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Hernandez L, Sullivan M, Casida J. Role of Mentorship in the Transition From Registered Nurse to Acute Care Nurse Practitioner in the Cardiothoracic Intensive Care Unit. AACN Adv Crit Care 2023; 34:53-58. [PMID: 36877647 DOI: 10.4037/aacnacc2023426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Affiliation(s)
- Lidia Hernandez
- Lidia Hernandez is Acute Care Nurse Practitioner, NorthShore University HealthSystem, 2650 Ridge Avenue, Evanston, IL 60201
| | - Mary Sullivan
- Mary Sullivan is Acute Care Nurse Practitioner, Washington University School of Medicine, St Louis, Missouri
| | - Jesus Casida
- Jesus Casida is Endowed Professor and Executive Director, Eleanor Mann School of Nursing, University of Arkansas, Fayetteville, Arkansas
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2
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Gonzalez J, Gigli K. Navigating Population Foci and Implications for Nurse Practitioner Scope of Practice. J Nurse Pract 2021. [DOI: 10.1016/j.nurpra.2021.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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3
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Carlson R, Burkett Vetter AC, Hauer M, Forton M, Jerardi K, Herrmann LE. The Role of the Advanced Practice Provider and the Evolving Health Care Landscape. Hosp Pediatr 2020; 10:1010-1013. [PMID: 33109519 DOI: 10.1542/hpeds.2020-0186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
| | - Abigail C Burkett Vetter
- Children's Minnesota Hospital, Minneapolis, Minnesota
- School of Nursing, North Dakota State University, Fargo, North Dakota
| | - Morgan Hauer
- Department of Pediatric Hospital Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
- Children's Wisconsin Hospital, Milwaukee, Wisconsin
| | - Melissa Forton
- Division of Pediatric Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and
| | - Karen Jerardi
- Division of Pediatric Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Lisa E Herrmann
- Division of Pediatric Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; and
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
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Gigli KH, Kahn J, Martsolf G. Availability of Acute Care Pediatric Nurse Practitioner Education in the United States: A Challenge to Growing the Workforce. J Pediatr Health Care 2020; 34:481-489. [PMID: 32173222 PMCID: PMC7483205 DOI: 10.1016/j.pedhc.2020.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/20/2020] [Accepted: 01/20/2020] [Indexed: 11/15/2022]
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Goodhue CJ, Harris DG. Nurse Practitioner Job Satisfaction and the Healthy Work Environment. AACN Adv Crit Care 2020; 30:274-277. [PMID: 31462524 DOI: 10.4037/aacnacc2019451] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Catherine J Goodhue
- Catherine J. Goodhue is Pediatric Nurse Practitioner, Division of Pediatric Surgery/Trauma Program, Children's Hospital Los Angeles, 4650 Sunset Blvd, MS #100, Los Angeles, CA 90027 . Deborah G. Harris is Pediatric Nurse Practitioner, Division of Hematology-Oncology, Children's Hospital Los Angeles, Los Angeles, California
| | - Deborah G Harris
- Catherine J. Goodhue is Pediatric Nurse Practitioner, Division of Pediatric Surgery/Trauma Program, Children's Hospital Los Angeles, 4650 Sunset Blvd, MS #100, Los Angeles, CA 90027 . Deborah G. Harris is Pediatric Nurse Practitioner, Division of Hematology-Oncology, Children's Hospital Los Angeles, Los Angeles, California
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6
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Neurointensive (NCCU) Care Business Planning. Neurocrit Care 2019. [DOI: 10.1017/9781107587908.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Gigli KH, Beauchesne MA, Dirks MS, Peck JL. White Paper: Critical Shortage of Pediatric Nurse Practitioners Predicted. J Pediatr Health Care 2019; 33:347-355. [PMID: 30878267 DOI: 10.1016/j.pedhc.2019.02.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/11/2019] [Accepted: 02/18/2019] [Indexed: 11/29/2022]
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American Association of Nurse Practitioners National Nurse Practitioner sample survey: Update on acute care nurse practitioner practice. J Am Assoc Nurse Pract 2019; 30:140-149. [PMID: 29757882 DOI: 10.1097/jxx.0000000000000030] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Data from national surveys on the practice of nurse practitioners (NPs) provides valuable information on aspects of practice, demographic characteristics of providers and patients, plans for continued employment, and role satisfaction. The American Association of Nurse Practitioners (AANP) has been conducting the AANP Sample Survey since 1988. METHODS The most recent AANP Sample Survey was conducted in 2016 with a random stratified survey of 40,000 NPs. Data were collected bimodally, by internet and mail surveys. Responses were received from 3,970 respondents (9.9% response rate), with 335 respondents reporting NP certification in acute care as adult-gerontology acute care and/or pediatric acute care. RESULTS Almost all acute care nurse practitioners (ACNPs) reported that they were clinically practicing in 2016 (99.3%), with the top three areas encompassing cardiovascular (20.5%), critical care (12.1%), and hospitalist roles (6.3%). More than 1 in 4 ACNPs worked in a hospital inpatient setting, with 16.1% reporting work in a hospital outpatient clinic, 7.7% in a private group practice, 6.5% at a public university, and some in combined roles covering both inpatient and outpatient care, or on consultation service or specialty-based teams. On average, 34.1% of the patients ACNPs saw were between the ages of 66 and 85 years, and 11.2% were 85 years and older. The top 3 medication classes in which ACNPs regularly prescribe were diuretics (31.9%), analgesic narcotics (31.2%), and antibiotics (27.3%). Majority (88%) report satisfaction with the role, and approximately one third (31.1%) expect to continue to work in their current practice for more than 10 years. IMPLICATIONS FOR PRACTICE The findings of the 2016 AANP National NP Sample Survey data related to ACNP practice identify expansion of work settings, practice consistent with acute care scope of practice, role satisfaction, and intent to continue working. Continued monitoring of practice components and employment is indicated to track ACNP workforce trends.
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9
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The future of population medicine: Investigating the role of advanced practice providers and simulation education in special patient populations. Dis Mon 2018; 65:221-244. [PMID: 30583793 DOI: 10.1016/j.disamonth.2018.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Advanced practice providers (APPs) have come to play an increasingly significant role in the United States healthcare system in the past five decades, particularly in primary care. The first portion of this paper will explore the utilization of APPs in specific patient populations: pediatrics, obstetrics, geriatrics, and psychiatry. After a brief discussion of the demand for these specialties, the authors will outline the educational preparation and competencies that nurse practitioners and physician assistants must achieve before working with these special populations. Finally, the authors will discuss the current and future roles of APPs in pediatric, obstetric, geriatric, and psychiatric populations. Simulated patient interactions and scenarios have become integrated into clinical education for many health care providers. Although traditionally utilized only in emergency medicine education, medical simulation has grown to become a staple of training in nearly every area of medicine. Healthcare providers of all levels can benefit from both individual and team-based training designed to improve everything from patient communication to procedural competence. The flexible nature of simulation training allows for customized teaching that is directly relevant to a specific specialty. The second half of this paper will demonstrate simulation's versatilite applications in the specialty areas of urgent care, pediatrics, mental health, geriatrics, and obstetrics.
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Litchman ML, Schlepko T, Rowley T, McFarland M, Fiander M. A scoping review of Advanced Practice Registered Nurses Consensus Model outcomes: Part four of a four-part series on critical topics identified by the 2015 Nurse Practitioner Research Agenda. J Am Assoc Nurse Pract 2018; 30:710-723. [PMID: 30540631 DOI: 10.1097/jxx.0000000000000111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE The Advanced Practice Registered Nurses (APRN) Consensus Model was produced by the APRN Joint Dialogue Group in 2008. The aim of the Consensus Model is to guide state boards on the implementation of APRN practice components, including licensure, accreditation, certification, and education and to clarify the legal scope of practice and APRN roles. The purpose of this scoping review and gap analysis was to appraise the evidence related to patient, nurse practitioner (NP) and organizational outcomes resulting from the Consensus Model. METHODS A scoping review of research studies and grey literature reports was conducted and focused on the outcomes and key concepts related to the Consensus Model. Areas of foci included patients, NPs, and organizations. A subsequent gap analysis was conducted. CONCLUSIONS Several positive findings related to the Consensus Model, or components thereof, were identified for patient, NP, and organizational outcomes on various levels. Research gaps exist. Additional research is needed to fully evaluate the health outcomes on a broader scale. IMPLICATIONS FOR PRACTICE Existing evidence may support NPs and supporting organizations to further legislative efforts to more fully implement the Consensus Model nationwide.
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Affiliation(s)
| | - Thomas Schlepko
- School of Nursing and Health Science, University of Miami, Coral Gables, Florida
| | - Tom Rowley
- College of Nursing, University of Utah, Salt Lake City, Utah
| | - Mary McFarland
- Eccles Health Sciences Library, University of Utah, Salt Lake City, Utah
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Abstract
OBJECTIVES To describe physicians' and nurse practitioners' perceptions of the national and local PICU physician and other provider supply in institutions that employ PICU nurse practitioners, assess for differences in perceptions of supply, and evaluate the intent of institutions to hire additional nurse practitioners to work in PICUs. DESIGN National, quantitative, cross-sectional descriptive study via a postal mail survey from October 2016 to January 2017. SETTING Institutions (n = 140) identified in the 2015 American Hospital Association Annual Survey with a PICU who employ PICU nurse practitioners. SUBJECTS PICU physician medical directors and nurse practitioners. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS There were 119 respondents, representing 93 institutions. Responses were received from 60 PICU medical directors (43%) and 59 lead nurse practitioners (42%). More than half (58%) of all respondents reported the national supply of PICU physicians is less than demand and 61% reported the local supply of PICU providers (physicians in all stages of training, nurse practitioners, and physician assistants) is less than demand. Of the respondents from institutions that self-reported a local provider shortage (n = 54), three fourths (78%) reported plans to increase the number of PICU nurse practitioners in the next 3 years and 40% were likely to expand the nurse practitioner's role in patient care. CONCLUSIONS Most PICU medical directors and lead nurse practitioners in institutions that employ PICU nurse practitioners perceived that national and local supply of providers to be less than the demand. Nurse practitioners are employed in PICUs as part of interdisciplinary models of care being used to address provider demand. The demand for more PICU nurse practitioners with expanded roles in care delivery was reported. Further evaluation of models of care and provider roles in care delivery can contribute to aligning provider supply with demand for care delivery.
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Gigli KH, Dietrich MS, Buerhaus PI, Minnick AF. Nurse Practitioners and Interdisciplinary Teams in Pediatric Critical Care. AACN Adv Crit Care 2018; 29:138-148. [DOI: 10.4037/aacnacc2018588] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objective:
To describe the members of pediatric intensive care unit interdisciplinary provider teams and labor inputs, working conditions, and clinical practice of pediatric intensive care unit nurse practitioners.
Methods:
A national, quantitative, crosssectional, descriptive postal survey of pediatric intensive care unit medical directors and nurse practitioners was administered to gather information about provider-team members, pediatric intensive care unit nurse practitioner labor inputs, working conditions, and clinical practice. Descriptive statistics, cross-tabulations, and χ2 tests were used.
Results:
Responses from 97 pediatric intensive care unit medical directors and 59 pediatric intensive care unit nurse practitioners representing 126 institutions were received. Provider-team composition varied between institutions with and without nurse practitioners. Pediatric intensive care units employed an average of 3 full-time nurse practitioners; the average nurse practitioner-to-patient ratio was 1 to 5. The clinical practice reported by medical directors was consistent with practice reported by nurse practitioners.
Conclusion:
Nurse practitioners are integrated into interdisciplinary pediatric intensive care unit teams, but institutional variation in team composition exists. Investigating models of care contributes to the understanding of how models influence positive patient and organizational outcomes and may change future role implementation.
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Affiliation(s)
- Kristin H. Gigli
- Kristin H. Gigli is a doctoral student, Vanderbilt University School of Nursing, 461 21st Avenue South, Nashville, TN 37240 . Mary S. Dietrich is Professor, Vanderbilt University School of Nursing, Nashville, Tennessee. Peter I. Buerhaus is Professor, Montana State University College of Nursing, Bozeman, Montana. Ann F Minnick is Senior Associate Dean for Research, Julia Eleanor Chenault Professor of Nursing, Vanderbilt University School of Nursing, Nashville, Tennessee
| | - Mary S. Dietrich
- Kristin H. Gigli is a doctoral student, Vanderbilt University School of Nursing, 461 21st Avenue South, Nashville, TN 37240 . Mary S. Dietrich is Professor, Vanderbilt University School of Nursing, Nashville, Tennessee. Peter I. Buerhaus is Professor, Montana State University College of Nursing, Bozeman, Montana. Ann F Minnick is Senior Associate Dean for Research, Julia Eleanor Chenault Professor of Nursing, Vanderbilt University School of Nursing, Nashville, Tennessee
| | - Peter I. Buerhaus
- Kristin H. Gigli is a doctoral student, Vanderbilt University School of Nursing, 461 21st Avenue South, Nashville, TN 37240 . Mary S. Dietrich is Professor, Vanderbilt University School of Nursing, Nashville, Tennessee. Peter I. Buerhaus is Professor, Montana State University College of Nursing, Bozeman, Montana. Ann F Minnick is Senior Associate Dean for Research, Julia Eleanor Chenault Professor of Nursing, Vanderbilt University School of Nursing, Nashville, Tennessee
| | - Ann F. Minnick
- Kristin H. Gigli is a doctoral student, Vanderbilt University School of Nursing, 461 21st Avenue South, Nashville, TN 37240 . Mary S. Dietrich is Professor, Vanderbilt University School of Nursing, Nashville, Tennessee. Peter I. Buerhaus is Professor, Montana State University College of Nursing, Bozeman, Montana. Ann F Minnick is Senior Associate Dean for Research, Julia Eleanor Chenault Professor of Nursing, Vanderbilt University School of Nursing, Nashville, Tennessee
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Debout C. [The integration of advanced practice nurses in emergency departments]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2018; 63:38-43. [PMID: 29773254 DOI: 10.1016/j.soin.2018.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The saturation of emergency departments due to inappropriate attendance by patients is becoming increasingly commonplace. It often leads to the discontent of users, due to long waiting times, and stretches the hospital staff physically, mentally and psychologically. Innovative organisation models have been developed abroad. They draw on the skills of advanced practice nurses in emergency departments. The impact of these models has been assessed very positively in numerous studies. They improve the quality and safety of care as well as the satisfaction of users.
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Affiliation(s)
- Christophe Debout
- c/o Soins, Elsevier Masson SAS, 65, rue Camille-Desmoulins, 92442 Issy-les-Moulineaux, France.
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Simone S, McComiskey CA, Andersen B. Integrating Nurse Practitioners Into Intensive Care Units. Crit Care Nurse 2018; 36:59-69. [PMID: 27908947 DOI: 10.4037/ccn2016360] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
As demand for nurse practitioners in all types of intensive care units continues to increase, ensuring successful integration of these nurses into adult and pediatric general and specialty intensive care units poses several challenges. Adding nurse practitioners requires strategic planning to define critical aspects of the care delivery model before the practitioners are hired, develop a comprehensive program for integrating and training these nurses, and create a plan for implementing the program. Key strategies to ensure successful integration include defining and implementing the role of nurse practitioners, providing options for orientation, and supporting and training novice nurse practitioners. Understanding the importance of appropriate role utilization, the depth of knowledge and skill expected of nurse practitioners working in intensive care units, the need for a comprehensive training program, and a commitment to continued professional development beyond orientation are necessary to fully realize the contributions of these nurses in critical care.
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Affiliation(s)
- Shari Simone
- Shari Simone is a senior nurse practitioner clinical program manager, Women and Children's Services, a pediatric critical care nurse practitioner, University of Maryland Medical Center, Baltimore, Maryland, and an assistant professor, University of Maryland School of Nursing, Baltimore, Maryland. .,Carmel A. McComiskey is the director of nurse practitioners and physician assistants, University of Maryland Medical Center, and an assistant professor, University of Maryland School of Nursing. .,Brooke Andersen is a nurse practitioner clinical program manager, R. Adams Cowley Shock Trauma Center critical care units, and an adult acute care nurse practitioner, University of Maryland Medical Center.
| | - Carmel A McComiskey
- Shari Simone is a senior nurse practitioner clinical program manager, Women and Children's Services, a pediatric critical care nurse practitioner, University of Maryland Medical Center, Baltimore, Maryland, and an assistant professor, University of Maryland School of Nursing, Baltimore, Maryland.,Carmel A. McComiskey is the director of nurse practitioners and physician assistants, University of Maryland Medical Center, and an assistant professor, University of Maryland School of Nursing.,Brooke Andersen is a nurse practitioner clinical program manager, R. Adams Cowley Shock Trauma Center critical care units, and an adult acute care nurse practitioner, University of Maryland Medical Center
| | - Brooke Andersen
- Shari Simone is a senior nurse practitioner clinical program manager, Women and Children's Services, a pediatric critical care nurse practitioner, University of Maryland Medical Center, Baltimore, Maryland, and an assistant professor, University of Maryland School of Nursing, Baltimore, Maryland.,Carmel A. McComiskey is the director of nurse practitioners and physician assistants, University of Maryland Medical Center, and an assistant professor, University of Maryland School of Nursing.,Brooke Andersen is a nurse practitioner clinical program manager, R. Adams Cowley Shock Trauma Center critical care units, and an adult acute care nurse practitioner, University of Maryland Medical Center
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Eastern Association for the Surgery of Trauma and Society of Trauma Nurses advanced practitioner position paper: Optimizing the integration of advanced practitioners in trauma and critical care. J Trauma Acute Care Surg 2017; 83:190-196. [PMID: 28328684 DOI: 10.1097/ta.0000000000001455] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Nurse practitioners and physician assistants, collectively known as advanced practitioners (APs), enhance the provision of care for the acutely injured patient. Despite their prevalence, institutions employ, train, and utilize these providers with significant variability. The Eastern Association for the Surgery of Trauma, the Society of Trauma Nurses, and the American Association of Surgical Physician Assistants acknowledge the value of APs and support their utilization in the management of injured and critically ill patients. This position paper offers insight into the history of, scope of practice for, and opportunities for optimal utilization of APs in trauma, critical care, and acute care surgery services.
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Preparation and Evolving Role of the Acute Care Nurse Practitioner. Chest 2017; 152:1339-1345. [PMID: 28823758 DOI: 10.1016/j.chest.2017.08.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 07/26/2017] [Accepted: 08/07/2017] [Indexed: 11/21/2022] Open
Abstract
Acute care nurse practitioners (ACNPs) are increasingly being employed as members of critical care teams, an outcome driven by increasing demand for intensive care services, a mandated reduction in house officer hours, and evidence supporting the ability of ACNPs to provide high-quality care as collaborative members of critical care teams. Integration of adult ACNPs into critical care teams is most likely to be successful when practitioners have appropriate training, supervision, and mentoring to facilitate their ability to practice efficiently and effectively. Accomplishing this goal requires understanding the educational preparation and skill set potential hires bring to the position as well as the development of an orientation program designed to integrate the practitioner into the critical care team. Pediatric ACNPs are also commonly employed in critical care settings; however, this commentary focuses on the adult ACNP role.
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Redesigning Care in the PACU With an Adult-Gerontology Acute Care Nurse Practitioner (A-GACNP). J Perianesth Nurs 2017; 33:407-411. [PMID: 30077282 DOI: 10.1016/j.jopan.2017.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 02/27/2017] [Accepted: 03/12/2017] [Indexed: 11/23/2022]
Abstract
The adult-gerontology acute care nurse practitioner (A-GACNP) engages in all levels of care within the acute care setting. The postanesthesia care unit (PACU), a specialized entity within the acute care environment, encounters patients at their most vulnerable through various stages of awakening. The evolving state in the health care system today creates opportunity for innovations in the hospital setting that have yet to see the advantages of the nurse practitioner. The A-GACNP possesses the education, training, and skill necessary to treat patients in the critical stages of recovery from anesthesia. This article provides the rationale for incorporating the A-GACNP into the PACU. A systematic review of the literature will examine the benefits of the nurse practitioner in the acute care setting, the A-GACNP competencies, and propose a transformation of care in the PACU where the A-GACNP has an exclusive role.
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