Pub Date : 2024-09-11DOI: 10.1097/01.jaa.0000000000000125
Sarah Nargiso,Mary Lo,Leyda Ramos,Amarilis Bolaños,Evelyn Lee,Linda Sher
OBJECTIVESThis study assessed the use and perceptions of physician associates/assistants (PAs) and NPs at liver transplant centers and sought to determine their financial effect.METHODSLeaders of liver transplant programs performing 25 or more transplants in 2020 were contacted to complete an 11-question survey about the role and effect of PAs and NPs in liver transplant. A single-center retrospective analysis compared length of stay (LOS) and readmission rates for primary liver transplants and simultaneous liver-kidney transplants before and after a dedicated PA team was established. Chi-square and t-test analyses were performed.RESULTSThe survey achieved a 77% response rate, and 98% of institutions reported using PAs and NPs. The single-center study found the mean LOS post-transplant was significantly shorter in the post-PA cohort (P = .0005). No significant difference was found in 30-day readmission rates.CONCLUSIONSPAs and NPs are used broadly across the post-liver transplant care continuum. Using LOS as a surrogate financial marker suggests that a dedicated PA and NP team may contribute to cost savings.
目的：本研究评估了肝移植中心对医生助理/助手（PA）和护士（NP）的使用情况和看法，并试图确定他们的财务影响。方法：我们联系了2020年进行25例或更多移植手术的肝移植项目的负责人，让他们完成一项包含11个问题的调查，内容涉及PA和NP在肝移植中的作用和影响。一项单中心回顾性分析比较了在建立专门的PA团队之前和之后，初次肝移植和同时进行的肝肾移植的住院时间（LOS）和再入院率。结果调查的回复率为77%，98%的机构报告使用了PA和NP。这项单中心研究发现，PA 后队列的移植后平均住院日明显缩短（P = 0.0005）。结论肝移植术后护理过程中广泛使用PA和NP。将 LOS 作为替代财务指标表明，专门的 PA 和 NP 团队可能有助于节约成本。
{"title":"PAs and NPs in liver transplantation: Perceptions, implementation, and effect.","authors":"Sarah Nargiso,Mary Lo,Leyda Ramos,Amarilis Bolaños,Evelyn Lee,Linda Sher","doi":"10.1097/01.jaa.0000000000000125","DOIUrl":"https://doi.org/10.1097/01.jaa.0000000000000125","url":null,"abstract":"OBJECTIVESThis study assessed the use and perceptions of physician associates/assistants (PAs) and NPs at liver transplant centers and sought to determine their financial effect.METHODSLeaders of liver transplant programs performing 25 or more transplants in 2020 were contacted to complete an 11-question survey about the role and effect of PAs and NPs in liver transplant. A single-center retrospective analysis compared length of stay (LOS) and readmission rates for primary liver transplants and simultaneous liver-kidney transplants before and after a dedicated PA team was established. Chi-square and t-test analyses were performed.RESULTSThe survey achieved a 77% response rate, and 98% of institutions reported using PAs and NPs. The single-center study found the mean LOS post-transplant was significantly shorter in the post-PA cohort (P = .0005). No significant difference was found in 30-day readmission rates.CONCLUSIONSPAs and NPs are used broadly across the post-liver transplant care continuum. Using LOS as a surrogate financial marker suggests that a dedicated PA and NP team may contribute to cost savings.","PeriodicalId":519966,"journal":{"name":"Journal of the American Academy of Physician Assistants","volume":"117 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-11DOI: 10.1097/01.jaa.0000000000000088
Becky Ness,Amy Mosman
Chronic kidney disease (CKD) is an increasingly common condition worldwide that leads to substantial mortality. Research in the past decade has informed significant advances in preventing CKD or delaying its progression, mainly through new medications. This progress, however, requires adequate screening and identification of early CKD to truly transform patient outcomes. Revised guidelines from the Kidney Disease: Improving Global Outcomes consortium of experts aim to help clinicians incorporate these advances into practice. This article summarizes key updates from the guidelines regarding the evaluation and management of CKD that can lead to better patient outcomes.
{"title":"Updated guidelines for chronic kidney disease.","authors":"Becky Ness,Amy Mosman","doi":"10.1097/01.jaa.0000000000000088","DOIUrl":"https://doi.org/10.1097/01.jaa.0000000000000088","url":null,"abstract":"Chronic kidney disease (CKD) is an increasingly common condition worldwide that leads to substantial mortality. Research in the past decade has informed significant advances in preventing CKD or delaying its progression, mainly through new medications. This progress, however, requires adequate screening and identification of early CKD to truly transform patient outcomes. Revised guidelines from the Kidney Disease: Improving Global Outcomes consortium of experts aim to help clinicians incorporate these advances into practice. This article summarizes key updates from the guidelines regarding the evaluation and management of CKD that can lead to better patient outcomes.","PeriodicalId":519966,"journal":{"name":"Journal of the American Academy of Physician Assistants","volume":"41 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-11DOI: 10.1097/01.jaa.0000000000000120
Andrew P Chastain,Anne L Geary,Kevin M Bogenschutz
More than 80% of newborn infants experience jaundice as a result of elevated bilirubin during the first few weeks after birth. In most cases, hyperbilirubinemia is physiologic, but persistent and extreme elevations can lead to serious long-term complications, such as kernicterus. To avoid these complications and help clinicians in the successful assessment, evaluation, and treatment of hyperbilirubinemia, the American Academy of Pediatrics updated its clinical practice guideline for neonatal hyperbilirubinemia. This article reviews the guideline and highlights significant updates, such as an elevation in the threshold for phototherapy and exchange transfusion, inclusion of gestational age, and removal of racially based norms.
{"title":"Managing neonatal hyperbilirubinemia: An updated guideline.","authors":"Andrew P Chastain,Anne L Geary,Kevin M Bogenschutz","doi":"10.1097/01.jaa.0000000000000120","DOIUrl":"https://doi.org/10.1097/01.jaa.0000000000000120","url":null,"abstract":"More than 80% of newborn infants experience jaundice as a result of elevated bilirubin during the first few weeks after birth. In most cases, hyperbilirubinemia is physiologic, but persistent and extreme elevations can lead to serious long-term complications, such as kernicterus. To avoid these complications and help clinicians in the successful assessment, evaluation, and treatment of hyperbilirubinemia, the American Academy of Pediatrics updated its clinical practice guideline for neonatal hyperbilirubinemia. This article reviews the guideline and highlights significant updates, such as an elevation in the threshold for phototherapy and exchange transfusion, inclusion of gestational age, and removal of racially based norms.","PeriodicalId":519966,"journal":{"name":"Journal of the American Academy of Physician Assistants","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-21DOI: 10.1097/01.jaa.0000996660.52088.51
{"title":"CME POST-TEST","authors":"","doi":"10.1097/01.jaa.0000996660.52088.51","DOIUrl":"https://doi.org/10.1097/01.jaa.0000996660.52088.51","url":null,"abstract":"","PeriodicalId":519966,"journal":{"name":"Journal of the American Academy of Physician Assistants","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141530145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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