NURSE PRACTITIONER最新文献

In celebration of its 50th year in publication, The Nurse Practitioner has asked 50 influential NPs for their thoughts on topics of import to the profession and its future, to be published in select months throughout the year. This month, five NPs share their wisdom on the future of NP practice and/or education.

Background: Proton pump inhibitors (PPIs) are frequently prescribed in the hospital setting, often without clear indications, leading to unnecessary medication use and associated risks. This single-center, retrospective cohort study evaluated the impact of a nurse practitioner (NP)-led educational intervention on PPI prescribing in adult, non-critically ill hospitalized patients.

Methods: Patients admitted to medical-surgical or step-down floors during the pre- and postintervention periods with active PPI orders were analyzed. The intervention included 15-minute educational sessions for providers and distribution of infographics emphasizing appropriate PPI use.

Results: The study included 549 patients, with 412 in the preintervention group and 137 in the postintervention group. Overall, PPI orders decreased by 66% (P < .001) and the percentage of appropriate PPI orders increased significantly in the postintervention group (57% vs 77%, P < .001). Surveys of 28 providers revealed that 96% felt the education increased their knowledge, and 100% anticipated it would influence their prescribing practices, though only 40% were aware of the educational infographics.

Conclusion: This study demonstrated that NP-led targeted education was significantly associated with reduced unnecessary PPI prescribing and increased adherence to appropriate indications. The findings highlight the effectiveness of provider education in optimizing prescribing behaviors. Future research should evaluate the sustainability of these results and explore additional strategies, such as indication-based prescribing, to further enhance medication safety and reduce inappropriate prescribing practices.

Abstract: Pharmacologic treatment of heart failure with reduced ejection fraction (HFrEF) has been a focus of research for decades. HFrEF guidelines recommend use of medications from four different classes (beta blockers, renin-angiotensin-aldosterone system [RAAS] inhibitors, mineralocorticoid receptor antagonists [MRAs], and sodium-glucose cotransporter-2 [SGLT2] inhibitors) to modulate the neurohormonal complexities of cardiomyopathies that result in a reduction in left ventricular function. Clinicians have become comfortable managing the triad of beta blockers, RAAS inhibitors, and MRAs. Adding the fourth class, SGLT2 inhibitors, poses more challenges, especially with regard to volume management. This article will explore clinical considerations of the integration of SGLT2 inhibitors into complex regimens in the outpatient setting.

Abstract: Chronic abnormal uterine bleeding holds considerable clinical significance. Up to 50% of reproductive-aged women experience abnormal bleeding. The differential diagnosis list is lengthy, presenting a potential challenge to practitioners in making a definitive diagnosis. Complicating the diagnostic process further, a patient may exhibit overlapping symptoms associated with multiple pathologies. The two International Federation of Gynecology and Obstetrics (FIGO) systems provide the practitioner with an organized framework of the causes of abnormal uterine bleeding and a pathway to diagnosis.

In celebration of its 50th year in publication, The Nurse Practitioner has asked 50 influential NPs for their thoughts on topics of import to the profession and its future, to be published in select months throughout the year. This month, five NPs share their wisdom on diversity, equity, and inclusion.