Medicine and Health Sciences Commons^™

Can The Role Of The Nurse As Surgical Assistant Add Value In The Australian Public Health Care Sector?, Toni Hains, Anojan Navaratnam Dr, Andrew O'Brien, Karen Walsh, Jane Neilsen, Susan Firth

Journal of Perioperative Nursing

While the role of the Registered Nurse/Nurse Practitioner as surgical assistant has been underutilised in the Australian public health care sector, this role adds value by enhancing learning opportunities for medical and nursing staff. This extended practice role also provides a mechanism for increasing nurses’ job satisfaction leading to nursing workforce retention and workforce capacity building. Additionally, a consistent and experienced nurse in the role of table-side assistant for robotic-assisted surgery can improve patient safety, communication and enhance surgical flow.

Health Care Initiative To Evaluate The Impact Of A Nurse Practitioner Led Community Wound Care Service On Emergency Department Utilization, Sherry Morrell

Electronic Thesis and Dissertation Repository

Nurse Practitioners (NP) diagnose and treat wounds and wound-related conditions based on their advanced scope of practice. An NP with graduate-level wound care education (NP(W)) gains additional knowledge and clinical experience to provide comprehensive wound care.

This research aimed to explore community patients’ access to wound care in Southwestern Ontario (Canada). A quality improvement project was initiated utilizing stakeholder feedback to develop and implement a 12-week pilot NP(W)-Led community-based wound care service; the NP(W) wound care practices, clinical outcomes, and adverse events were described. One hundred twelve participants attended the service over 117 visits. The NP(W) services included prescribing and …

Changing The Culture Of Nurse Practitioners: Incorporating Medical Billing And Coding To Prevent Fraud, Waste And Abuse, Tralissa Morrow

DNP Research Projects

Medical coding and billing errors are avoidable problems that have afflicted practitioners for decades. Correct coding and billing are required for reimbursement of healthcare services. Fraud, waste and abuse increase healthcare costs, reduce the quality of care provided and directly impact costs to patients. This pilot study was intended to evaluate the impact of an educational webinar on medical billing and coding, fraud, waste and abuse on nurse practitioner (NP) knowledge using a pretest posttest design. Mean scores increased from 58.4% to 76.4%. Test reliability was low at 0.477 (pretest) and 0.142 (posttest) with two questions that were unable to …

Mentorship Experience Among Nurse Practitioners, Chelsea L. Noble

Doctor of Nursing Practice Scholarly Projects

Background and Review of Literature: The current literature provides the context of mentorship and its benefits across various disciplines. Nursing and medicine use mentorship frequently to guide each new generation of healthcare providers. There is a current lack of research focusing on nurse practitioners as it relates specifically to mentorship.
Purpose: The purpose of this Doctor of Nursing Practice (DNP) project was to evaluate mentorship in nurse practitioners and across subspecialties.
Methods: A descriptive correlational study was conducted. Data were collected using the Mentor Evaluation Tool (MET) and the National University Hospital Mentorship Evaluation (NUH ME) tool that were administered …

Pediatric Caregiver Health Literacy: Comparing Perceptions Of Pediatricians And Nurse Practitioners, Kirbey Flora

Mahurin Honors College Capstone Experience/Thesis Projects

Throughout life, most people will interact with the healthcare system to manage information in order to make healthcare decisions. Health literacy is the ability to comprehend health information needed to make healthcare decisions. Pediatric patients often do not have a voice in their healthcare decisions; therefore, their health outcomes may be affected by the health literacy of their caregivers. In addition, the child’s health may be impacted by the ability of the healthcare team to provide appropriate health education. The purpose of this honors thesis was to determine pediatric healthcare providers’ perception of health literacy in their practices. Qualitative data …

Providing Hispanic Immigrant And Migrant Health Care In America: Could Nps Be The Answer?, Hamabwe Kabwe

All Graduate Theses, Dissertations, and Other Capstone Projects

In recent years, the United States (U.S.) has seen an influx of Hispanic/Latino migrants/ immigrants fleeing their homes in South America, seeking opportunities for a better life in the U.S. Immigrants and their families often present to the U.S. with unique, unmet health care needs that ultimately impact the U.S. healthcare system and migrant health outcomes. Migration is a significant burden for the U.S. health care delivery system today and further magnifies known problems including inability to provide care to all because of lack of insurance for all, racial disparities in care outcomes, and unequal distribution of providers. There is …

Social Network Centrality, Social Construction Of Knowledge, And Nurse Practitioner Competency In Asynchronous Online Discussions Among Adult Gerontology Acute Care Nurse Practitioner Students, Sharon Schaaf

Organization, Information and Learning Sciences ETDs

The relationships between social network centrality, social construction of knowledge, and nurse practitioner competency among adult gerontology acute care nurse practitioner students participating in asynchronous online discussions were explored. Social network centralities (betweenness, in-degree, out-degree, closeness, and eigenvector) were determined through social network analysis. Social construction of knowledge was assessed by the Interaction Analysis Model (IAM). Nurse practitioner competency was evaluated using the Novice to Expert model. A retrospective exploration of an online discussion board from the College of Nursing at the University of New Mexico was conducted. The centralities of betweenness, closeness, and eigenvector demonstrated a significant relationship with …

A Survey Identifying Leadership And Research Activities Among Nurse Practitioners, Mary Ryder, Elisabeth Jacob, Joyce Hendricks

Research outputs 2014 to 2021

Background:

Nurse Practitioners are identified as the ideal conduit to transform healthcare delivery internationally. Healthcare transformation requires the application of leadership and research skills. Current literature has limited information on NPs as leaders or researchers in the nursing profession.

Objectives:

Determine if Nurse Practitioners identify themselves as leaders in nursing. Identify the leadership and research activities and influencing characteristics of Nurse Practitioners in Ireland and Australia. Establish similarities in leadership and research activities between Nurse Practitioners in Ireland and Australia. To identify if there is a relationship between leadership and research activities.

Design:

A quantitative electronic survey.

Methods:

A …

Nurse Practitioner Intervention In Palliative Care Settings, Lacie N. Harris

MSN Capstone Projects

Palliative care is a specialty of healthcare that focuses on chronic and severe disease. As chronic disease continues to rise annually related to genetics, sedentary lifestyle, and environmental factors, the need for interventions will increase to meet demands of patients, families, and organizations. Therefore, implementation of a nurse practitioner in the palliative care setting is ideal for optimal patient outcomes.

Ultrasound-Guided Peripheral Intravenous Catheter Insertion For Nurse Practitioners, Alvin Joseph Abad

Doctor of Nursing Practice (DNP) Projects

Problem

Intravenous (IV) catheter insertion is a necessary skill in the emergency department (ED) for indications such as medications, fluids, and blood transfusions. Occasionally, patients present with difficult IV access (DIVA), requiring multiple insertion attempts and central venous catheter (CVC) placements. Due to the invasive nature of these procedures, patients can experience a great deal of pain and discomfort. Furthermore, although CVCs are necessary in critically ill patients that require hemodynamic monitoring or vasopressor infusions, they can cause several problems. For instance, central-line associated blood stream infections are some of the most common complications and result in increased costs and …

Cardiovascular Surgery Practice Remodel: Increasing Job Satisfaction And Reducing Turnover Rates Of Advanced Practice Providers, Christian Brooks

Doctor of Nursing Practice Scholarly Project

Cardiovascular Surgery Practice Remodel: Increasing Job Satisfaction and Reducing Turnover Rates of Advanced Practice Providers

Background: The CVS practice in a Midwestern state had a shift in morale and job satisfaction in their advanced practice providers (APPs). This shift lead to the high turnover rate of 35% in 2018. In an effort to bring a halt to the high turnover rate, and to continue the excellent patient care for which the hospital is known, hospital administration became involved and set up a committee to guide the development of a new CVS APP practice model. The goal was to develop …

Communication, Leadership And Organizational Support Facilitates Successful Transition Into Practice For Nurse Practitioners In The Emergency Department, Cheryl Anne Soco

College of Science and Health Theses and Dissertations

Background and purpose: Post-graduate programs, specialized academic programs, and national health organizations like the Institute of Medicine (IOM) have identified and begun addressing the gap in knowledge, skills and factors for successful transition into practice. The purpose of this study is to examine the relationships and differences among the personal and community resources which promote successful transition for Nurse Practitioners (NP) that practice in the Emergency Department (ED) and the skills or procedures they find difficult to perform independently.

Methods: A descriptive, correlational-comparative study design was conducted using an online survey administered to a convenience sample of NPs with …

Communication, Leadership And Organizational Support Facilitates Successful Transition Into Practice For Nurse Practitioners In The Emergency Department, Cheryl Soco

College of Science and Health Theses and Dissertations

Background and purpose: Post-graduate programs, specialized academic programs, and national health organizations like the Institute of Medicine (IOM) have identified and begun addressing the gap in knowledge, skills and factors for successful transition into practice. The purpose of this study is to examine the relationships and differences among the personal and community resources which promote successful transition for Nurse Practitioners (NP) that practice in the Emergency Department (ED) and the skills or procedures they find difficult to perform independently.

Methods: A descriptive, correlational-comparative study design was conducted using an online survey administered to a convenience sample of NPs with …

Improving Access To Care In Virginia: Reaching Nurse Practitioner Training Capacity Through Preceptor Incentives, Debra Barksdale, Christine Kennedy, Shelly Smith

Translational Research Fellows Policy Briefs

Workforce data reinforces the notion that educating nurse practitioners in Virginia is critical in helping to improve access to care in the Commonwealth, particularly in underserved communities. Six of Virginia’s thirty-nine state funded colleges and universities offer nurse practitioner programs. All of these universities report their capacity to train nurse practitioners is not limited by qualified applicants but rather by a shortage of clinical preceptors. This paper provides a summary of public policy initiatives that support preceptors as an example for Virginia to consider.

Clarifying Workforce Flexibility From A Division Of Labor Perspective: A Mixed Methods Study Of An Emergency Department Team, Sarah Wise, Christine Duffield, Margaret Fry, Michael Roche

Research outputs 2014 to 2021

Background: The need for greater flexibility is often used to justify reforms that redistribute tasks through the workforce. However, "flexibility" is never defined or empirically examined. This study explores the nature of flexibility in a team of emergency doctors, nurse practitioners (NPs), and registered nurses (RNs), with the aim of clarifying the concept of workforce flexibility. Taking a holistic perspective on the team's division of labor, it measures task distribution to establish the extent of multiskilling and role overlap, and explores the behaviors and organizational conditions that drive flexibly.

Methods: The explanatory sequential mixed methods study was set in the …

A Nurse Practitioner-Led Group Advance Care Planning Program In An Independent And Assisted Living Community, Alexander Bustos

DNP Qualifying Manuscripts

It has been well documented that the majority of people want to spend their last days in the comfort of their own homes, free of pain, and off any dependent machine. , However, the majority of people have not documented these wishes or talked with their family or provider about end of life care (Hamel, Wu, & Brodie, 2017). The Patient Self Determination Act (PSDA), which took effect on December 1, 1991, was enacted to raise awareness and promote discussions between patients and providers about end of life (EOL) healthcare decisions. The primary care nurse practitioner is in a prime …

Defining Young Adulthood, Elena Higley

DNP Qualifying Manuscripts

Young adulthood is a unique developmental period that occurs between the ages of 18 and 25 years, during which there are key developmental tasks that allow the young adult to participate in self-exploration and identity formation. Currently, among various organizations there are differing definitions and age range inclusions for young adulthood, which cause confusion during program development, healthcare service delivery, and research. Young adulthood should be categorized separately from adolescence and adulthood, because young adults have lower rates of healthcare utilization and worse health outcomes related to preventable causes of morbidity and mortality than the surrounding age groups. Young adults …

Knowledge, Attitudes, And Perceptions Of Nurse Practitioners About Antibiotic Stewardship, Robert M. Hamilton

Theses and Dissertations

Background: Antibiotic stewardship (ABS) is a set of strategies to optimize the use of antibiotics with the goal of reducing antibiotic resistance, improving patient outcomes and decreasing unnecessary costs. ABS affects all venues of patient care, including outpatient, inpatient, and long-term care. While many strategies for ABS exist and best practice continues to evolve, successful ABS programs utilize a multidisciplinary approach. Nurse practitioners (NPs) play an essential role in health care education and represent a valuable potential resource for ABS efforts. The purpose of this study is to describe the knowledge, attitudes, and perceptions of NPs towards ABS.Methods: A convenience …

Identifying Perceived Barriers To Primary Health Care Access In Rural, Medically Underserved Areas, Suzanne Hewitt

Doctoral Projects

Persons living in rural areas designated as having primary care provider shortages often lack access to timely and appropriate levels of care, frequently forcing them to forego care, delay treatment, or seek care in an emergency department for non-urgent complaints. This qualitative study reviewed evidence-based research and data generated from two focus groups sessions to generate a body of distinctive knowledge of the barriers to primary healthcare access as perceived by members of this rural, medically-underserved area of northern California. The theme that was identified, through conventional qualitative content analysis, as most prevalent among subjects was the inability to schedule …

Implementation Of Emergency Severity Index Training To Improve Accuracy Of Triage Levels, Erinn Hileman, Douglas Mckain

Doctor of Nursing Practice Projects

This quality improvement project was created to help increase knowledge of the Emergency Severity Index (ESI) in the Emergency Department (ED), a form of triage used to categorize patients by their acuity. Proper ESI use shortens the length of stay times, door to provider times and reduces the number of patients that leave without being seen.

The goal of this project was to develop an online learning module that would increase the nurses’ knowledge of triage to enhance triage accuracy. Nineteen (19) emergency department nurses were given a pretest, an ESI educational presentation, and a follow-up post-test.

Data analysis indicated …

Development Of A Breast Cancer Survivorship Care Toolkit, Lauren Elaine Scott

UNLV Theses, Dissertations, Professional Papers, and Capstones

A breast cancer survivor’s journey does not end with treatment. After treatment, most breast cancer survivors go on to face many life-long physical and mental challenges caused by their cancer and treatment. Once active cancer treatment is completed, patients enter the next important step in cancer care, cancer survivorship. Cancer survivorship is a comprehensive approach to post-oncology management that promotes the best outcomes for survivors as they transition from oncology care to primary care; and new breast-cancer survivorship guidelines have emerged. Research suggests that primary care NPs’ lack of awareness of the current 2016 American Cancer Society/American Society of Clinical …

Nurse Practitioner Attitudes, Perceptions And Knowledge About Antimicrobial Stewardship, Evelyn C. Fabian

Walden Dissertations and Doctoral Studies

Resistance to antibiotics has increased dramatically in the United States, with serious associated medical, social, and economic consequences. The purpose of this project was to assess nurse practitioners' attitudes, perceptions, and knowledge about antimicrobial stewardship and knowledge in the management of anaerobic infections as well as resistant gram-negative bacteremia. Data were collected using a web-based survey in a hospital facility. The practice question explored whether nurse practitioners' attitudes, perceptions, and knowledge about antimicrobial stewardship significantly increased after an education program on antimicrobial stewardship. The project was framed by Knowles's adult learning theory. A 16-item survey was administered before and after …

Primary Care Panel Comanagement By A Physician And An Advanced Practice Clinician: Impact On Provider Burnout, Jennifer Strobel

Doctor of Nursing Practice Projects

Background: Levels of burnout have reached epidemic proportions among health care professionals, resulting in a number of negative consequences, including loss of productivity, increased turnover, and increased organizational costs. Advanced Practice Clinicians (“APCs”- a term that encompasses both ARNPs and PAs) were integrated into teams with physicians at a network of primary care clinics in a greater metropolitan area in the United States with the goal of reducing provider burnout. This approach has not yet been evaluated to determine whether there are benefits for reduction of burnout levels in clinicians. Few studies have been conducted to date about the …

Nursing Staff Development For Novice Nurse Practitioners In Acute Care, Carolyn Berglund

Walden Dissertations and Doctoral Studies

An acute care practice site reported 75% turnover of novice nurse practitioners (NPs),

which indicated a gap in the transition from student to practitioner within the first year of

clinical practice. This gap can leave novice NPs unprepared to manage patients

effectively and contribute to high turnover. The practice-focused question addressed

whether an evidence-based staff development program for novice NPs at an acute care

site could be developed. The purpose of this project was to create a framework based on

evidence to transition novice NPs successfully into practice. Benner's skill-acquisition

in-nursing theory informed this project. Evidence was obtained by searching …

The Role Of An Advanced Practice Provider (App) And Its Relation To Physician Shortages And Rural Healthcare Survival: A State-By-State Analysis, Allen Anderson

Dissertations, Theses, and Projects

The extent that Advanced Practice Providers (APPs) are able to practice independently with a full scope of practice varies state-by-state. The purpose of this paper was to review how APPs could help in a number of different areas of healthcare. This analysis examines the state of rural healthcare and reviews physician shortage statistics and hospital closures by state. In the examination, it also evaluates which states have full scope, reduced scope, and restricted scope of practice laws and cross-references that with states that have experienced a hospital closure. Through case studies, this research finds that APPs can be an alternative …

Political Astuteness In Tn Nurse Practitioners: Strategies To Inform, Tracie Gooch, Tracie Herrell

Doctoral Projects

Abstract

Political astuteness among nurse practitioners practicing in states like Tennessee where their scope of practice is restricted needs evaluation to promote policy and scope of practice change to increase access to quality healthcare in rural and underserved areas to decrease healthcare disparities in vulnerable populations. There is a scant amount of literature that specifically addresses political astuteness in nurse practitioners. The purpose of this project is to assess and provide strategies to inform nurse practitioners on political astuteness and activity. A cross sectional survey included the administration of an online version of the Political Astuteness Inventory (PAI), compared results …

Nurse Practitioner Students: Providing Wellness Screenings To Underserved Older Adults, Rexanna Tatlock

Purdue Journal of Service-Learning and International Engagement

Rexanna Tatlock (BSN, RN, CCRN) received a BSN from Saint Francis College in 2003. As a registered nurse, she specialized in critical care nursing and eventually enrolled in the Adult Gerontology Nurse Practitioner master’s program in Purdue University’s School of Nursing in 2016. Upon graduation in May 2018, Rexanna has planned to focus on primary health care. The service-learning project provided primary care clinical experience, while meeting the needs of an underserved older adult population. This article will discuss the community partnership, a needs assessment, and a wellness screening offered to Fairington Apartments (FA) residents.

Benefits Of Interprofessional Education Between Advanced Practice Nurse Practitioner And Dentistry Students, Oksana Prodan

DNP Qualifying Manuscripts

Background: Interprofessional Education (IPE) is mandated for accreditation in health professional schools. IPE between Advanced Practice Registered Nurse (APRN) and dentistry students have been developed to improve health oral systemic health outcomes and improve inter-professional practice competencies.

Method: Literature on APRN dental IPE was searched was searched via CINAHL Complete from 2007-2018, looking for scholarly journals, English language. The search was narrowed from 55 to three relevant, data-based studies.

Results: Review of literature produced one study demonstrating benefits of IPE for both APRN and dentistry students, one study only focused on benefits for APRN students, and another IPE article was …

Improving Pediatric Oral-Systemic Health Through Motivational Interviewing: An Interprofessional Training Intervention, Oksana Prodan

Doctor of Nursing Practice (DNP) Projects

Introduction: In response to the prevalence of early childhood carries (ECC) in the United States, recommendations were established for pediatric primary care providers to routinely incorporate oral-systemic health promotion services into clinical practice. An interprofessional education project was developed between Advanced Practice Registered Nurses (APRNs) and dentistry students in San Francisco to assist trainees in the effective delivery of oral systemic health promotion services. Improving health promotion communication skills was identified as an area of need for both sets of learners. Therefore, the IPE activity was designed to incorporate Motivational Interviewing (MI) into the training along with pediatric oral …

Changing Health Care Policy By Utilizing Kingdon's Policy Stream Theory, Brittney Welch

Graduate Theses, Dissertations, and Capstones

The purpose of this paper is to describe the policy process of changing current regulations regarding rural health clinics (RHCs). Using Kingdon’s Policy Stream Theory for guidance, the change project was designed to amend current regulations regarding the directorship of the RHCs, consequently allowing Nurse Practitioners (NP) to act as medical directors for rural health clinics (RHCs). This change fulfills the Institute of Medicine’s charge to have nurses work to the highest level of their education, as well as a defined need to fill a gap in the health care system by decreasing rural health disparities. The Rural Health Care …