Journal of the American Association of Nurse Practitioners
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J Am Assoc Nurse Pract · Oct 2015
Certification and education as determinants of nurse practitioner scope of practice: An investigation of the rules and regulations defining NP scope of practice in the United States.
In 2008, a consortium of advanced practice nursing organizations authored the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education. The document's aim is to provide guidance for states to adopt uniformity in the regulation of advanced practice registered nurse roles. Despite a target date to complete that work by 2015, there remains an extensive amount of variation in how states define the scope of practice (SOP) for nurse practitioners (NPs). ⋯ The findings suggest much work is needed to ensure NP SOP accurately reflects NP board-certification and graduate educational preparation.
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J Am Assoc Nurse Pract · May 2015
ReviewSubstantive review of the literature of medication treatment of chronic low back pain among adults.
Pain can be debilitating, and it is often inadequately treated, particularly among patients with chronic low back pain (CLBP). CLBP has a substantial economic impact, as it affects an individual's ability to perform activities of daily living and maintain employment. This study aims to review original studies related to the evidence-based management of patients with CLBP to develop an algorithm for prescribing medications and recommending other treatment modalities for patients with CLBP. ⋯ Providers should encourage patients to explore a variety of treatment modalities that can provide pain relief and improve functionality and overall well-being.
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J Am Assoc Nurse Pract · Dec 2014
Influence of self-management and self-management support on chronic low back pain patients in primary care.
This study utilized a nonexperimental, cross-sectional, descriptive design to examine self-management (SM), self-management support (SMS), and other pain-related variables in chronic low back pain (CLBP), and described participants' perceptions of their SM, SMS, and functional ablement. ⋯ Study findings increase our understanding of the SM, SMS, and functional ablement of CLBP patients with relevance to application in practice. There is a great need to develop evidence-based SM and SMS programs specific to CLBP patients' needs. Nurses and nurse practitioners play major roles in leading this initiative. Study findings also reinforce the importance of psychologists and physical therapists' collaboration in the complex care of CLBP. Longitudinal and experimental studies are recommended to evaluate SM and SMS programs that include physical therapy and psychological care components.
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J Am Assoc Nurse Pract · Nov 2014
Case ReportsA case of a patient with hyperosmolar hyperglycemic state: implications for nurse practitioners in primary care.
The purpose of this case study is twofold: first, to present the pathophysiology of hyperosmolar hyperglycemic state (HHS) as it relates to a hospitalized patient with undiagnosed diabetes; the second is to increase awareness among primary care nurse practitioners (NPs) about the complexities of diagnosing less typical forms of diabetes. The case illustrates how HHS can be life threatening, how it is differentiated from diabetic ketoacidosis (DKA), and how it is treated. The importance of closer surveillance of blood glucose in high-risk individuals is highlighted. ⋯ With improved understanding of the phenomena leading to glucose dysregulation, less typical forms of diabetes might be identified earlier and controlled. NPs in primary care are uniquely positioned to reduce the risk of hyperglycemic crises.
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J Am Assoc Nurse Pract · Aug 2014
Knowledge translation: a Nurse Practitioner Clinical Ladder Advancement Program in a university-affiliated, integrated medical center.
A Nurse Practitioner Clinical Ladder (NPCL) Advancement Program was designed to recognize and reward advanced nursing practice and promote nurse practitioner (NP) retention at New York University Hospitals Center (NYUHC). ⋯ Organizational commitment to a structured NPCL Advancement Program is critical for NP professional development, evolving role responsibilities, and job satisfaction. The NPCL Advancement Program provides requisite structures and processes supportive of clinical excellence. The development of the NPCL has highlighted the need for structured NP orientation and mentorship, knowledge translation, and leadership programs to meet the professional needs of NPs in diverse clinical settings.