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 leadership.

Abstract: In the final half of 2024, the US FDA approved several new drugs that have relevance for those practicing in primary care. This article highlights the following new medications: donanemab-azbt (Kisunla), nalmefene injection (Zurnai), epinephrine nasal spray (neffy), palopegteriparatide (Yorvipath), xanomeline and trospium chloride (Cobenfy), and sulopenem etzadroxil/probenecid (Orlynvah). Additionally, this article highlights the recent approval of obstructive sleep apnea as a new indication for tirzepatide (Zepbound) and chronic obstructive pulmonary disease as a new indication for dupilumab (Dupixent).

Background: Patient satisfaction scores (PSSs) were first introduced to enhance patient experiences and health outcomes and offer a standardized platform to compare care across various facilities. These subjective assessments of patients' satisfaction with the healthcare they received have since been used to determine healthcare facility reimbursement. In recent years, healthcare administration has undergone a paradigm shift toward incentivizing higher PSSs for individual providers through compensation. This pilot study aims to evaluate this shift and investigate whether linking PSSs with provider compensation influences medical decision-making.

Methods: In this quantitative pilot study, a 14-item survey, consisting of 10 Likert scale and 4 demographic questions, was disseminated to medical providers working in an urgent care setting.

Results: All survey respondents affirmed that PSSs were utilized by their employer, and 85% agreed they were tied to compensation. Seventy percent of respondents changed their initial treatment plan, and 65% stated they changed how they interacted with patients based on feedback from their PSS; however, only 15% agreed that the use of PSSs has improved their medical care.

Conclusion: Results from this pilot study indicate that the use of PSSs may have a negative impact on healthcare providers' medical decision-making. This could drive up healthcare costs and negatively affect patient outcomes due to factors such as overprescribing and excessive diagnostic testing. Further research is also needed regarding the use of PSSs as a metric factor in provider compensation and development of more equitable patient care evaluation surveys to encourage appropriate evidence-based medical decision-making.

Abstract: This overview provides a brief review of the 2023 American Heart Association, American College of Cardiology, American College of Clinical Pharmacy, American Society for Preventive Cardiology, National Lipid Association, and Preventive Cardiovascular Nurses Association guideline for the management of patients with chronic coronary disease. Clinical recommendations with a focus on a team-based approach, lifestyle modification, risk stratification, diagnostic testing, and pharmacologic and nonpharmacologic management are discussed.

Abstract: More than 200 people die daily in the US from a drug overdose. Advanced practice registered nurses play an instrumental role in the opioid crisis by conducting a comprehensive assessment, understanding guidelines for use of prescription opioids, utilizing alternatives to opioids for pain, identifying possible signs of opioid misuse, managing patients with opioid use disorder, and seeking knowledge and training relevant to opioid use disorder.