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BACKGROUND: The trauma service experienced preventable delays caused by an Accreditation Council for Graduate Medical Education work restrictions and a 16% increase in patient census. Furthermore, nurses needed a consistently accessible provider for the coordination of care. We hypothesized that using experienced acute care nurse practitioners (ACNPs) on the stepdown unit would improve throughput and decrease length of stay (LOS) and hospital charges. Moreover, we hypothesized that adding ACNPs would improve staff satisfaction. On December 1, 2011, the Vanderbilt University Medical Center Division of Trauma reassigned ACNPs to the stepdown area 5 days a week for a pilot program. METHODS: LOS data from December 1, 2011 through December 1, 2012 was compared with data from the same months from the previous two years and estimated hospital charges and patient days were extrapolated. Physician and nursing surveys were performed. Data from 2010 (n = 2,559) and 2011 (n= 2,671) were averaged and the mean LOS for the entire trauma service was 7.2 days. After adding an experienced ACNP, the average LOS decreased to 6.4 days, a 0.8 day reduction. Per patient, there was a $ 9,111.50 savings in hospital charges, for a reduction of $27.8 million dollars in hospital charges over the 12 month pilot program. RESULTS: A confidential survey administered to attending physicians showed that 100% agreed that a nurse practitioner in the stepdown area was beneficial and helped throughput. Dayshift nurses were surveyed, and 100% agreed or strongly agreed that the ACNPs were knowledgeable about the patient's plan of care, experienced in the care of trauma patients, and improved patient care overall. CONCLUSION: The addition of experienced ACNPs resulted in the decrease of overall trauma service LOS, saving almost $9 million in hospital charges

This article discusses how overall outcomes are better for patients when ACNP are members of a unit or service-based provider team. It also touches on how to hire ACNP for different patient populations.

This link shows all the certifying bodies available and has links to those websites The American Association of Nurse Practitioners (AANP) is the largest and only full-service national professional membership organization for nurse practitioners (NPs) of all specialties.

This is a nice synopsis of key moments in history that have triggered the growth and development of the NP role in the US.

The American Association of Nurse Practitioners (AANP) is the largest and only full-service national professional membership organization for nurse practitioners (NPs) of all specialties.

This article discusses APRNs working in Title X Family Planning Clinics, what lead them to practice in these clinics, and why they remain practicing in these clinics as new opportunities for APRNs arise. APRNs are described by the authors as 'critical safety nets', as they play a major role in reproductive health services and provide care to vulnerable populations and rural communities. The findings of this study, which collected data through an online survey, can and will be used during policy change decisions to improve APRN satisfaction and retention.

This article is about the scope of practice of midwives and childbirth outcomes. It discusses the relationship between autonomous practice and better birth outcomes. The article suggests there should be future policies to expand the access to midwifery services.

Approximately 70 to 80% of healthcare errors are due to poor team communication and understanding. High-risk environments such as the trauma setting (which covers a broad spectrum of departments in acute services) are where the majority of these errors occur. Despite the emphasis on interprofessional collaborative practice and patient safety, interprofessional teamworking in the trauma setting has received little attention.

In case anyone else is thinking about potentially practicing in Washington, DC.

Interdisciplinary Teamwork article

Interdisciplinary team work is a complex process in which different types of staff work together to share expertise, knowledge, and skills to impact on patient care. Despite increasing emphasis on interdisciplinary team work over the past decade, in particular the growth of interdisciplinary education [ 1], there is little evidence as to the most effective way of delivering interdisciplinary team work [ 2].

Interdisciplinary team work is a complex process in which different types of staff work together to share expertise, knowledge, and skills to impact on patient care. Despite increasing emphasis on interdisciplinary team work over the past decade, in particular the growth of interdisciplinary education [ 1], there is little evidence as to the most effective way of delivering interdisciplinary team work [ 2].

This article reviewed several different studies on interdisciplinary care and looked for ways that we can improve on health care and implement better teamwork. What I found most interesting is that the article talks about how educating staff on the benefits of teamwork is seriously lacking. Two issues are emerging in health care as clinicians face the complexities of current patient care: the need for specialized health professionals, and the need for these professionals to collaborate. Interdisciplinary health care teams with members from many professions answer the call by working together, collaborating and communicating closely to optimize patient care.

This article finds two emerging issues that must be addressed to optimize patient care: "the need for specialized health professionals, and the need for these professionals to collaborate." In nursing we talk a lot about "continuity of care" and that a seamless transition between PCPs, specialists, in-patient, and out-patient services is not only good-practice but vital for thorough health care delivery and improving long term outcomes.

Systematic review of literature on the impact of Nurse Practitioners in Emergency Departments. Limited evidence of high quality. Most high quality evidence conducted in English speaking countries outside the U.S. Evidence suggests NPs in EDs associated with quality care, improved patient satisfaction, reduced wait times. Insufficient evidence related to cost-effectiveness. #BecomingAPRN16

This 2015 article, written in the Journal of Pediatric Health Care, discusses the critical importance of intervening and advocating for APRNs to have full practice authority as opposed to the current varying state-by-state practice laws. The author explains the primary reasons for states retaining restrictions on APRN practice are outdated and include lack of awareness of the current scope of practice of APRNs and organized medicine's persistent opposition to expanding the authority of other providers to practice and receive the full amount for their rendered services. The author supports her argument by including the IOM Committee's view; removing APRN practice restrictions would assist in addressing health care access, high-quality care, and an overall healthier population.