097/JXX.0000000000000986","url":null,"abstract":"<p><strong>Background: </strong>Prematurity represents a critical health disparity. It is important to note that late preterm (LPT) infants comprise the majority of preterm births, yet they are the least studied within the premature population. Evidence-based practice guidelines are now a decade old, indicating the potential need for review and revision.</p><p><strong>Objectives: </strong>This systematic review proposed the assessment of sociodemographic characteristics of LPT infants, clinical practice standards, and associated hospital readmission rates, mortality, and morbidity to determine the need for revision of evidence-based practice guidelines for these infants.</p><p><strong>Data sources: </strong>The Preferred Reporting System Items for Systematic Reviews and Meta Analysis methodology provided the framework for the completion of this review. Literature searches of PubMed/Medline (Ovid), Web of Science, Cumulative Index of Nursing, and Allied Health Literature Plus databases and citation searches included articles published after 2012 using the search terms \"late preterm infants,\" \"readmissions,\" and \"readmission rates.\"</p><p><strong>Conclusions: </strong>The literature search identified 11 studies meeting search criteria. These studies included quasi experimental, retrospective, and prospective cohort studies. These studies highlighted the characteristics of LPT infants that potentially contribute to increased readmission rates, morbidity and mortality rates, health care costs, and long-term health inequities. Overall findings indicate the need for review and revision of evidence-based practice guidelines for these infants.</p><p><strong>Implications for practice: </strong>This systematic review manifests the vulnerability of LPT infants and the accompanying need for up-to-date clinical practice guidelines to effectively reduce their morbidity and mortality rates, hospital readmissions rates, and burden of health care costs.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139478724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pharmacogenetic testing may benefit people receiving low-dose lithium in clinical practice. 药物遗传学测试可能有利于在临床实践中接受低剂量锂的人。
IF 1.2 4区 医学 Pub Date : 2024-06-01 DOI: 10.1097/JXX.0000000000000968
Michael Ray Dickerson, Jennifer Reed

Background: Mental illnesses are leading causes of disability in the United States. Some evidence supports that pharmacogenetic testing may be beneficial in select populations and that lithium is beneficial for treating mood disorders and anxiety in some populations.

Purpose: This research aimed to determine whether low-dose lithium effectively decreases depression and anxiety in adults with a risk allele for CACNA1C genotypes.

Methodology: The study design was correlational. Fifty patients were treated at a nurse practitioner-owned clinic in Prairie Village, Kansas. Chart review was used. Adults older than 18 years diagnosed with major depressive disorder, bipolar disorder, or generalized anxiety disorder presenting with an abnormality in the CACNA1C gene single-nucleotide polymorphism rs1006737 were included in this research. Assessment tools used were the Patient Health Questionnaire-9 for depression and GAD-7 for anxiety.

Results: Low-dose lithium significantly decreased depression by 66% ( p < .001) and anxiety by 65% ( p = <.001). There was a significant difference in pretest depression levels based on CACNA1C genotype ( p = .033). The A allele frequency was 60% higher (48%) in this population than found in general population (30%).

Conclusions: Low-dose lithium significantly decreased anxiety and depression compared with baseline. People with different versions of the CACNA1C genotype had responses that differed significantly. The A risk allele was 60% more common than in the general population.

Implications: This study could aid in establishing genetic testing as an effective clinical tool for treating depression and anxiety using lithium, an inexpensive and widely available medication.

背景:在美国,精神疾病是导致残疾的主要原因。一些证据支持药物遗传学测试可能对特定人群有益,锂对治疗某些人群的情绪障碍和焦虑有益。目的:本研究旨在确定低剂量锂是否能有效降低具有CACNA1C基因型风险等位基因的成年人的抑郁和焦虑。方法:研究设计具有相关性。50名患者在堪萨斯州草原村的一家执业护士诊所接受治疗。使用了图表审查。本研究纳入了18岁以上被诊断为重度抑郁症、双相情感障碍或广泛性焦虑症并伴有CACNA1C基因单核苷酸多态性rs1006737异常的成年人。使用的评估工具是抑郁症患者健康问卷-9和焦虑症GAD-7。结果:低剂量锂可显著降低66%的抑郁情绪(p<.001)和65%的焦虑情绪(p=结论:与基线相比,低剂量锂显著降低了焦虑和抑郁。具有不同版本CACNA1C基因型的人的反应差异显著。A风险等位基因比普通人群中更常见60%。提示:这项研究可以帮助建立基因检测,将其作为治疗抑郁症和使用锂的焦虑,锂是一种廉价且广泛可用的药物。
{"title":"Pharmacogenetic testing may benefit people receiving low-dose lithium in clinical practice.","authors":"Michael Ray Dickerson, Jennifer Reed","doi":"10.1097/JXX.0000000000000968","DOIUrl":"10.1097/JXX.0000000000000968","url":null,"abstract":"<p><strong>Background: </strong>Mental illnesses are leading causes of disability in the United States. Some evidence supports that pharmacogenetic testing may be beneficial in select populations and that lithium is beneficial for treating mood disorders and anxiety in some populations.</p><p><strong>Purpose: </strong>This research aimed to determine whether low-dose lithium effectively decreases depression and anxiety in adults with a risk allele for CACNA1C genotypes.</p><p><strong>Methodology: </strong>The study design was correlational. Fifty patients were treated at a nurse practitioner-owned clinic in Prairie Village, Kansas. Chart review was used. Adults older than 18 years diagnosed with major depressive disorder, bipolar disorder, or generalized anxiety disorder presenting with an abnormality in the CACNA1C gene single-nucleotide polymorphism rs1006737 were included in this research. Assessment tools used were the Patient Health Questionnaire-9 for depression and GAD-7 for anxiety.</p><p><strong>Results: </strong>Low-dose lithium significantly decreased depression by 66% ( p < .001) and anxiety by 65% ( p = <.001). There was a significant difference in pretest depression levels based on CACNA1C genotype ( p = .033). The A allele frequency was 60% higher (48%) in this population than found in general population (30%).</p><p><strong>Conclusions: </strong>Low-dose lithium significantly decreased anxiety and depression compared with baseline. People with different versions of the CACNA1C genotype had responses that differed significantly. The A risk allele was 60% more common than in the general population.</p><p><strong>Implications: </strong>This study could aid in establishing genetic testing as an effective clinical tool for treating depression and anxiety using lithium, an inexpensive and widely available medication.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50161980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Scholarly analytics for nurse practitioners. 针对执业护士的学术分析。
IF 1.2 4区 医学 Pub Date : 2024-06-01 DOI: 10.1097/JXX.0000000000001027
Rodney W Hicks

Abstract: Nurse practitioners who publish contribute to the profession's body of knowledge. Today's digitally inclined environment easily allows for the tracking of contributing to knowledge and impact. Four popular measures for tracking include Altmetric, Google Scholar, Scopus, and Web of Science. Authors should understand each tracking source's purpose, process, and value. The strengths and limitations of the tracking sources are reviewed. Awareness of the tracking sources and knowing how to influence the tools will bring additional attention to the authors.

摘要:发表论文的执业护士对本专业的知识体系做出了贡献。在当今数字化的环境中,很容易对知识贡献和影响进行跟踪。四种流行的跟踪方法包括 Altmetric、Google Scholar、Scopus 和 Web of Science。作者应了解每个跟踪来源的目的、过程和价值。我们对跟踪来源的优势和局限性进行了评述。了解跟踪来源并知道如何影响这些工具将为作者带来更多关注。
{"title":"Scholarly analytics for nurse practitioners.","authors":"Rodney W Hicks","doi":"10.1097/JXX.0000000000001027","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001027","url":null,"abstract":"<p><strong>Abstract: </strong>Nurse practitioners who publish contribute to the profession's body of knowledge. Today's digitally inclined environment easily allows for the tracking of contributing to knowledge and impact. Four popular measures for tracking include Altmetric, Google Scholar, Scopus, and Web of Science. Authors should understand each tracking source's purpose, process, and value. The strengths and limitations of the tracking sources are reviewed. Awareness of the tracking sources and knowing how to influence the tools will bring additional attention to the authors.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141237821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Confronting mental health stigma in Haitian Americans suffering from mental health challenges. 正视美籍海地人在心理健康方面的污名化问题。
IF 1.2 4区 医学 Pub Date : 2024-06-01 DOI: 10.1097/JXX.0000000000000992
Marie M Moreau, Rene A Love, Dany Fanfan

Background: Haitian Americans have been disproportionately exposed to risk factors known to play a significant role in the development of mental illness. Yet despite the documented effectiveness of mental health treatment, a high proportion of Haitian Americans with mental health disorders have not received care.

Local problem: Internalized stigma of mental illness (ISMI) was reported as one of the primary reasons Haitian Americans do not seek help for mental illnesses, resulting in poor long-term outcomes for individuals and families in this community. This quality improvement project characterized ISMI among Haitian Americans, examined associated demographic factors, and tested the impact of a culturally relevant ISMI educational video intervention on willingness to seek mental health treatment.

Methods: Haitian Americans who self-reported mental illness ( N = 20) were recruited from a South Florida clinic. Descriptive statistics, correlations, and thematic analyses were completed to analyze the data.

Interventions: Participants completed the nine-item ISMI scale, watched an educational video about ISMI, completed a post-intervention survey, and engaged in conversations about mental health and ISMI.

Results: Sixty-five percent of participants reported mild levels of ISMI. Sex was significantly correlated with ISMI ( r = -0.458, p = .042); male participants experienced higher levels of ISMI. The educational video improved participants' knowledge of ISMI, and 85% indicated increased willingness to seek treatment.

Conclusions: When caring for Haitian Americans with mental illnesses, nurse practitioners should initiate conversations about ISMI, consider gender differences in mental illness beliefs and attitudes, and provide culturally responsive psychoeducational interventions to promote more mental health treatment utilization.

背景:美国海地人不成比例地暴露在风险因素中,而这些因素在精神疾病的发展中起着重要作用。当地问题:据报道,美国海地人对精神疾病的内在化耻辱感(ISMI)是他们不寻求精神疾病帮助的主要原因之一,导致该社区的个人和家庭长期治疗效果不佳。本质量改进项目描述了美国海地人中的 ISMI 特征,研究了相关的人口因素,并测试了与文化相关的 ISMI 教育视频干预对寻求心理健康治疗意愿的影响。方法:从南佛罗里达州的一家诊所招募了自我报告患有精神疾病的美国海地人(N = 20)。对数据进行了描述性统计、相关性分析和主题分析:干预措施:参与者填写由九个项目组成的 ISMI 量表,观看有关 ISMI 的教育视频,完成干预后调查,并参与有关心理健康和 ISMI 的对话:结果:65%的参与者报告了轻度的 ISMI。性别与 ISMI 有明显的相关性(r = -0.458,p = .042);男性参与者的 ISMI 水平更高。教育视频提高了参与者对 ISMI 的认识,85% 的参与者表示更愿意寻求治疗:结论:在护理患有精神疾病的美籍海地人时,执业护士应主动与他们进行有关 ISMI 的对话,考虑他们在精神疾病信念和态度方面的性别差异,并提供符合文化特点的心理教育干预措施,以促进他们更多地利用心理健康治疗。
{"title":"Confronting mental health stigma in Haitian Americans suffering from mental health challenges.","authors":"Marie M Moreau, Rene A Love, Dany Fanfan","doi":"10.1097/JXX.0000000000000992","DOIUrl":"10.1097/JXX.0000000000000992","url":null,"abstract":"<p><strong>Background: </strong>Haitian Americans have been disproportionately exposed to risk factors known to play a significant role in the development of mental illness. Yet despite the documented effectiveness of mental health treatment, a high proportion of Haitian Americans with mental health disorders have not received care.</p><p><strong>Local problem: </strong>Internalized stigma of mental illness (ISMI) was reported as one of the primary reasons Haitian Americans do not seek help for mental illnesses, resulting in poor long-term outcomes for individuals and families in this community. This quality improvement project characterized ISMI among Haitian Americans, examined associated demographic factors, and tested the impact of a culturally relevant ISMI educational video intervention on willingness to seek mental health treatment.</p><p><strong>Methods: </strong>Haitian Americans who self-reported mental illness ( N = 20) were recruited from a South Florida clinic. Descriptive statistics, correlations, and thematic analyses were completed to analyze the data.</p><p><strong>Interventions: </strong>Participants completed the nine-item ISMI scale, watched an educational video about ISMI, completed a post-intervention survey, and engaged in conversations about mental health and ISMI.</p><p><strong>Results: </strong>Sixty-five percent of participants reported mild levels of ISMI. Sex was significantly correlated with ISMI ( r = -0.458, p = .042); male participants experienced higher levels of ISMI. The educational video improved participants' knowledge of ISMI, and 85% indicated increased willingness to seek treatment.</p><p><strong>Conclusions: </strong>When caring for Haitian Americans with mental illnesses, nurse practitioners should initiate conversations about ISMI, consider gender differences in mental illness beliefs and attitudes, and provide culturally responsive psychoeducational interventions to promote more mental health treatment utilization.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Improving patient education in hospitalized patients with chronic obstructive pulmonary disease: A quality improvement initiative using LEAN methodology. 改善慢性阻塞性肺病住院患者的患者教育:采用精益方法的质量改进计划。
IF 1.2 4区 医学 Pub Date : 2024-05-10 DOI: 10.1097/JXX.0000000000001024
Jacquelyn M Stewart, Freny Shah, Jolly Thomas, Myrtle White

Background: Chronic obstructive pulmonary disease (COPD) is a costly chronic disease affecting more than 15 million Americans. The prevalence among US veterans is 3 times higher than the general population.

Local problem: The Veteran Health Administration developed a standardized, evidence-based COPD educational tool called Green Light to Go (GLTG) designed to educate patients on managing their COPD symptoms at home. Despite the availability of this resource, inpatient education on COPD self-management practices is highly variable across different medical teams. This quality improvement (QI) initiative sought to standardize inpatient COPD patient education using the GLTG tool. This initiative also assessed whether patients receiving standardized patient education during their index hospitalization had lower COPD 30-day readmission rates.

Method: The QI initiative followed the LEAN methodology and the A3 framework. The team performed rapid tests of change (plan-do-study-act cycles) to increase the percentage of veterans receiving COPD education.

Interventions: The interventions implemented for this QI initiative focused on clinical, patient, and system improvements.

Results: This initiative standardized COPD patient education and increased the percentage of veterans receiving (a) daily COPD education from 0% to 66%, (b) verbal COPD education on discharge from a baseline of 20% to 100%, (c) receipt of written educational material on discharge from 20% to 100%, and (d) the cohort all-cause 30-day readmission rate declined from 19.3% to 14.3%.

Conclusions: Given the substantial economic burden of COPD readmissions on the health care system and patients, evidence-based educational interventions may potentially improve outcomes and reduce hospital readmissions in this veteran population.

背景:慢性阻塞性肺病(COPD)是一种代价高昂的慢性疾病,影响着 1500 多万美国人。当地问题:退伍军人健康管理局开发了一种名为 "绿灯行动"(GLTG)的标准化循证慢性阻塞性肺病教育工具,旨在教育患者如何在家中控制自己的慢性阻塞性肺病症状。尽管有这一资源,但在不同的医疗团队中,慢性阻塞性肺病患者自我管理实践的住院教育差异很大。这项质量改进(QI)计划旨在使用 GLTG 工具对慢性阻塞性肺病住院患者进行标准化教育。该计划还评估了在住院期间接受标准化患者教育的患者是否会降低慢性阻塞性肺病 30 天再入院率:该 QI 计划遵循 LEAN 方法和 A3 框架。团队进行了快速变革测试(计划-实施-研究-行动循环),以提高接受慢性阻塞性肺病教育的退伍军人比例:干预措施:该 QI 计划实施的干预措施侧重于临床、患者和系统的改进:结果:该倡议对慢性阻塞性肺病患者教育进行了标准化,并提高了退伍军人接受以下教育的比例:(a)慢性阻塞性肺病日常教育从 0% 提高到 66%;(b)出院时接受慢性阻塞性肺病口头教育的比例从基线的 20% 提高到 100%;(c)出院时接受书面教育材料的比例从 20% 提高到 100%;以及(d)队列全因 30 天再入院率从 19.3% 下降到 14.3%:鉴于慢性阻塞性肺病再入院对医疗系统和患者造成的巨大经济负担,基于证据的教育干预可能会改善退伍军人群体的治疗效果并减少再入院率。
{"title":"Improving patient education in hospitalized patients with chronic obstructive pulmonary disease: A quality improvement initiative using LEAN methodology.","authors":"Jacquelyn M Stewart, Freny Shah, Jolly Thomas, Myrtle White","doi":"10.1097/JXX.0000000000001024","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001024","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is a costly chronic disease affecting more than 15 million Americans. The prevalence among US veterans is 3 times higher than the general population.</p><p><strong>Local problem: </strong>The Veteran Health Administration developed a standardized, evidence-based COPD educational tool called Green Light to Go (GLTG) designed to educate patients on managing their COPD symptoms at home. Despite the availability of this resource, inpatient education on COPD self-management practices is highly variable across different medical teams. This quality improvement (QI) initiative sought to standardize inpatient COPD patient education using the GLTG tool. This initiative also assessed whether patients receiving standardized patient education during their index hospitalization had lower COPD 30-day readmission rates.</p><p><strong>Method: </strong>The QI initiative followed the LEAN methodology and the A3 framework. The team performed rapid tests of change (plan-do-study-act cycles) to increase the percentage of veterans receiving COPD education.</p><p><strong>Interventions: </strong>The interventions implemented for this QI initiative focused on clinical, patient, and system improvements.</p><p><strong>Results: </strong>This initiative standardized COPD patient education and increased the percentage of veterans receiving (a) daily COPD education from 0% to 66%, (b) verbal COPD education on discharge from a baseline of 20% to 100%, (c) receipt of written educational material on discharge from 20% to 100%, and (d) the cohort all-cause 30-day readmission rate declined from 19.3% to 14.3%.</p><p><strong>Conclusions: </strong>Given the substantial economic burden of COPD readmissions on the health care system and patients, evidence-based educational interventions may potentially improve outcomes and reduce hospital readmissions in this veteran population.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140898749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Timing of stroke survivors' hospital readmissions to guide APRNs in primary care 中风幸存者再入院的时间安排可为全科护士提供指导
IF 1.2 4区 医学 Pub Date : 2024-05-03 DOI: 10.1097/jxx.0000000000000984
Teresa Connolly, Kim Paxton, Bryan McNair
Caring for patients after a neurovascular incident is common for advanced practice registered nurses (APRNs). Most neurological readmission studies focus on a small subset of neurovascular incident groups, but advanced practice nurses in primary care attend to a diverse neurovascular population and lack time to adequately search hospital records. The aim of this study was to determine readmission risk factors after a neurovascular incident to guide APRNs in the primary care setting. The study is a retrospective observational study that used a crude single predictor model to determine potential risks for readmission. A total of 876 neurovascular participants were studied. Of these, only 317 experienced at least one hospital readmission, with 703 readmissions within 1 year, indicating some were readmitted more than once. Risks for readmission varied across neurovascular events. The main reasons for readmission were because of neurological, cardiovascular, and musculoskeletal complications. Stroke readmission rates are high and require intervention by APRNs. To prevent readmission includes timely follow-up within 30 days and should also include longitudinal follow-up beyond 90 days to prevent hospital readmission. Future studies are needed to create guidelines for APRNs that implement rehabilitation strategies to decrease hospital readmission for the neurovascular population that focus on interdisciplinary communication.
对高级执业注册护士 (APRN) 来说,在神经血管事件发生后护理患者是很常见的事情。大多数神经科再入院研究都集中在一小部分神经血管事件群体,但初级医疗保健中的高级执业护士要照顾的神经血管事件群体多种多样,而且没有时间充分搜索医院记录。 本研究旨在确定神经血管事故后的再入院风险因素,为初级医疗机构的高级护理师提供指导。 该研究是一项回顾性观察研究,采用粗略的单一预测模型来确定再入院的潜在风险。 共有 876 名神经血管参与者接受了研究。其中,只有 317 人至少经历过一次再入院,703 人在一年内再入院,这表明有些人再入院不止一次。不同神经血管事件的再入院风险各不相同。再入院的主要原因是神经、心血管和肌肉骨骼并发症。 脑卒中再入院率很高,需要全科护士进行干预。预防再入院包括 30 天内的及时随访,还应该包括 90 天后的纵向随访,以防止再入院。 未来的研究需要为全科护士制定指导方针,实施康复策略以减少神经血管人群的再入院率,重点是跨学科沟通。
{"title":"Timing of stroke survivors' hospital readmissions to guide APRNs in primary care","authors":"Teresa Connolly, Kim Paxton, Bryan McNair","doi":"10.1097/jxx.0000000000000984","DOIUrl":"https://doi.org/10.1097/jxx.0000000000000984","url":null,"abstract":"\u0000 \u0000 Caring for patients after a neurovascular incident is common for advanced practice registered nurses (APRNs). Most neurological readmission studies focus on a small subset of neurovascular incident groups, but advanced practice nurses in primary care attend to a diverse neurovascular population and lack time to adequately search hospital records.\u0000 \u0000 \u0000 \u0000 The aim of this study was to determine readmission risk factors after a neurovascular incident to guide APRNs in the primary care setting.\u0000 \u0000 \u0000 \u0000 The study is a retrospective observational study that used a crude single predictor model to determine potential risks for readmission.\u0000 \u0000 \u0000 \u0000 A total of 876 neurovascular participants were studied. Of these, only 317 experienced at least one hospital readmission, with 703 readmissions within 1 year, indicating some were readmitted more than once. Risks for readmission varied across neurovascular events. The main reasons for readmission were because of neurological, cardiovascular, and musculoskeletal complications.\u0000 \u0000 \u0000 \u0000 Stroke readmission rates are high and require intervention by APRNs. To prevent readmission includes timely follow-up within 30 days and should also include longitudinal follow-up beyond 90 days to prevent hospital readmission.\u0000 \u0000 \u0000 \u0000 Future studies are needed to create guidelines for APRNs that implement rehabilitation strategies to decrease hospital readmission for the neurovascular population that focus on interdisciplinary communication.\u0000","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141015359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A mixed-methods pilot examination of Montana, North Dakota nurse practitioner telepresence behaviors through web-camera eye-tracking and qualitative descriptive interviews 通过网络摄像头眼动跟踪和定性描述性访谈,对北达科他州蒙大拿州执业护士的远程呈现行为进行混合方法试点研究
IF 1.2 4区 医学 Pub Date : 2024-05-01 DOI: 10.1097/jxx.0000000000001022
{"title":"A mixed-methods pilot examination of Montana, North Dakota nurse practitioner telepresence behaviors through web-camera eye-tracking and qualitative descriptive interviews","authors":"","doi":"10.1097/jxx.0000000000001022","DOIUrl":"https://doi.org/10.1097/jxx.0000000000001022","url":null,"abstract":"","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141024912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A Tribute to Dr. Loretta Ford. 向洛雷塔-福特博士致敬。
IF 1.2 4区 医学 Pub Date : 2024-05-01 DOI: 10.1097/JXX.0000000000001023
Kim Curry, Elayne DeSimone
{"title":"A Tribute to Dr. Loretta Ford.","authors":"Kim Curry, Elayne DeSimone","doi":"10.1097/JXX.0000000000001023","DOIUrl":"https://doi.org/10.1097/JXX.0000000000001023","url":null,"abstract":"","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of the American Association of Nurse Practitioners
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1