Journal of the American Academy of Nurse Practitioners
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J Am Acad Nurse Pract · Apr 2010
ReviewNurse practitioners as an underutilized resource for health reform: evidence-based demonstrations of cost-effectiveness.
Healthcare reform in 2009 was motivated by an imperative to reduce the relentless increase in spending on medical care. Many efforts to solve the problem focused on applying proven principles of evidence-based practice and cost-effectiveness to find the least-expensive way to produce a specific clinical service of acceptable quality. This paper combines economic analysis and reviews published literature to show how the goals of healthcare reform can be accomplished by allowing independently licensed nurse practitioners to provide their wide range of services directly to patients in a variety of clinical settings. The paper presents extensive, consistent evidence that nurse practitioners provide care of equal or better quality at lower cost than comparable services provided by other qualified health professionals.
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J Am Acad Nurse Pract · Apr 2010
Postoperative fever: a normal inflammatory response or cause for concern.
To devise a systematic diagnostic strategy displayed in algorithm format to assist advanced practice registered nurses (APRNs) in determining when postoperative fever is simply a normal inflammatory response and when further investigation is needed to rule out infection or other serious noninfectious causes of fever. ⋯ The role of the APRN in managing surgical patients requires being able to accurately assess and evaluate the cause of postoperative fever and take action accordingly. That means taking into account a variety of factors (e.g., patient's medical history, physical examination findings, and type of surgery), so that appropriate diagnostic tests can be ordered to evaluate the cause of the postoperative fever. By being aware of the causes of postoperative fever, the APRN can also take prophylactic action to decrease the risk associated with many of these potential febrile causes.
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To provide nurse practitioners (NPs) information about sickle-cell disease (SCD) and pulmonary hypertension (PHTN) as a complication. A case study is presented to illustrate the diagnosis of PHTN in a patient with SCD. Clinical manifestations, diagnosis, and interventions for both SCD and PHTN are also discussed. ⋯ Many patients with SCD are seen in primary care practices. Such is the situation for the patient in this case study. Familiarity with pulmonary hypertension secondary to SCD can increase the awareness of NPs of this potential consequence and initiate early diagnostic evaluation.