Journal of the American Academy of Nurse Practitioners
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J Am Acad Nurse Pract · Jun 2011
Meta AnalysisProbiotics for prevention of antibiotic-associated diarrhea and Clostridium difficile-associated disease in hospitalized adults--a meta-analysis.
A serious complication associated with the use of most antibiotics is antibiotic-associated diarrhea (AAD). The purpose of this article is to report findings from a meta-analysis of available studies on adult hospitalized populations to evaluate efficacy of probiotics for prevention of AAD and Clostridium difficile-associated disease (CDAD). ⋯ Extended hospital stays, readmissions, and higher hospital costs are just some of the consequences of ADD and CDAD. Strategies currently used include discontinuing or changing the inciting antibiotic, restricting high-risk antibiotics, and encouraging the use of antibiotics based on sensitivity reports. Healthcare spending, morbidity, and mortality can potentially be reduced considerably by reducing the occurrence of ADD and CDAD by administering prophylaxis with probiotics concurrently with antibiotics.
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This descriptive study was designed to investigate the relationship between nurse practitioners' (NPs) perceptions of collaboration with physician colleagues and level of autonomy NP practice. ⋯ Collaboration between NPs and physician colleagues is said to improve the quality and cost of health outcomes and also leads to professional satisfaction. Further research into the relationships between collaboration and autonomy are necessary to understand these complex concepts.
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J Am Acad Nurse Pract · Jan 2011
ReviewFamily presence during cardiopulmonary resuscitation: using evidence-based knowledge to guide the advanced practice nurse in developing formal policy and practice guidelines.
To provide advanced practice nurses (APNs) with the best available evidence for implementation of policies and procedures to allow family presence during cardiopulmonary resuscitation (CPR) in the acute care environment. ⋯ With this evidence-based knowledge the APN will be able to disseminate information to facilitate collaborative change in current practices surrounding staff education, decision making, and self-governance. The APN can then address controversial changes when developing formal policies and procedures, which will increase patient satisfaction and outcomes.
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J Am Acad Nurse Pract · Dec 2010
ReviewBreast cancer screening in women: An integrative literature review.
To (a) conduct a thorough search of the literature for breast cancer screening studies utilizing mammography, ultrasound, or breast magnetic resonance imaging (MRI), and (b) critically appraise these studies to aid the nurse practitioner in choosing the most appropriate screening tool for their individual patients. ⋯ Women who fall into high-risk categories should be screened yearly with breast MRI and mammography. Women with dense breast tissue according to a standardized density score should be screened yearly with ultrasound and mammography. Women in the general population should be screened yearly with mammography.
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J Am Acad Nurse Pract · Dec 2010
Improving cardiovascular health with motivational interviewing: A nurse practitioner perspective.
The purpose of this article is to provide nurse practitioners (NPs) with an evidence-based counseling strategy for motivating patients to adopt healthier cardiovascular lifestyles and reduce their cardiovascular disease (CVD) risk. A comprehensive overview of motivational interviewing (MI), framed within the context of the transtheoretical model of change (TTM), demonstrates how primary care NPs can utilize this counseling approach to optimize cardiovascular outcomes in their patients. ⋯ NPs working in primary care can integrate MI with TTM into ongoing patient encounters to facilitate positive behavior changes in their patients over time. Thus, NPs can play a key role in decreasing the growing burden of CVD in North America.