Journal of the American Association of Nurse Practitioners
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J Am Assoc Nurse Pract · Jul 2016
Practice patterns and organizational commitment of inpatient nurse practitioners.
Nurse practitioners (NPs) deliver a wide array of healthcare services in a variety of settings. The purpose of this study was to examine the practice patterns and organizational commitment of inpatient NPs. ⋯ Supportive hospital/nursing leadership should acknowledge the value of the clinical and nonclinical roles of inpatient NPs as they can contribute to the operational effectiveness of their organization. By fostering the organizational commitment behaviors of identification, loyalty, and involvement, management can reap the benefits of these professionally dedicated providers.
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J Am Assoc Nurse Pract · Jun 2016
ReviewCan the use of urgent care clinics improve access to care without undermining continuity in primary care?
There is a niche for urgent care clinics as an alternate source of health care in the United States. This systematic review examines whether the use of urgent care clinics can improve access to care or if these facilities undermine continuity of primary care. ⋯ NPs are frontline healthcare providers essential to developing and maintaining successful communication and collaboration among providers across healthcare settings. In both primary care and urgent care facilities, NPs can ensure continuity of care, decreased healthcare costs, and optimized health outcomes for patients.
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J Am Assoc Nurse Pract · Feb 2016
Implementation of a rapid chest pain protocol in the emergency department: A quality improvement project.
The purpose of this quality improvement (QI) project is to compare the effectiveness of a rapid 90-min chest pain screening and evaluation protocol to a 120-min screening and evaluation protocol in determining patient readiness for hospital admission or discharge home. ⋯ Use of the rapid screening and evaluation protocol decreased the time to disposition by an average of 73 min, which enhanced ED flow without influencing disposition and patient safety.
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J Am Assoc Nurse Pract · Dec 2015
ReviewNonvitamin K antagonist oral anticoagulants in everyday practice: Stroke prevention in atrial fibrillation and treatment of venous thromboembolism.
In recent years, four nonvitamin K antagonist oral anticoagulants (NOACs) were approved to prevent stroke in patients with nonvalvular atrial fibrillation (AF) and to treat venous thromboembolism (VTE). Edoxaban, a direct factor Xa inhibitor, is the latest NOAC to be approved for use by the U.S. Food and Drug Administration. The other NOACs include two direct factor Xa inhibitors, apixaban and rivaroxaban, and one direct thrombin inhibitor, dabigatran. The purpose of this article is to introduce these agents to providers, discuss dosing, and offer insights into practical considerations for each NOAC. ⋯ NOACs may benefit some patients by avoiding the numerous food or drug interactions and frequent laboratory monitoring associated with warfarin. Adherence to proper dosing is critical for NOAC efficacy and safety.
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J Am Assoc Nurse Pract · Nov 2015
Physician Orders for Life-Sustaining Treatment for nursing home residents with dementia.
Many nursing home (NH) residents with dementia receive burdensome, aggressive treatments at the end of life (EOL). The Physician Orders for Life-Sustaining Treatments (POLSTs) paradigm is a strategy to enhance EOL care. This article describes the history and features of the POLST paradigm, discusses the potential advantages of using this paradigm for NH residents with dementia, and briefly explores challenges that nurse practitioners (NPs) face in using the POLST for persons with dementia. ⋯ NPs should assess and optimize their knowledge and skills to conduct goals of care discussions, including POLST discussions.