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jazzymcc

NURSE PRACTITIONER GRADUATES' TRANSITION TO HOSPITAL-BASED PRACTICE - 2 views

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    The purpose of this hermeneutic phenomenology (van Manen, 1990) was to gain insight into the meaning and lived experience of nurse practitioners (NP) with at least one year of work experience regarding their initial transition from new graduate to hospital-based practitioner. This study provided information regarding NP hospital-based transition experience that had not been revealed in the nursing literature. The meaning of transitioning into hospital-based practice was discovered through analysis of nurse practitioner letters and interviews in this phenomenological study. Six themes emerged from this research including: Going from expert RN to novice NP; system integration; "Don't Give Up"; Learning "On the Fly"; They Don't Understand my NP Role; and Succeeding Through Collaboration.   Master's prepared, board-certified NPs in North Carolina (NC) with between one and three years of NP practice experience in a hospital setting comprised the population of interest for this study. Twelve participants were purposefully sampled from nine hospitals in NC. Individual, voice-recorded, in-depth, open-ended telephone interviews were conducted with each participant.   The majority of the participants indicated a timeframe that ranged from six to 18 months regarding how long it took them to feel more comfortable in their NP role, the lack of comfort was most intense during the first nine months of practice. Participants confronted multiple obstacles and challenges as new NPs. These challenges included navigating and negotiating a new health care provider role; becoming integrated into a hospital system in what was a new role for them and sometimes for the system; learning how to function effectively as a NP while simultaneously working to re-establish themselves as proficient clinicians with a newly expanded practice scope; building key relationships; and educating physicians, hospital leaders, clinical staff, patients, and families about the NP
kzoda26

Outcomes of adding acute care nurse practitioners to a Level I trauma service with the ... - 2 views

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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
marevalo

Full Practice Authority for Advanced Practice Registered Nurses is a Gender Issue - 0 views

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    In this article, author Lugo discusses the findings of her study relating limits on full practice authority for APRNs to issues of gender equality. She investigated the link between state support of the Equal Rights Amendment (ERA) and laws in these states allowing APRNs full scope of practice and prescribing rights. Her study showed that states that have historically and currently supported the ERA in fact allow greater APRN scope of practice, and thus she draws conclusions about attitudes towards women's equality and the regulation of advanced practice nursing, which remains to be a woman-dominated profession.
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    In this May 2016 article published in the Online Journal of Issues in Nursing, Dr. Nancy Rudner Lugo argues that advanced practicing nursing viewed through a gendered perspective due to nursing's history as a predominantly female profession; because of this, APRNS in states that are less accepting of women's equality have a more narrow scope of practice. There is not currently a national-level evidence based method used to determine APRN scope, and is instead decided at the state level. The author seeks to explain the cause of the discrepancy between differing APRN scopes of practice in different states by comparing the APRN scope of practice between states that did and did not vote to pass the Equal Right Amendment, positing that states with cultural attitudes that are more equitable between genders reflect this at the legislative level, thus explaining the wider or full practice authority given to APRNs in these states. In conclusion, Lugo advocates for increasing the number of women in legislative positions, forming relationships between women's equality organizations and groups working towards expanded health care access, and emphasizing the skills and competency of APRNs in achieving positive patient health outcomes.
geoffhall08

Ten principles of good interdisciplinary team work - 8 views

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    Interdisciplinary Teamwork article
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    Interdisciplinary team work is increasingly prevalent, supported by policies and practices that bring care closer to the patient and challenge traditional professional boundaries. To date, there has been a great deal of emphasis on the processes of team ...
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    Interdisciplinary team work is increasingly prevalent, supported by policies and practices that bring care closer to the patient and challenge traditional professional boundaries. To date, there has been a great deal of emphasis on the processes of team ...
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    This study outlines what they found to be the top ten principles of effective interdisciplinary teamwork. They researched different approaches members of the interdisciplinary team in various healthcare settings took and why/how they found those approaches to be effective.
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    This article explains the ten characteristics that make interdisciplinary teamwork effective and high functioning
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    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].
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    Interdisciplinary team work is increasingly prevalent, supported by policies and practices that bring care closer to the patient and challenge traditional professional boundaries. To date, there has been a great deal of emphasis on the processes of team ...
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    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].
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    This article discusses the complexity of Interdisciplinary team work with different types of staff working together to share expertise, knowledge, and skills to impact on patient care. . Despite emphasis on interdisciplinary team work over the past decade and the growth of interdisciplinary education, there is little evidence as to the most effective way of delivering interdisciplinary team work. This difficulty is compounded by the multifactorial nature of team work, which comprises the skill mix, setting of care, service organization, individual relationships and management structures. The research provided a theoretical understanding of interdisciplinary team work and developed a framework to define the characteristics.
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    This article highlighted that there is still a lot of work to do to get healthcare members to but in to the concept of teamwork and that the patient and the family should be the main focus. All personal differences need to be set aside and that team members need to understand how each roles plays an integral part into the patients and families' need for good outcomes.
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    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].
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    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].
Erica Eisen

Reading from final week thoughts - 5 views

As I finish the reading for the final week, ch 27 is the most interesting. It really brings in the topics of politics that we visited last week in our class session. As future APRNs, we must be fam...

scope

started by Erica Eisen on 05 Nov 14 no follow-up yet
kwaltos

Economic benefits of less restrictive regulation of advanced practice nurses in North C... - 2 views

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    The researchers in this article focused on analyzing what kind of economic impact that giving APRNs full scope of practice in North Carolina would have. They calculated the impact by first projecting the increase in APRN graduates choosing to work in the state after full scope would be awarded. Projections of the increase in demand for providers due to both the ACA and an aging population were also taken into consideration. The findings in this analysis were that giving APRNs full scope of practice in the state would benefit the economy with increased output, employment, and tax revenue all while decreasing provider shortages. The state could save upwards of $495 million in gross product annually.
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    Hopefully, results such as these will give other states with more restrictive policies incentive to change their practice guidelines.
erdixon

http://onlinelibrary.wiley.com.proxy.library.emory.edu/doi/10.1002/2327-6924.12203/epdf - 7 views

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    In 2006, APRNS gained legal authority to write prescriptions in Georgia. It has been shown that nearly 40% of APRNS are still not writing prescriptions. Georgia is one of the most restrictive states in terms of APRN scope of practice. Policy changes are recommended to enhance the practice environment of APRNs to support the delivery of quality care
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    This article discusses APRN's in Georgia and their prescriptive authority. Georgia is one of the most restrictive states regarding APRN scope of practice. After a lengthy battle, APRN's were granted prescriptive rights in 2006; although, many are still not practicing to their full scope.
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    This article discusses the evolution of APRN practice in the state of Georgia, the barriers to practice, and the implications. As many of us know, the south, and Georgia specifically, is one of the most restrictive states in regards to practice.
Hannah Addis

NAPNAP - About Us - History of PNPs and NAPNAP - 2 views

  • Established in 1973, NAPNAP has been actively advocating for  children's health by: providing funding, education, and research opportunities to PNPs; and producing and distributing educational materials to parents and families.
  • There are approximately 14,000 practicing PNPs in the U.S.
  • n 1965, a nurse and a pediatrician at the University of Colorado had the vision to extend the role of the pediatric nurse in providing child health care services. They began to educate registered nurses to become PNPs by teaching them to do physical examinations, diagnose and treat patients, and assist in family counseling.
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  • In May 1973, PNPs from six areas of the country met in Columbus, Ohio to explore alternatives for affiliating with nursing and medical professional organizations. The group decided PNPs could best be served by a specialty nursing organization. In September 1973, the first issue of the Pediatric Nurse Practitioner, the association's newsletter, was published highlighting the outcome of this meeting and announcing the agenda for the first national meeting of PNPs. In October 1973, 400 PNP's met at this national meeting and voted unanimously to support the development of NAPNAP.
arueschenberg

Interdisciplinary Primary Care Approach to Behavioral Health - 1 views

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    Article showing an application of teamwork in a primary care setting to develop a behavior health intervention. See the abstract below! J Am Board Fam Med. 2015 Sep-Oct;28 Suppl 1:S21-31. doi: 10.3122/jabfm.2015.S1.150042. Abstract PURPOSE: This paper sought to describe how clinicians from different backgrounds interact to deliver integrated behavioral and primary health care, and the contextual factors that shape such interactions. METHODS: This was a comparative case study in which a multidisciplinary team used an immersion-crystallization approach to analyze data from observations of practice operations, interviews with practice members, and implementation diaries. The observed practices were drawn from 2 studies: Advancing Care Together, a demonstration project of 11 practices located in Colorado; and the Integration Workforce Study, consisting of 8 practices located across the United States. RESULTS: Primary care and behavioral health clinicians used 3 interpersonal strategies to work together in integrated settings: consulting, coordinating, and collaborating (3Cs). Consulting occurred when clinicians sought advice, validated care plans, or corroborated perceptions of a patient's needs with another professional. Coordinating involved 2 professionals working in a parallel or in a back-and-forth fashion to achieve a common patient care goal, while delivering care separately. Collaborating involved 2 or more professionals interacting in real time to discuss a patient's presenting symptoms, describe their views on treatment, and jointly develop a care plan. Collaborative behavior emerged when a patient's care or situation was complex or novel. We identified contextual factors shaping use of the 3Cs, including: time to plan patient care, staffing, employing brief therapeutic approaches, proximity of clinical team members, and electronic health record documenting behavior. CONCLUSION: Primary care and behavioral health clinicians, through their interactions, c
jkirk13

Why Interdisciplinary Teamwork in Healthcare is Challenging - Emerging Nurse Leader - 2 views

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    The author figures out the challenges in interdisciplinary teamwork among healthcare providers. These challenges are worth attention if we hope to do well in interdisciplinary teamwork.
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    This article discusses some challenges to working as a team in healthcare
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    interdisciplinary teamwork
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    This article discusses the challenges that come with teamwork in healthcare. Helpful in making you think about what you can do to make a team better.
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    This article discusses how interdisciplinary teamwork is experienced at three levels: healthcare professionals, patients, and healthcare organizations.
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    The points made by the author - reaching decisions collectively, making sure everyone is committed to the same purpose and goal, full participation, understanding the work of other disciplines - can be applied in any type of teamwork setting for successful outcomes. However, with healthcare the author points out that effective teamwork can lead to decreasing health care costs, improved patient safety, and decreasing workload through shared responsibilities. All areas that can allow for better patient care and more efficient use of time and financial resources.
Hannah Addis

Nurse Practitioners: Shaping the Future of Health Care - Evolution - 0 views

  • A major factor that supported the development and evolution of the Nurse Practitioner role in the 1960s was lack of access to health services. The American public’s struggles to gain access to primary care and preventive services are certainly nothing new, and this need crosses socioeconomic lines.
  • Certification programs that focused on training the practitioner to work in a specific field followed specialization, and were sometimes tied to state licensure requirements.
  • By the early 1980s, nurse practitioner education moved into graduate programs and by 1981, most states required graduate degrees for nurse practitioner practice.  In response to the scientific knowledge explosion, programs kept adding new courses, expanding their length and their credit loads. By the turn of the 21st century, most nurse practitioner programs credit hours far exceeded those in other graduate programs. At the same time there was a growing movement towards practice doctorates in other professions and this led educators to think about new types of nurse practitioner programs. By 2005, the Doctorate of Nursing Practice (DNP) became the newest level of practitioner training, giving credit for the breadth of content in the nurse practitioner programs.
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    This is a nice synopsis of key moments in history that have triggered the growth and development of the NP role in the US.
kzoda26

The Online Journal of Issues in Nursing ANA Home About OJIN FA... - 0 views

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    The Online Journal of Issues in Nursing ANA Home About OJIN FAQs Author Guidelines Featured Authors Editorial Staff Board Contact Us Site Map What's New New Postings Journal Recognition OJIN News Journal Topics Care Coordination Cornerstone Documents in Healthcare Emotional Health: Strategies for Nurses Healthy Nurses: Perspectives on Caring for Ourselves APRN Roles Opportunities and Challenges Societal Violence: What is Our Response? Healthcare and Quality: Perspectives from Nursing Delivering Nursing Care: Current Factors to Consider Patient and Visitor Violence More... Columns Cochrane Review Briefs Informatics Legislative Ethics Information Resources Keynotes of Note Table of Contents Vol 21 2016 Vol 20 2015 Vol 19 2014 Vol 18 2013 Vol 17 2012 Vol 16 - 2011 Vol 15 - 2010 Vol 14 - 2009 Vol. 13 - 2008 More... Letters to the Editor Continuing Ed ANA Home Login » ANA OJIN About Logo OJIN is a peer-reviewed, online publication that addresses current topics affecting nursing practice, research, education, and the wider health care sector. Find Out More... Announcements Permission to Reprint OJIN Articles Planning a conference or class? Call for OJIN Manuscripts on a previous topics... Benefit for Members Members have access to current topic Send a Letter to the Editor on any OJIN column or article... More... Letter to the Editor Since the introduction of the Health Insurance Portability and Accountability Act (HIPAA) in 1996, nurses have become the frontline
jstanto

Entry-Level Competencies Required of Primary Care Nurse Practitioners Providing HIV Spe... - 0 views

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    This article touches on a topic of particular interest to me, specifically how APRN's can help fill a critical shortage of primary care providers in HIV medicine. The article validates that APRN's (NP's) are more than capable of providing high quality care to those living with HIV. Moreover, we are well positioned to fill the provider shortage that is only expected to grow over the next decade and beyond.
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    As NPs, many of us who have not practiced as nurses, it might be difficult to get your foot in the door of that first job. This is a personal strategy that I came up with to try and help mitigate that for myself, I'm obviously hoping that it works! For those of us who know where we want to work, for me that's in HIV medicine, I think it's important to develop the competencies that your employer will be looking for when you walk in the door. This article does a nice job of laying those out for entry level NPs looking to get into HIV medicine. What I'm trying to do is add as many of these skills to my resume while I'm attending school. My hope is that will give me an edge over NPs that I'm competing with who may not have been in the specialty specific time. If you can identify your desired areas of practice then its just a matter of looking for opportunities to add to your skillset. Look for faculty that have a shared interest, see if you can work on a research project with them. Look for nursing organizations in that specialty. There are two HIV specific organizations for APRNs looking to get into HIV medicine (ANAC and AAHIV). Join them and start networking. Take as much CNE as you can in your specialty topic - much of its free and can be done online at your own pace.
marklamb7

The impact of nurse practitioner services on cost, quality of care, satisfaction and wa... - 1 views

shared by marklamb7 on 22 Sep 16 - No Cached
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    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
kwaltos

The Trials of Hanna Porn: The Campaign to abolish midwifery in MA - 2 views

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    This is an older but fascinating article about a midwife working in Gardener, Massachusetts in the 19th century. Hanna continued to attend births of mostly the immigrant population of the city despite being told by courts to cease. She was convicted of "practicing medicine without a license" and had to pay many fines and spend 3 months in a correctional facility. Note that the charges brought against her were never from clients, but from the physicians working in the area.
samhydes

Advanced practice nursing in Latin America and the Caribbean: regulation, education and... - 3 views

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    This article describes the results of a survey conducted of nurse leaders in Latin America and the Caribbean about their perception and knowledge of advance practice nursing. The results show that the majority of nurse leaders recognize a need for APRNS in order to create better access to care, however, the nursing education and legislation in the majority of the countries does not support APRN practices. This is an interesting introduction of APRNs in Latin America and the Caribbean for anyone who has interest of working in these areas.
Elizabeth Elliott

Why We Need NP Emergency Specialty.pdf - 1 views

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    This article gives a great glimpse into the need for ENP programs in order to support our health system in emergency care. It was written in 2011, so before ENP certification was approved by the ANCC.
ncholak89

Acute care pediatric nurse practitioner: a vital role in pediatric cardiothoracic surgery. - 1 views

http://www.ncbi.nlm.nih.gov/pubmed/21419973 In this article the authors touched on the role of the APRN in pediatric CT surgery areas. They explain that the role of the APRN is helpful in the cont...

APRN Scope practice

started by ncholak89 on 29 Aug 16 no follow-up yet
Chelsea Elliott

Health Care Teamwork: Interdisciplinary Practice and Teaching - Theresa J. K. Drinka, P... - 2 views

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    For fifty years, health care teams have been a misunderstood, undervalued, and neglected part of health care. Yet, as Drinka and Clark make clear, well functioning interdisciplinary health care teams (IHCTs) have the potential to help the health care system face its demons--financial constraints and comprehensive error-free care. Because of misunderstandings, administrators, funders, and policy makers keep the potential for interdisciplinary teams hidden. IHCTs have characteristics and problems that are unique to health care settings and the health providers who work in them. Drinka and Clark present a groundbreaking attempt to develop a comprehensive framework for IHCTs.
dianakimbal

Acquisition and Maintenance of Competencies Through Simulati... : Advances in Neonatal ... - 0 views

  • Neonatal nurse practitioners from novice to expert attend a didactic review of high-risk, low volume occurrences (such as recognition and treatment of various cardiac arrhythmias and utilization of a defibrillator in an emergency situation), followed by a procedure lab where participants can demonstrate mastery of all technical skills
  • practitioners are then placed in multidisciplinary teams and undergo several advanced level simulations followed by video-debriefing sessions which allow for further evaluation of their knowledge base, critical thinking, leadership and communication abilities, team performance, and technical skills performance in critical situations.
  • This article will review the evidence supporting simulation, define the core elements of health care simulation, describe the bodies that regulate advanced practice nursing, identify the principle areas in which neonatal nurse practitioners (NNPs) must maintain proficiency and expertise, and illustrate how simulation is utilized in acquisition, maintenance and competency evaluation for NNPs
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