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Nurse practitioner and physician assistant onboarding in a family medicine practice. 家庭医学实习的执业护士和医师助理。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2022-03-01 DOI: 10.1097/JXX.0000000000000611
Amanda Chaney, Angela Martin, Kathy Cardona, Richard J Presutti

Abstract: The nurse practitioner (NP) and physician assistant (PA) professions are rapidly growing. Historically, these professions have filled a health care delivery gap caused by lack of health care access and physician shortages. Many medical practices are more accustomed to adding new physicians as compared with adding new NPs or PAs. This article describes one institution's approach to develop and implement a successful NP/PA onboarding program. Several key components are discussed, including (1) established roles and responsibilities, (2) a clear timeline of the onboarding period including a foundational curriculum, (3) the mentor-mentee relationship, (4) the onboarding checklist, and (5) the onboarding itinerary. The objective was to have our NPs/PAs on a regular patient calendar within the 6-month period. The success rate with this has been 86%. In addition, there has been a 90% retention of NP/PA hires over the past 3 years. The authors believe this approach to NP/PA onboarding serves the patients well, providing excellent patient outcomes and patient experience.

摘要:执业护士(NP)和医师助理(PA)职业正在迅速发展。从历史上看,这些职业填补了由于缺乏卫生保健机会和医生短缺而造成的卫生保健服务缺口。与增加新的np或pa相比,许多医疗实践更习惯于增加新的医生。本文描述了一个机构开发和实施成功的NP/PA入职计划的方法。本文讨论了几个关键组成部分,包括:(1)确立的角色和职责;(2)明确的入职时间表,包括基础课程;(3)师徒关系;(4)入职清单;(5)入职行程。目的是在6个月内将我们的NPs/ pa纳入常规患者日程表。这种方法的成功率是86%。此外,在过去三年中,NP/PA的保留率达到90%。作者认为这种NP/PA入职方法可以很好地为患者服务,提供良好的患者结果和患者体验。
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引用次数: 5
The level of quality care nurse practitioners provide compared with their physician colleagues in the primary care setting: A systematic review. 在初级保健环境中,执业护士提供的质量护理水平与医生同事的比较:一项系统评价。
IF 1.2 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2022-03-01 DOI: 10.1097/JXX.0000000000000660
Michael Barnett, Christopher Balkissoon, Jodie Sandhu

Background: There is an increasing demand for high-quality primary care providers without adequate supply to meet the need. Nurse practitioners (NPs) are uniquely positioned to fill this demand but influence on regulatory practice authority from concerned groups regarding patient safety and quality of care has delayed this as an effective solution.

Objectives: The objective was to address concerns abovt NP-led care by examining evidence regarding patient safety, clinical outcomes, cost, and patient satisfaction that reflect on the ability of NPs to provide high-quality care within the primary care setting and to compare their ability with standard models of care led by physicians.

Data sources: A systematic review was completed using PubMed, CINHAL Complete, and Scopus. Using PRISMA guidelines to critique literature and the John's Hopkins Research Evidence Appraisal tool, articles were analyzed comparing the quality of care between NP and physician providers in the primary care setting.

Conclusions: A total of 11 articles met the criteria and reveal that NPs provide equal or better quality of care for all outcomes outcomes when compared with their physician colleagues.

Implications for practice: Quality patient care provided by NPs in the primary care setting is equal to, and in several cases superior to, that of physicians. Concerns for patient safety and quality care outcomes seem unsupported by data, and state legislatures should continue to grant full practice authority. as an effective source of providing high-quality primary health care.

背景:对高质量初级保健提供者的需求不断增加,但没有足够的供应来满足需求。护士从业人员(NPs)在满足这一需求方面处于独特的地位,但有关团体对患者安全和护理质量的监管实践权威的影响推迟了这一有效解决方案。目的:目的是通过检查有关患者安全、临床结果、成本和患者满意度的证据来解决np领导的护理问题,这些证据反映了np在初级保健环境中提供高质量护理的能力,并将其能力与医生领导的标准护理模式进行比较。数据来源:使用PubMed、CINHAL Complete和Scopus完成系统评价。使用PRISMA指南来评价文献和约翰霍普金斯大学研究证据评估工具,对文章进行分析,比较初级保健环境中NP和医生提供者之间的护理质量。结论:共有11篇文章符合标准,并表明与医生同事相比,NPs在所有结局方面提供了相同或更好的护理质量。对实践的启示:初级保健环境中NPs提供的高质量患者护理与医生相当,在某些情况下甚至优于医生。对患者安全和高质量护理结果的关注似乎没有数据支持,州立法机构应该继续授予充分的实践权力。作为提供高质量初级卫生保健的有效来源。
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引用次数: 0
The nurse practitioner's role in addressing chronic sequelae of Lyme disease as a climate change related disease. 在解决莱姆病作为气候变化相关疾病的慢性后遗症护士执业的作用。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2022-03-01 DOI: 10.1097/JXX.0000000000000670
Patrice Nicholas, Linda A Evans, Marisa Albert, Debra Kelly, Naomi Michelson

Abstract: A major health consequence of climate change is an increased prevalence of vector-borne diseases due to changes in temperatures and the environments in which vectors can survive and carry out transmissible activity. Because of climate change, emerging health challenges related to the warming of the planet have led to an increase in vector-borne diseases in broadening geographic areas. Individuals affected with Lyme disease may present with a variety of symptoms, which highlights the importance of illness recognition to ensure that a patient can receive timely treatment and effective support. Despite the focus on early detection and treatment of acute Lyme disease, chronic health problems associated with Lyme disease are an emerging problem in the 21st century. This article focuses on the role of nurse practitioners and members of the health professional team in the recognition, clinical care, patient education, and management of increasing rates of chronic Lyme disease.

气候变化的一个主要健康后果是,由于温度和媒介生存和传播活动的环境变化,媒介传播疾病的流行率增加。由于气候变化,与地球变暖有关的新出现的卫生挑战导致病媒传播疾病在更广泛的地理区域增加。患有莱姆病的个体可能会出现各种症状,这突出了疾病识别的重要性,以确保患者能够得到及时治疗和有效支持。尽管关注急性莱姆病的早期发现和治疗,但与莱姆病相关的慢性健康问题是21世纪的一个新问题。这篇文章的重点是护士从业人员和卫生专业团队的成员在慢性莱姆病的认识,临床护理,患者教育和管理的增长率。
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引用次数: 2
Trauma-informed care in the primary care setting: An evolutionary analysis. 创伤知情护理在初级保健设置:进化分析。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2022-03-01 DOI: 10.1097/JXX.0000000000000663
Latha Varghese, Amanda Emerson

Background: The high prevalence of trauma in the United States and its adverse effects on patient wellbeing has led to the adoption of trauma-informed care (TIC) in some specialized health care services. However, the implementation of TIC in primary care, where many nurse practitioners (NPs) provide services, is relatively uncommon and the concept not well-defined. Trauma includes physically and emotionally devastating experiences that have a lasting impact on individuals.

Objectives: To synthesize a definition of TIC in the primary care setting for NPs to guide future practice and research.

Data sources: We searched CINAHL, PsycINFO, Social Work Abstracts, Scopus, and PubMed for articles published 2010-2020 that described the use of TIC in primary care. Rodgers' evolutionary method and the framework method of analysis were used to identify attributes and contexts of TIC in primary care and synthesize a definition. Thirty-one articles from nursing, medical, and social work sources were selected, including data-based studies ( n = 15) and thought pieces ( n = 16). Attributes, antecedents, and consequences were combined to provide a definition grounded in the literature.

Conclusion: Trauma-informed care in primary care is a strengths-based approach in which trained, trauma-aware health care professionals provide services that prioritize safety, empowerment, and support, resulting in improved patient satisfaction and health care engagement in individuals who have experienced trauma.

Implications for practice: A clearly defined concept provides a starting point for developing strategies to help NPs recognize and respond more effectively to the needs of patients who have experienced trauma.

背景:在美国,创伤的高患病率及其对患者健康的不利影响导致在一些专门的卫生保健服务中采用创伤知情护理(TIC)。然而,在许多执业护士(NPs)提供服务的初级保健中,TIC的实施相对不常见,概念也没有明确定义。创伤包括对个人产生持久影响的身体和情感上的破坏性经历。目的:在初级保健环境中对神经性脑出血进行综合定义,以指导未来的实践和研究。数据来源:我们检索了CINAHL、PsycINFO、Social Work Abstracts、Scopus和PubMed,检索了2010-2020年发表的描述TIC在初级保健中使用的文章。采用Rodgers的进化方法和框架分析方法来识别初级保健中TIC的属性和背景,并综合定义。从护理、医学和社会工作来源中选择了31篇文章,包括基于数据的研究(n = 15)和思想文章(n = 16)。属性、前因和结果结合在一起,提供了一个基于文献的定义。结论:初级保健中的创伤知情护理是一种基于优势的方法,在这种方法中,训练有素的创伤意识卫生保健专业人员提供优先考虑安全性、授权和支持的服务,从而提高患者满意度和经历过创伤的个体的卫生保健参与度。实践意义:明确定义的概念为制定策略提供了一个起点,以帮助NPs更有效地识别和响应经历过创伤的患者的需求。
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引用次数: 0
Commentary on "Development of postgraduate training in critical care medicine for nurse practitioners and physician assistants" JAANP, 33(12):1116-1119, December 2021. 《危重病医学研究生培训对护士执业和医师助理的发展》评论,中华医学杂志,33(12):1116-1119,2021年12月
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2022-03-01 DOI: 10.1097/JXX.0000000000000694
Carolina D Tennyson, Vikas Pathak, Christine Y Zhou
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引用次数: 0
COVID-19 vaccination in adults living with HIV. 成人艾滋病毒感染者的COVID-19疫苗接种
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2022-03-01 DOI: 10.1097/JXX.0000000000000674
Christopher W Blackwell, Humberto López Castillo

Abstract: The Centers for Disease Control and Prevention has recommended use of vaccines manufactured by Pfizer-BioNTech, Moderna, and Johnson & Johnson/Janssen to prevent COVID-19 infection in the United States. Although these vaccines are safe and have been administered to millions of persons nationwide, special populations warrant closer focus. Adults living with HIV may have specific clinical considerations that should be acknowledged when making COVID-19 vaccination prescribing decisions. This article discusses these practice considerations and provides clinical and additional guidance for nurse practitioners and other clinicians responsible for prescribing COVID-19 vaccines in adults living with HIV.

美国疾病控制与预防中心建议在美国使用辉瑞biotech、Moderna和强生/杨森生产的疫苗来预防COVID-19感染。虽然这些疫苗是安全的,并已在全国范围内为数百万人接种,但特殊人群需要更加关注。成年艾滋病毒感染者可能有特定的临床考虑因素,在作出COVID-19疫苗接种处方决定时应承认这一点。本文讨论了这些实践注意事项,并为护士从业人员和负责为艾滋病毒感染成人开COVID-19疫苗的其他临床医生提供了临床和额外指导。
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引用次数: 1
Development and implementation of virtual clinical skills experiences for psychiatric nurse practitioner students. 精神科护士实习学生虚拟临床技能体验的开发与实施。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2022-03-01 DOI: 10.1097/JXX.0000000000000669
Anjanetta Davis, Lori Moore, Joe Farmer, Shannon Lewis

Abstract: The educational preparation of nurse practitioner (NP) students includes didactic content and clinical experiences. These clinical experiences can be via clinical rotations or simulation. Although there is no specific list of clinical skills to prepare NP students for professional practice, the National Organization for Nurse Practitioner Faculties identifies core competencies for the basic education of NP students. These core competencies can be fulfilled through simulated clinical experiences. However, due to the COVID-19 pandemic, many institutions had to develop alternate methods of facilitating simulated clinical experiences for their NP students. Because of national, state, and university guidelines to transition all face-to-face educational activities to a virtual format, a Southeastern university simulation program developed and implemented virtual clinical skills experiences for psychiatric mental health NP students. Based on student survey results, the utilization of standardized patients in this virtual clinical skills experience proved beneficial and improved NP students' interviewing and communication skills via a telehealth format.

摘要:执业护士(NP)学生的教育准备包括教学内容和临床经验。这些临床经验可以通过临床轮转或模拟。虽然没有具体的临床技能清单来为NP学生的专业实践做准备,但国家护士执业院系组织确定了NP学生基础教育的核心能力。这些核心能力可以通过模拟临床经验来实现。然而,由于COVID-19大流行,许多机构不得不开发替代方法,为他们的NP学生提供模拟临床体验。由于国家、州和大学的指导方针将所有面对面的教育活动转变为虚拟形式,东南大学的一个模拟项目开发并实施了精神病学心理健康NP学生的虚拟临床技能体验。根据学生调查结果,在这种虚拟临床技能体验中使用标准化患者被证明是有益的,并通过远程医疗格式提高了NP学生的访谈和沟通技巧。
{"title":"Development and implementation of virtual clinical skills experiences for psychiatric nurse practitioner students.","authors":"Anjanetta Davis, Lori Moore, Joe Farmer, Shannon Lewis","doi":"10.1097/JXX.0000000000000669","DOIUrl":"10.1097/JXX.0000000000000669","url":null,"abstract":"<p><strong>Abstract: </strong>The educational preparation of nurse practitioner (NP) students includes didactic content and clinical experiences. These clinical experiences can be via clinical rotations or simulation. Although there is no specific list of clinical skills to prepare NP students for professional practice, the National Organization for Nurse Practitioner Faculties identifies core competencies for the basic education of NP students. These core competencies can be fulfilled through simulated clinical experiences. However, due to the COVID-19 pandemic, many institutions had to develop alternate methods of facilitating simulated clinical experiences for their NP students. Because of national, state, and university guidelines to transition all face-to-face educational activities to a virtual format, a Southeastern university simulation program developed and implemented virtual clinical skills experiences for psychiatric mental health NP students. Based on student survey results, the utilization of standardized patients in this virtual clinical skills experience proved beneficial and improved NP students' interviewing and communication skills via a telehealth format.</p>","PeriodicalId":48812,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"537-541"},"PeriodicalIF":1.2,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39541138","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: 2
Dermatologic simulations in nurse practitioner education: Improving skin cancer knowledge, confidence, and performance. 皮肤科模拟护士执业教育:提高皮肤癌知识,信心和表现。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2022-03-01 DOI: 10.1097/JXX.0000000000000637
Katherine D Shue-McGuffin, Kelly Powers

Background: The rising incidence of skin cancer continues to be a significant public health concern in the United States. Nurse practitioners (NPs) have a key role in early detection of skin cancer. However, NP students currently demonstrate low levels of knowledge related to skin cancer assessments and recognition of skin lesions.

Purpose: The aim of this pilot study was to determine if simulations with standardized patients wearing three-dimensional (3D) prosthetic skin lesions improved NP students' knowledge, self-confidence, and observed simulation performance with regard to assessing, diagnosing, and managing patients with nonmalignant versus malignant skin lesions.

Methodology: A quasi-experimental approach was used with a convenience sample of 39 NP students. Students participated in three consecutive simulations, each followed by a debriefing. Performance was assessed during the simulations using a rubric. Knowledge and self-confidence were measured immediately before and after the simulation.

Results: Correct responses on knowledge items increased for 14 of the 18 items. Self-confidence significantly improved from pretest to posttest. There was a statistically significant improvement in performance from the first to third simulation encounter.

Conclusion: Simulation with standardized patients wearing 3D lesions can enhance NP students' knowledge, self-confidence, and performance of skin cancer assessments.

Implications: Nurse practitioner programs can consider using simulation to prepare students for dermatologic care and to help improve the probability of early detection of skin cancer in various health care settings.

背景:在美国,皮肤癌发病率的上升一直是一个重要的公共卫生问题。执业护士(NPs)在皮肤癌的早期发现中起着关键作用。然而,NP学生目前在皮肤癌评估和皮肤病变识别方面的知识水平较低。目的:本初步研究的目的是确定标准化患者佩戴三维(3D)假体皮肤病变的模拟是否提高了NP学生在评估、诊断和管理非恶性与恶性皮肤病变患者方面的知识、自信和观察模拟表现。研究方法:采用准实验方法,选取39名NP学生作为方便样本。学生们参加了三个连续的模拟,每个模拟之后都有一个汇报。在模拟过程中,使用一个标题来评估性能。在模拟之前和之后立即测量知识和自信。结果:18项知识题中有14项答对正确。从测试前到测试后,自信心显著提高。从统计数据来看,从第一次模拟到第三次模拟,性能有显著提高。结论:标准化患者戴三维病灶模拟能增强NP学生皮肤癌评估的知识、自信和表现。启示:执业护士课程可以考虑使用模拟来帮助学生做好皮肤护理的准备,并帮助提高在各种医疗机构中早期发现皮肤癌的可能性。
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引用次数: 5
Men and suicide: Primary care prevention in the era of COVID-19 and beyond. 男性与自杀:COVID-19时代及以后的初级保健预防。
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2022-03-01 DOI: 10.1097/JXX.0000000000000614
Rachel H Adler

Abstract: The COVID-19 pandemic has had detrimental effects on mental health, including a predicted increase in suicidality, making suicide prevention a high priority. The rate of men's suicide in the United States is significantly higher than that of women's suicide. This case study considers the role of primary care advanced practice nurses in addressing the risks of suicide in their practice with male patients. It is argued that a gender-sensitive approach is necessary to be effective in male suicide prevention efforts.

摘要:2019冠状病毒病(COVID-19)大流行对心理健康产生了不利影响,包括自杀率预计会上升,因此预防自杀成为重中之重。美国男性自杀率明显高于女性自杀率。本案例研究考虑了初级保健高级实践护士在解决男性患者自杀风险方面的作用。本文认为,性别敏感的方法是必要的,以有效预防男性自杀的努力。
{"title":"Men and suicide: Primary care prevention in the era of COVID-19 and beyond.","authors":"Rachel H Adler","doi":"10.1097/JXX.0000000000000614","DOIUrl":"10.1097/JXX.0000000000000614","url":null,"abstract":"<p><strong>Abstract: </strong>The COVID-19 pandemic has had detrimental effects on mental health, including a predicted increase in suicidality, making suicide prevention a high priority. The rate of men's suicide in the United States is significantly higher than that of women's suicide. This case study considers the role of primary care advanced practice nurses in addressing the risks of suicide in their practice with male patients. It is argued that a gender-sensitive approach is necessary to be effective in male suicide prevention efforts.</p>","PeriodicalId":48812,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"572-578"},"PeriodicalIF":1.2,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39082931","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
Recognition of diversity, equity, and inclusion in scientific writing: Not just sticks and stones. 承认科学写作中的多样性、公平性和包容性:不仅仅是棍子和石头
IF 1.2 4区 医学 Q2 Nursing Pub Date : 2022-03-01 DOI: 10.1097/JXX.0000000000000698
Susan D Ruppert, Mary Ellen E Roberts
{"title":"Recognition of diversity, equity, and inclusion in scientific writing: Not just sticks and stones.","authors":"Susan D Ruppert, Mary Ellen E Roberts","doi":"10.1097/JXX.0000000000000698","DOIUrl":"10.1097/JXX.0000000000000698","url":null,"abstract":"","PeriodicalId":48812,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":"1 1","pages":"441-442"},"PeriodicalIF":1.2,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42496285","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: 1
期刊
Journal of the American Association of Nurse Practitioners
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