Дисертації з теми "Aged care nurse practitioner"
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1
Mechling, Eileen. "Nurse practitioner clinic utilization by elderly women." Thesis, The University of Arizona, 1994. http://hdl.handle.net/10150/144648.
Повний текст джерелаАнотація:
The purpose of this study was to explore the utilization patterns of elderly women in a nurse managed clinic (NMC). A convenience sample of 20 women, 65 and older, attending an NMC completed an questionnaire and an interview. A pilot study guided the development of the questionnaire. Interrater reliability was performed to enhance the reliability of the pattern categories developed from the interviews. The findings of this research were that elderly women utilized this NMC for: physical assessment and monitoring; health care information; evaluating a physical need; referral; emotional support; socialization; convenience; cost; familiarity/comfort; health care need; and reliability. Satisfaction was the main component of the clients' perception of their visit to the NMC. Conclusions reached were that utilization of this NMC was based mainly on perceptions of health care needs and that cost, convenience, and familiarity influenced clients in choosing this clinic in addition to their primary care provider.
2
Cruz, Anna Maria, and Anna Maria Cruz. "Patient Satisfaction with Nurse Practitioner Care on Guam." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/623005.
Повний текст джерелаАнотація:
Patient satisfaction has been identified as an indicator of quality care. There is no research on patient satisfaction with Nurse Practitioner (NP) care on Guam. Therefore, a cross sectional descriptive study was conducted to assess patient satisfaction with NP care at three primary care clinics on Guam. A convenience sample of patients 18 years and older, seen by an NP were invited to participate in completing the Nurse Practitioner Satisfaction Survey (NPSS). Data collection concluded after a one-month period (N = 108). Descriptive statistics, between group differences, and correlational analyses were conducted. Participation in the survey was voluntary and anonymity, confidentiality, and privacy were ensured. General patient satisfaction was very high for NP care on Guam. "My NP is caring" was the highest scoring item on the NPSS with a mean score of 4.43 (n=56). Participants selected the NP as providing the health education and care the patient found most satisfying. A statistically significant weak negative correlation between patient satisfaction and age and level of injury was found. Singles reported significantly higher patient satisfaction scores than widowers. Study limitations included the small sample size, convenience sampling, social desirability and selection bias. Caring is an essential tenet of NP care and patient satisfaction. Improving NP role clarity is vital to the continued success and growth of the NP profession. The value that NPs bring to primary care is substantiated by the high patient satisfaction levels consistently produced from studies across the globe. In order for NPs to significantly impact the primary care provider shortage all 50 states and the US territories must enact full practice authority (FPA).
3
Newbold, David Anthony. "An evaluation of the rheumatology nurse practitioner." Thesis, King's College London (University of London), 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.263598.
Повний текст джерела
4
Kinne, Mary Ann. "EMERGENCE AND FUTURE PROJECTION FOR THE ACUTE CARE NURSE PRACTITIONER." Thesis, The University of Arizona, 2004. http://hdl.handle.net/10150/610471.
Повний текст джерелаАнотація:
The Acute Care Nurse Practitioner (ACNP) is the newest Advanced
Practice Nurse with advanced clinical education and experience in acute and
critical care. The ACNP uses a collaborative practice model to provide direct
services to acutely and critically ill adult patients in a variety of settings. There
are approximately 21,000 Nurse Practitioners in the United States with 8%
working in the acute care setting. The literature was reviewed to examine
historical evolution and assess if the role has resulted in favorable cost and quality
outcomes, future employment potential and autonomy. The role has not been
without controversy, however early research finding suggest that ACNPs make a
substantial impact on quality and cost of health care. Legislation has been
favorable, diminishing previous limitations and swinging the door of opportunity
wide for further development and autonomy in the Acute Care Nurse Practitioner
Role.
5
Salcedo, Maria Victoria Trinidad. "Needs Assessment for a Nurse Practitioner-Led Transitional Care Program." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1450.
Повний текст джерелаАнотація:
The rising cost of health care and changes in healthcare delivery have prompted a need to improve continuity from the hospital to home. This scholarly project was initiated to assess the impact on patient outcomes related to initiation of a nurse practitioner-led transitional care program (TCP). Using the Diffusion of Innovations and Health Belief Models, the purpose of this study was to identify the impact of a TCP on improving the health of patients with congestive heart failure (CHF), diabetes mellitus Type II (DM II), and chronic obstructive pulmonary disorder (COPD). The impact of the TCP was evaluated by a review of patient satisfaction results, reduction in patient readmission rate, and emergency room consults. Two years of data from a community-based health care program were collated from a sample of 819 individuals with chronic disease between 65- and 85-years-old who had a 30-day hospital readmission after a nurse practitioner home visit and a 30- day readmission for an exacerbation of their CHF, DM II, or COPD. The secondary data were analyzed, using SPSS, to determine changes in rates of readmission. Descriptive statistics were used to represent and compare changes in rates. After implementation of the nurse practitioner home visit program, the 30-day readmission demonstrated an 81.07% reduction and the 30-day readmission for exacerbation of COPD, CHF, and DM II was reduced by 36.77%. The project findings contribute to social change by identifying how a reduction in the frequency of hospitalizations could contribute to decreased health care expenses and improved health outcomes. Home care and chronic health care organizations, as well as advanced-practice nurses working in home care settings, may use the results of the study to establish effective community interventions that reduce health care costs.
6
Martin, Christine. "The lived experience of the aged care nurse." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1996. https://ro.ecu.edu.au/theses/959.
Повний текст джерелаАнотація:
The purpose of this phenomenological study was to describe and interpret the common, shared meanings of the experience of aged care nursing from the perspective of the registered nurse working in a nursing home. There are insufficient registered nurses being attracted into aged care, with resulting difficulties in maintaining regular staffing levels in nursing homes. Previous studies conducted in Australia have predominantly used quantitative research methods to investigate various influences QD the recruitment and retention of aged care nurses. These studies do not take into account the practitioners' perceptions of their experience of aged care nursing. A purposive sample of 15 registered nurses was interviewed and the resulting data were analysed using phenomenology to identify thematic structures of the experience of aged care nursing. The NUD.IST qualitative data analysis software package was used as an analysis tool. Significant statements were coded, patterns and relations between categories were identified and the categories were clustered into conceptual, hierarchical themes. Four major themes emerged as being central to the experience of aged care nursing-Gratification, Rapport, Non-productivity and Conflict. While constraints and obstacles to productivity and personal and political conflict may be seen as the negative aspects of aged care, these experiences were relieved by uplifting events described within the framework of resident care and rapport, and collegial support. The nature of aged care nursing is both complex and ambiguous but nurses have readily identified the interwoven threads of the experience. Findings from this study will increase the depth of understanding of aged care nursing and hence contribute to the development of a nursing home environment which enriches the experience of both nurse and resident.
7
Saenz, Mia Nicole, and Mia Nicole Saenz. "Home Care Nurse Practitioner Knowledge of Self-Care Management in Patients with Heart Failure." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/622940.
Повний текст джерелаАнотація:
Objective: The purpose of this project is to explore the depth of HF self-care management knowledge of home care NPs that will help improve patient HF management in New Mexico. Methods: A quantitative descriptive study design was used. Home care NPs (n=6) were recruited from the New Mexico Nurse Practitioner Council to participate in a 22-item survey on HF self-care management topics administered to participants via email. Results: Home care NPs' scores demonstrated at 74% knowledge base in overall heart failure self-care management education topics. NPs scored the lowest (0% answered correctly) in recognition of signs and symptoms of a worsening condition, sodium restrictions (50% answered correctly), weight gain (50% answered correctly), and hospital follow-up (50% answered correctly). Limitations of the study include a small sample size with inability to generalize results. Conclusions: Findings suggest that home care NPs may not be sufficiently knowledgeable in evidence-based HF self-care management education topics. Development of educational programs may be warranted to aid in the management of HF patients ultimately resulting in quality education for the patient. Further research is warranted to identify specific deficits and whether educational programs would enhance and maintain home care NPs knowledge of HF self-care management education.
8
Van, Roper Stephen. "Evidence Based Practice Among Primary Care Nurse Practitioners." Diss., The University of Arizona, 2011. http://hdl.handle.net/10150/217049.
Повний текст джерелаАнотація:
This study describes primary care nurse practitioner (PCNP) beliefs in, knowledge, implementation and utilization of evidence based practice (EBP). Research questions answered are: 1. What are the levels of belief, implementation, knowledge and utilization of EBP among PCNPs? 2. Is there a relationship with PCNP demographics (personal, professional, and practice), belief, knowledge, implementation and utilization of EBP? 3. Do PCNP demographics (personal, professional, and practice) and scores on belief, knowledge and implementation influence EBP utilization? EBP is considered a standard of care and essential to nurse practitioner practice. The primary advantages of EBP include improved quality of care through the utilization of patient resources, provider resources and experiences, current research and scientific information. However, few studies describe nurse practitioner beliefs, knowledge in EBP and the extent to which this may affect primary care nurse practitioners' (PCNP) utilization of EBP in their practice. Four questionnaires incorporated into one survey were used to examine PCNP beliefs, knowledge, implementation and utilization of EBP. JNC7 guideline knowledge and self-reported use was used to measure EBP utilization. A convenience sample of 202 FNPs, ANPs and GNPs were obtained during the American Academy of Nurse Practitioners National Conference 2011 in Las Vegas, Nevada. PCNPs surveyed were found to have a high level of belief in EBP but did not report implementing EBP more than 3 times in the past 8 weeks. Belief was statistically higher in doctorally prepared PCNPs. Ninety-five percent of the participants were familiar with the JNC7 guideline but the group scored a mean of 69% on knowledge of JNC7 guideline specifics. Only 25% of respondents indicated they utilized guidelines in hypertension management. Future studies should include quantitative and qualitative evaluation of EBP implementation facilitators and obstacles. Findings in this study have provided initial information to better understand PCNPs and EBP.
9
Lamb, Gerri S. "NURSE PRACTITIONER JUDGMENTS ABOUT INTERACTION AND PARTICIPATORY DECISION-MAKING IN PRIMARY CARE SETTINGS." Diss., The University of Arizona, 1987. http://hdl.handle.net/10150/184244.
Повний текст джерелаАнотація:
The purpose of the study was to test a theoretical model explaining nurse practitioner judgments about the amount of interaction and participatory decision-making between nurse practitioners and physicians. The specific aims of the study included: (1) to examine the influence of nurse practitioner perceptions of care complexity and expected benefit-cost ratio of physician involvement on interaction and participatory decision-making; (2) to test a theory that integrates two alternative explanations of amount of interaction and participatory decision-making derived from social exchange theory and technology theory; and (3) to investigate the effect of practice rules on the relationships in the theoretical model. The study used a mathematical correlational design with a causal modeling methodology for model testing. A convenience sample of 38 nurse practitioners participated. Major concepts in the model were measured using a four scale magnitude estimation instrument developed for the study. The instrument consisted of operational definitions for each of the concepts and a set of 18 clinical situations scaled according to care complexity. Psychometric properties of the instrument including stability, internal consistency, content and construct validity were estimated. Matching of responses across two modalities was used to validate the production of ratio level data. Multiple regression techniques were used for theoretical model testing. In the test of the theoretical model, both care complexity and expected benefit-cost ratio had a significant impact on the nurse practitioners' judgments about amount of interaction and participatory decision-making. Predictions derived from social exchange theory and technology theory were supported. The effect of practice rules on the relationships in the model could not be determined since the index of practice rules did not achieve an acceptable level of stability. Nurse practitioner judgments about interaction and participatory decision-making were influenced by perceptions of care complexity and expectations of the benefits and costs of interaction with a specific physician. An understanding of the factors that affect nurse practitioner judgments about interaction and participatory decision-making may be used to guide interventions that enhance the fit between these structures and outcomes of care.
10
Rys, Gregory Paul. "Nurse Practitioner Residency Programs: An Educational Journey." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2056.
Повний текст джерелаАнотація:
Primary care is in a state of crisis due to the lack of clinicians and increasing numbers of insured patients. Encouraging more students to go directly through school for their doctor of nursing practice degree and nurse practitioner (NP) certifications is one proposal to alleviate this crisis. However, this approach would deliver graduates with minimal leadership and clinical experiences directly into practice. One resolution to mitigate this concern would be an NP residency program. Evaluating the knowledge and attitudes of stakeholders prior to the implementation of a NP residency program is an important first step to this implementation plan. The purpose of this project was to assess the knowledge and attitudes about NP residency programs of 2 stake holders: administrators and NPs at a rural upstate New York health care system, Bassett Healthcare, and to compare responses of those fiscally with those clinically oriented. Using literature less than 6 years old about NP residencies, a 28-question survey tool was created to assess knowledge and attitudes of NP residency programs. Content validity was established by 6 hand-selected NPs and administrators who had expert knowledge of residency programs. Once validity was established, the tool was distributed to a convenience sample of NPs and administrators at Bassett Healthcare Network via e-mail. The sample included 20 administrators and 44 NPs. A Mann-Whitney U test revealed no statistical differences between the 2 groups on any item. However, a majority of both groups felt the programs should be mandatory for all NPs. This project may be the first step in formation of a NP residency program that could alleviate transitional stress, decrease turnover, and produce better clinically-prepared NPs, thus benefitting the profession and society.
11
Allnutt, S. Jane. "An Exploration of Three New South Wales Nurse Practitioner Services in 2008." Thesis, Australian Catholic University, 2018. https://acuresearchbank.acu.edu.au/download/10006e59ffd517c6e3c66eabe3a26a5a441eba18650548dca86fcf9b073f1ffb/4830225/ALLNUTT_2018_THESIS.pdf.
Повний текст джерелаАнотація:
Background
To control increasing health costs, the Australian government initiated a range of health care reforms in the late 1990s. In 2000, the development of the Nurse Practitioner (NP) Service in New South Wales (NSW) was one strategy implemented to improve health care delivery. Supported by legislation, NPs extended their role beyond other nursing roles. The number of NPs in NSW doubled between 2004 and 2007, and NP Services flourished. With little published evidence, research was vital to justify the contribution of this new and rapidly evolving service model to existing health services and the acceptability of the new service model to patients seeking health care. Through interviewing relevant stakeholders and a medical record audit, this study generated knowledge about both the integration of the NP Service with existing health services and patient perceptions of the NP Service.
Aim and Research Objectives
Aim:
Using an intrinsic case study design, the aim of this study was to gain an understanding of the early implementation of the NSW NP Service in 2008.
Specifically, this study sought to answer five research objectives:
1) To understand the physical environment and organisational characteristics of the NP Service.
2) To investigate the patient care provided by the NP Service.
3) To examine NPs’ views about their role and its integration into the existing health care team.
4) To investigate health professionals’ views about the NP Service and its integration into the existing health care team.
5) To examine the patients’ experiences of the NP Service.
Methods
Using Stake’s (1995) classification, this intrinsic case study design was conducted from November 2008 to April 2009. The case was the NP Service and three services were studied as embedded units. Three NPs from three different health services (a mental health NP working in an emergency department, an emergency NP working in the subacute area of an emergency department and a neonatal NP working in neonatal intensive care), who met the inclusion criteria of being authorised and endorsed nurse practitioners, were sampled by geographical and service diversity. Data sources included participant observation, interviews and medical record audit. Participant observation examined the physical and organisational characteristics of the NP Service. The NPs were interviewed about their role and integration with health care teams using face-to-face semi-structured interviews. Semi-structured interviews were also conducted with 5 health professionals and 5 patients per site, selected using maximum variation sampling, about their views and experiences of the NP Service. A medical record audit of 10 consecutive patients (included those interviewed plus an additional 5 patients per site) was undertaken following consultation with the NP, to identify the elements of care provided by the NP. Qualitative data (interviews and participant observation) were analysed using thematic analysis, triangulation and concept modelling. Medical record audit data were analysed descriptively. Enablers and constrainers to the implementation of the NP Service were identified. Results were compared and contrasted within and between the three sites.
Findings:
Medical record audit data showed that all three NPs engaged in therapeutic communication (96.7%), prescribed medications (80%) and referred patients for further assessment (73.3%). From thematic analysis, four themes emerged that reflected the concept of evolution: speciation, adaptation, co-operation and succession. Enabling factors that supported the implementation of the NP Service included the legislated protection of the NP title and scope of practice, and the development of standards of practice. The perceived overlapping boundaries between the NP and other colleagues on the health team were identified as constrainers during implementation. Findings were consistent across all three sites.
Conclusion:
This thesis provides new knowledge on the implementation and evolution of the NP Service in NSW. New knowledge includes support given (or withheld) to the NP Services, the physical environment and organisational characteristics of each service, the diversity of patient care provided, the perceptions of NPs and health professionals regarding integration of the NP Service with existing services, and patients’ understanding of their experience with the NP Service. NPs have worked through the stages of speciation and adaptation to define the scope and work differentiating them from their colleagues. Through co-operation with their colleagues NPs continue to define their specific contribution to the health care team, but they experience ongoing impediments to establishing succession, primarily due to organisational and fiscal constraints within the workplace. Two key recommendations from this study were the need for better communication with patients and health professionals about the role of the NP Service and the need to generate short and long-term workforce strategies to sustain NP Services. If the NP Service is to be viable in the future, health services need to develop comprehensive communication strategies to promote the role of the NP Service and establish strong and formal succession planning programs.
12
McDonald, Jacqueline. "Managing Diabetic A1C at a Primary Care Center: A Nurse Practitioner Perspective." NSUWorks, 2017. https://nsuworks.nova.edu/hpd_con_stuetd/53.
Повний текст джерелаАнотація:
Background: At a primary care center in Brooklyn, New York, approximately 27% of diabetic patients with abnormal Hgb A1C fail to return for follow-up appointments, as recommended by the Centers for Disease Control and Prevention (CDC). According to electronic medical records (EMR), healthcare providers demonstrated inconsistency in ordering and monitoring Hgb A1C and clinic follow-up appointments for patients.
Purpose: The purpose of this quality improvement project was to determine retrospectively the healthcare providers’ ordering, monitoring, and follow-up appointments for adult diabetic patients with abnormal Hgb A1Cs; to develop and implement astandardized process for healthcare providers to monitor and follow these patients, especially those with possible nonclinic follow-up compliance and abnormal Hgb A1C; to determine prospectively healthcare providers’ ordering, monitoring, and follow-up appointments; and to evaluate the prospective charts to determine if Hgb AIC results changed from abnormal to normal or elevation over time until the next follow-up appointment.
13
Berglund, Carolyn. "Nursing Staff Development for Novice Nurse Practitioners in Acute Care." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6401.
Повний текст джерелаАнотація:
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 electronic
databases, reviewing professional organization websites, and consulting with experts.
The search revealed journal articles, best-practice guidelines, and useful insights from
experts. The Elkins literature review matrix was used to organize, summarize, and weigh
the evidence. A summary of consultations with experts was used. Commonalities within
the evidence included guided clinical experiences and nonclinical activities such as (a)
formal didactic sessions, (b) professional development, and (c) quality improvement.
Outcomes include recommendations for a 12-month postgraduate development program
framework and educational content. Recommendations were also provided for formative
and summative evaluations. The implications of this project for social change include
effective preparation of novice NPs and stabilization of the NP workforce at the project
site.
14
Nuttall, Craig, and Craig Nuttall. "Development of an Education Module on Concussions in Youth for Primary Care Nurse Practitioners in Utah." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/622925.
Повний текст джерелаАнотація:
Background: Sports-related concussions (SRC) are very common in youth in the US and represent a major clinical challenge. Clinical Practice Guidelines (CPG) have been developed to help guide the health care provider (HCP) in the diagnosis and management of SRC. Seventy-three percent of HCPs report that they deviate from current concussion CPGs in their clinical practices. The Protection of Athletes with Head Injuries Law in Utah requires HCPs caring for youth with concussions receive continuing education (CE) regarding SRC every three years. Currently, there are no CE modules on SRC developed for nurse practitioners (NPs) in the state of Utah. Project Purpose: The purpose of this DNP project was to develop and pilot an evidence-based educational module for primary care NPs in Utah on the evaluation and management of SRC in children and adolescents under the age of 18 years old. Methods: The education module integrates the concussion education curriculum developed by Pamela Mapstone DNP, PCNP. The module incorporates current CPGs and an extensive literature search. Following development of the module three clinical experts in SRC independently reviewed the module. Modifications were made accordingly and a pilot study evaluating the quality and usability of the education module was conducted. Sixteen NPs working in Utah were invited to complete the module followed by a short survey related to user satisfaction. The final version of the education module was modified based on the results of the pilot study. Results: An education module on SRC in youth for NPs working in primary care in Utah was successfully developed and piloted for quality and usability. The results of the pilot study support the content addressing the learning objectives; and that the module was easy to use. Conclusion: The education module tailored to the needs of NPs working in primary care in Utah has the potential to improve NPs’ knowledge of SRC in youth. Further study is recommended to evaluate the effects of the education module on clinical practice outcomes.
15
Rowand, Leanne Christine. "Primary Care Nurse Practitioners and Organizational Culture." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4169.
Повний текст джерелаАнотація:
Nurse practitioners (NPs) were introduced to the British Columbia healthcare system 12 years ago. Integration challenges related to infrastructure and relationships between administrators and physicians continue. The purpose of this project was to understand how nurse practitioners, working in primary care roles, experience the organizational climate within their healthcare agency. Kanter's empowerment theory guided this project. Data were collected using the Nurse Practitioner Primary Care Organizational Climate Questionnaire. A total of 64 NPs relayed their degree of perceived organizational support. NPs scored highest on Autonomy and Independent Practice (Mean [M] = 3.54, Standard Deviation [SD] = 0.59). Organizational Support and Resources and NP-Physician Relations were comparable (M = 3.00, SD = 0.86; M = 2.98; SD = 0.73). NPs scored lowest on Professional Visibility (M = 2.74, SD = 0.76) and NP-Administration Relations (M = 2.63, SD = 0.79). Recommendations included optimization of NPs as advance practice nurses, establishing adequate administrative and clinical support, provision for interprofessional team development and function, distribution of standardized information about the NP role across and within institutions, and further exploration of NPs' experiences related to work hours and agency culture. Positive social change was supported as the NP practice model was extended throughout the current health care system, contributing to the shifting health care narrative/culture (from illness-focused care to wellness-focused care), and demonstrating full appreciation of patient/client-centeredness.
16
Williamson, Graham Richard. "Developing lecturer practitioner roles in nursing using action research." Thesis, University of Plymouth, 2003. http://hdl.handle.net/10026.1/414.
Повний текст джерелаАнотація:
The lecturer practitioner role in nursing is widely seen as offering hope for the future of nurse education, by overcoming the 'theory-practice gap', and establishing and maintaining effective links at many different levels between education and practice. It is clear, however, that there are a number of issues of concern about the role. These can be summarised as: lack of role clarity about overcoming the theory-practice gap; varying conceptions of the role and unclear job descriptions; and role conflicts and overload, from the conflicting demands of service and education settings Despite current political support for strengthening the links between higher education institutions and practice settings, a new governmental emphasis on the support of students in practice, and a growing in-depth evaluative literature about the role, there is no research examining its systematic development, or measuring and addressing aspects of lecturer practitioners' occupational stress and burnout. Initial project planning work found that lecturer practitioners perceived themselves as 'adding value' to education provision, with personal and professional gains for postholders. However, their key concerns were: absence of role clarity; absence of effective joint review/appraisal;a bsenceo f formal support In, order to develop and address aspects of lecturer practitioners' work roles and their employment position, this action research project was established. Using a spiral methodological framework, and a multi-methods approach to data collection to triangulate the findings, new knowledge about lecturer practitioner roles was uncovered, and employment practices were developed as a result. The project established three new mechanisms, and these outcomes can be summarised as: joint appraisal policies and materials; orientation/induction policies and materials; group support network. In addition, previously validated measures of occupational stress and burnout were used to meas. ure those conceptsi n this group of lecturer practitioners, and the impact of the project. They were found to be generally no more stressed or burnt out than comparable workers, and the project was unable to demonstrate statistically significant differences in beforeand after-scores. Synthesis of quantitative and qualitative findings indicates that these LPs were 'thriving rather than just surviving'.
17
Martin-Misener, Ruth. "A case study on the nature of primary health care nurse practitioner work." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0021/MQ57241.pdf.
Повний текст джерела
18
Anderson, Helen. "Professional identity and the advanced nurse practitioner in primary care : a qualitative study." Thesis, University of York, 2017. http://etheses.whiterose.ac.uk/17287/.
Повний текст джерелаАнотація:
Background: Health professional roles are being adapted in response to increased demand and declining medical workforces, both in England and internationally. This is exemplified by advanced nurse practitioners (ANP) in primary care. However, evidence suggests ANP practice may lack acceptability and understanding, leading to underutilisation. Professional identity (how colleagues are perceived by themselves and others) may influence how professionals work together to utilise such roles. Previous research has explored ANP professional identity during transition and in isolation from workplace cultures. Less is known about relationships between professional identity and established ANP practice within primary healthcare teams, or how ANP practice is affected by workplace cultures. Wider societal level influences have not been fully explored. This study aimed to explore the relationship between professional identity and ANP practice in a context where ANP practice was established. Methods: The study consisted of a qualitative cross-sectional study which explored professional identity of ANPs on a sample of general practice websites. Then the relationship between professional identity and ANP practice was explored, in-depth, in an ethnographic study of two general practices in England. Findings: ANPs lacked visibility on general practice websites. Both studies found ANPs were framed within a traditional nursing identity. This impacted on ANP practice and has implications for how professionals and the wider public understand ANP roles. Individual characteristics and interactional relationships were central to acceptance and utilisation of ANPs within the workplace, but were limited by broader societal level understanding of professional identities. ANPs negotiated their place within the workforce by utilising established understanding of professional identity. Intra-professional tensions were identified between ANPs and nursing. Conclusions: Professional identity is a useful framework within which to develop contextual understanding of ANP practice. Primary healthcare team members utilised shared understanding of professional identity to shape ANP roles, which both supported and inhibited ANP utilisation.
19
Hummer, Kirk A. "Assessing the Lived Experience of the Family Nurse Practitioner in Urgent Care Practice." Otterbein University / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1368536937.
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20
Rejzer, Courtney Brynne. "The influence of the acute care nurse practitioner on healthcare delivery outcomes : a systematic review /." Full-text of dissertation on the Internet (211 KB), 2009. http://www.lib.jmu.edu/general/etd/2009/Honors/Rejzer_CourtneyB/rejzercb_honors_11-11-2009.pdf.
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21
Carlsen, Stephanie Ann. "Identifying Practice Barriers to Use of Adult Gerontology-Acute Care Nurse Practitioners in the Northern Nevada Region." Diss., The University of Arizona, 2015. http://hdl.handle.net/10150/578410.
Повний текст джерелаАнотація:
The number of adult gerontology acute care nurse practitioners is increasing, as well as the number of patients requiring care in the northern Nevada region. The specialty training of adult gerontology nurse practitioners (AGACNPs) enables them to provide care for the increasing number of patients in the acute setting. Unfortunately, there are perceived barriers that inhibit the implementation of AGACNP into practice within this region. There is a need to understand the barriers to use of AGACNPs and provide feedback to organizational leaders throughout the region. Purpose and Objective: While many studies show the benefits of adding AGACNPs or nurse practitioners in general to an organization, there is a need for further literature on the evidence of the barriers to AGACNP use. This study attempts to identify those barriers, specifically looking into the northern Nevada region. Methods: A survey was sent out to 19 hospital and critical care group administrators in the northern Nevada region. There was an attempt made for phone interviews, if the survey was not completed during the allotted timeframe. The survey consisted of both quantitative and qualitative questions that were used to identify potential barriers influencing AGACNP role use. Results: Out of the 19 surveys sent out, six surveys were returned. A total of six surveys from six different organizations were completed for this study. Five of the six respondents do not currently have any AGACNPs within their organizations and the one that did use AGACNPs had less than 10. Four out of six respondents reported confusion on scope of practice as a current barrier to use within their organization. Conclusions: This survey helps AGACNPs understand the barriers to use within the northern Nevada region when looking for an acute care job. For the organizations in the northern Nevada region, there is a need for organizational education regarding the scope of practice of AGACNPs and how to utilize them within their organization, as well as create an effective collaborative practice model for their acute care organization.
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Tidwell, Justin, and Justin Tidwell. "Attitudes, Knowledge, and Skills among Nurse Practitioners Providing Care to Transgender Patients." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/624540.
Повний текст джерелаАнотація:
Context: The transgender community experiences excessive discrimination in in healthcare. Data continue to reveal that health care providers lack sufficient knowledge in transgender health, as well as difficulty in referring individuals to competent providers, to ensure the continuum of care (Brennan, Barnsteiner, Siantz, Cotter, & Everett, 2012; Cruz, 2014).
Methods: A modified Cross-Cultural Care Survey consisting of 56 questions was implemented via Qualtrics to 1,134 nurse practitioners (NPs) in the California Association of Nurse Practitioner to measure their cultural competence through the domains of attitude, knowledge, and skill.
Results: Completed responses were obtained from 30 out of 38 NPs (78.9%). Knowledge was positively correlated with Skills (Pearson's r = .688, p < .001); negatively correlated with Negative Attitude (Pearson's r = -.458, p = .011) and positively correlated with Positive Attitude (Pearson's r = .371, p = .043). Skills was positively correlated with Positive attitude (Pearson's r = .646, p < .001); however, the negative correlation between Skills and Negative Attitude was not statistically significant at the .05 level (Pearson's r = -.345, p =.062). There was a negative correlation between Negative Attitude and Positive Attitude, but this correlation was only marginally not significant at the .05 level (Pearson’s r = -.358, p = .052).
Conclusion: The results indicated that the balance between skills and negative attitudes may have created a barrier to care in transgender patients.
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Barnes, Ellen Sue M. "Perceived Importance of the Characteristics and Functions of the Advanced Nurse Practitioner." Thesis, North Texas State University, 1987. https://digital.library.unt.edu/ark:/67531/metadc330779/.
Повний текст джерелаАнотація:
The purpose of this study was two-fold: to identify role functions and characteristics perceived as important to Advanced Nurse Practitioners (ANPs) in Texas, and to identify differences in perceived importance of role functions and characteristics of ANPs according to gender, educational preparation, practice setting, and whether the practitioner entered practice before or after the current rules and regulations for ANP practice were adopted. Two questionnaires and a demographic data form were mailed to 300 ANPs in primary health care in Texas, with 152 responding. Data from the questionnaire, "Characteristics of the Advanced Nurse Practitioner," were analyzed using independent group t-tests. The findings indicated that the characteristics "person-oriented," "perceptive," and "skilled in problem-solving" were the most valued by the practitioners, while aggressive" was the least valued. Independent group t-tests were used to analyze data from the instrument, "Advanced Nurse Practitioner Functions." The results of this analysis were not significant. The Chi square test was used to further examine data from this questionnaire to determine if the responses differed from chance. With the exception of four items, all of the responses differed significantly from chance. The responses "extremely important or important" were selected significantly more frequently that any of the other options. Not appropriate," was selected significantly more often than could be expected by chance for two functions: suturing minor lacerations and performing incision and drainage of wounds. Fourteen functions were examined further using frequency, percentage of responses, and the Chi square test to determine if there were differences in responses between groups. There were significant differences in responses between ANPs in nurse-managed settings and those in physician-managed settings on four functions: ordering diagnostic tests, prescribing medications in consultation with a physician, suturing minor lacerations, and performing incision and drainage of wounds. Practice setting and educational preparation were the variables which had the greatest impact on perceived importance of the characteristics and functions to ANP practice.
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Cyr, Julia Anne, and Julia Anne Cyr. "Evaluation of a Nurse Practitioner Led Program on Decreasing Emergency Room Visits." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/626651.
Повний текст джерелаАнотація:
Background: The overuse of the emergency department (ED) for non- critical patients has been associated with overcrowding and a rise in healthcare cost. Green Valley Fire Department (GVFD) has created a program, Fire-Based Urgent Medicals Service (FBUMS) with a nurse practitioner (NP). Patients can call 9-1-1 or the ""NP hotline"" and request to be seen by the NP instead of being immediately transported to the hospital via ambulance.
Purpose: The purpose of this project is to evaluate the impact of the nurse practitioner led FBUMS, on ED visits and ambulance transports.
Methods: A survey was mailed to all persons, age 18 and older, who were seen by the NP with FBUMS between February 2017 and March 2017. The survey asked about the reasons for contacting GVFD, the type of treatment received, and whether they went to ED after treatment.
Data analysis: Descriptive statistics including frequencies, percentages, means and standard deviations were used to analyze each of the answered survey questions in Microsoft Excel©.
Results: Surveys completed (n=42). The majority, 39 (92.9%) stated they did not receive care at the ED within 72 hours following their appointment with the NP, three (7.1%) stated they did. By dramatically decreasing transport to the hospital and associated ED treatment, it is estimated to have saved approximately $53,425 in ambulance costs and $54,210 in ED treatment for a total savings of $99,632.52.
Conclusion: A Fire-Based Urgent Medical Service led by a nurse practitioner decreased emergency room visits and ambulance transports.
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Novotny, Jacqueline. "A General Design Methodology for Postpartum Nurse Practitioner-Led Clinics." Thesis, Université d'Ottawa / University of Ottawa, 2021. http://hdl.handle.net/10393/41857.
Повний текст джерелаАнотація:
Having a newborn can be a big change for families, especially for first-time parents. At hospital discharge, parents are often provided with a lot of information, which can be difficult to retain. Due to shortened postnatal lengths of stay, nurses typically have less time to educate parents, which often results in families feeling overwhelmed. After hospital discharge, it is recommended for families to see a health care provider (i.e., physician, nurse practitioner, or registered midwife) within 72 hours for a follow-up appointment. This follow-up appointment is meant to assess both the mother and newborn to ensure they are both in good health and to provide any needed support. Unfortunately, completing the appointment within this timeframe may not be possible for every family or they may not be aware of its importance. Depending on the family’s model of care, completing the follow-up appointment within 72 hours after hospital discharge can be challenging. Families that have a physician as their health care provider may experience delays in scheduling the follow-up appointment. This can be due to the physician’s lack of availability, as there is a physician shortage in most communities. Furthermore, some families do not have access to a health care provider and, therefore, do not see a care provider after hospital discharge. Completing the follow-up appointment later than when it is recommended, or not at all, can result in negative health consequences for the mother and newborn and can also increase re-admission hospital rates and related costs (Cargill et al., 2007). At the moment, postnatal lengths of stay are shortening but the service delivery has not changed to accommodate this trend (Lemyre et al., 2018). This means that the services typically provided to families in the hospital now need to be provided in the community. The follow-up appointment after hospital discharge is an opportunity to provide these services; however, timely access to a health care provider, specifically a physician, can be challenging. Thus, this thesis explores the development of a general design methodology for a postpartum nurse practitioner-led clinic. The aim of the clinic is to provide timely access to any family that needs to complete the necessary postpartum services after hospital discharge within a community. An analytical model was developed to explore the characteristics of a postpartum nurse practitioner-led clinic and how it would operate (i.e., what services would be offered, the amount of time needed for these services, what is needed to offer these services, etc.). The model conducts a simulation of the appointment scheduling process based on the input values entered into it and evaluates a number of performance metrics (e.g., number of diversions, patient wait times, resource idle time, clinic overtime, number of appointments provided within 72 hours and number of appointments provided beyond 72 hours). The findings from the model can support the potential implementation of a postpartum nurse practitioner-led clinic in any community. Implementing such clinics could increase awareness, further educate parents and increase access to postpartum services.
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O'Rourke, Tammy. "Stakeholder Participation in Primary Care System Change: A Case Study Examination of the Introduction of the First Nurse Practitioner-Led Clinic in Ontario." Thèse, Université d'Ottawa / University of Ottawa, 2013. http://hdl.handle.net/10393/24277.
Повний текст джерелаАнотація:
Purpose: To examine stakeholder participation in the primary care system change process that led to the introduction of the first Nurse Practitioner-Led Clinic in Ontario.
Design: Qualitative case study guided by the principles of stakeholder and system change theory.
Setting: Northern Community in Ontario, Canada.
Participants: Purposeful sample of healthcare providers, healthcare managers and health policy stakeholders.
Procedures: This case study was bound by place (Sudbury), time (January 2006–January 2008), activity (stakeholder participation), and process (introduction of an innovation, the first Nurse Practitioner-Led Clinic in Ontario, during a primary care system change). Semi-structured individual interviews were conducted with participants who represented the clinic, the local community, and the province. Public documents, such as newspaper articles published during the 2 year time boundary for this case and professional healthcare organization publications, were also examined. Interviews were analyzed using qualitative content analysis and public documents were reviewed for key messages to complement the interview findings. Field notes written during data collection and analysis were used to provide additional depth, contribute insights to the data, and ascribe meaning to the results.
Main Findings: Sixteen interviews were conducted with key stakeholders. Twenty public documents which yielded the most specific information relevant to the case study time boundaries and activities were selected and reviewed. Six main themes are reported: felt need, two visions for change (one for a Nurse Practitioner-Led Clinic and one for Family Health Teams [FHTs]), vision processes related to ensuring the visions became or continued to be a reality in Ontario’s healthcare system (shaping, sharing, and protecting the vision), stakeholder activities, and sustaining and spreading the vision.
Conclusions: In this case, stakeholder participation influenced policy decisions and was a key contributor to the primary care system change process to introduce the first Nurse Practitioner-Led Clinic in Ontario. Stakeholders are motivated by various needs to engage in activities to introduce an innovation in primary care. One of the most common needs felt by both those who supported the introduction of the first Nurse Practitioner-Led Clinic and those who were opposed to it was the need for improved patient access to primary care.
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Kilpatrick, Kelley. "Perceptions of team effectiveness following the introduction of a cardiology acute care nurse practitioner role." Thesis, McGill University, 2010. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=94931.
Повний текст джерелаАнотація:
Background: Cardiology acute care nurse practitioners (ACNP) enacting their roles in health care teams faced a number of challenges including a mix of positive and negative views of the ACNP role from health care team members, ACNP roles crossing the boundaries between the medical and nursing professions, and an expanded scope of practice that was not clearly defined. Understanding the process by which ACNP roles were enacted in teams is important since the boundaries between professions may change following the introduction of an ACNP role and affect the team's perceptions of its effectiveness. Little is known of how ACNP role enactment affects the team's perceptions of its effectiveness. Objectives: Following the introduction of a cardiology ACNP role in the health care team, the study aims to: 1) describe ACNP role components, 2) describe ACNP role enactment, and 3) explore how ACNP role enactment and boundary work of team members affect the team's perceptions of team effectiveness. Methods: The study was conducted in two university-affiliated teaching hospitals in Quebec. A descriptive multiple case study design with qualitative and quantitative data sources was used. The study produced a valid and reliable time and motion tool to measure cardiology ACNP activities. The study used Bales' interaction process analysis to identify differences in patterns of communication among team members. Findings: Team members believed they were more effective following the introduction of an ACNP role because the ACNP role filled a gap in patient care and improved team processes. The ACNP role components that were enacted were sensitive to the surrounding context and responsive to the needs of team members and patients. The patterns of communication among team members were aligned with the structural dimensions surrounding the team. A conceptual framework was developed. It highlighted the key inter-related dimensions and concepts that different stakeholderContexte : Les infirmières praticiennes spécialisées (IPS) en cardiologie qui exercent leur rôle au sein des équipes soignantes rencontrent certains défis. Des points de vue tant positifs que négatifs sont exprimés par les membres des équipes soignantes à l'égard du rôle même de l'IPS, du développement d'un rôle qui traverse les frontières entre les professions médicale, infirmière et autres professionnels et des modalités de pratique élargies non clairement définies. Par conséquent, il importe de comprendre le processus par lequel la pratique des IPS s'intègre aux équipes soignantes et bouleverse les frontières interprofessionnelles, et comment la présence des IPS influe sur les perceptions d'efficacité des équipes soignantes. Nous disposons de peu de données sur la relation entre le rôle des IPS et les perceptions d'efficacité des membres des équipes soignantes. Objectifs : Suite à l'introduction d'IPS en cardiologie au sein d'équipes soignantes, l'étude vise à : 1) décrire les composantes du rôle des IPS en cardiologie, 2) décrire le processus de développement du rôle des IPS, et 3) explorer comment ce processus et les changements au niveau des frontières interprofessionnelles entre les membres de l'équipe influencent leurs perceptions d'efficacité. Méthodologie : Nous avons réalisé une étude de cas multiples dans deux hôpitaux universitaires au Québec. Cette étude s'appuie sur des données qualitatives et quantitatives. Un outil de mesure des temps et mouvements valide et fiable a été développé afin d'étudier les activités des IPS en cardiologie. De plus, le système d'analyse des processus d'interaction de Bales a été utilisé pour identifier des modes de communications entre les membres des équipes. Résultats: Les membres des équipes soignantes estiment que l'introduction des IPS a amélioré leur efficacité parce qu'elles comblent une lacune en matière de soins aux patients et qu'elles per
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Knopp, Jennifer Ann. "A comparison of nurse practitioners versus physicians in managing ambulatory infectious diseases of children, ages 1 to 5, in primary care." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ60404.pdf.
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Barratt, Julian. "A case study of the nurse practitioner consultation in primary care : communication processes and social interactions." Thesis, London South Bank University, 2016. http://researchopen.lsbu.ac.uk/476/.
Повний текст джерелаАнотація:
Background: Nurse practitioners are increasingly conducting consultations with patients on the same basis as medical doctors. However little is known about communication within nurse practitioner consultations. Research on communication in nurse practitioner consultations has identified nurse practitioners communicate with patients in a hybrid style, combining biomedical information with the discussion of subjective information from everyday life. Research has not fully explained why this hybrid style occurs in nurse practitioner consultations, nor determined its links to consultation duration, patient expectations, satisfaction, and enablement. This study was developed to address these gaps in research of communication in nurse practitioner consultations. Aim: This study aims to advance understanding of the discrete nature of the communication processes and social interactions occurring in the nurse practitioner consultation, including explicating the reasons for the occurrence of the particular communication processes and interaction styles observed in those consultations. Methods: The study was conducted in a nurse-led primary care clinic providing general practice care. Within a case study research approach mixed methods were utilised, combining structured analysis of video recorded observations of nurse practitioner consultations, questionnaire-based measures of patient expectations, satisfaction, and enablement, and interviews with some of the participants of the consultations. The sample for video recording comprised three nurse practitioners employed at the clinic, and 30 patients registered at the clinic. Questionnaire responses were provided by 71 patients, including 26 whose consultations had been video recorded. All three nurse practitioners participated in post-consultation individual interviews, and 11 patient / carers participated in post-consultation individual interviews. The video recorded consultations were analysed with the Roter Interaction Analysis System (RIAS), a method of quantified interactions frequency analysis. The questionnaire responses were analysed with descriptive statistics. Transcripts of the interviews were analysed using computerised qualitative data analysis with NVivo. Findings: A significant majority of observed social interaction in the consultations used patient-centred communication styles (p=0.005), with neither nurse practitioners nor patients or carers being significantly more verbally dominant. Nurse ii practitioners guided the sequence of consultation interaction phases, but patients and carers participated through asking questions and involvement in negotiations for care planning. Patient / carers were highly satisfied with their consultations, and significantly higher general satisfaction was noted when participants expected the nurse practitioners to be able to diagnose their presenting problem (p=0.043). Patient / carers expressed significantly higher levels of enablement than have been seen in previous studies of enablement with other types of clinicians (p=0.003). The mean consultation time length of 10.97 minutes is comparable with studies of general practitioners. The participants’ perceptions of nurse practitioner consultation communication processes and social interactions were represented through six themes; Consulting style of nurse practitioners; Nurse practitioner – GP comparisons; Lifeworld content or lifeworld style issues; Nurse practitioner role ambiguity; Creating the impression of time; and Expectations for safety netting. Contribution to knowledge: This study reveals nurse practitioner consultations comprise collaborative openness to peoples’ agendas and questions, expressions of everyday lifeworld experiences, expanded impressions of time, clear explanations augmented by integrated clinical reasoning, and participatory negotiations. These communicative features arise from a combination of social, ideological, and epistemological factors, prompting nurse practitioners to privilege how they interact with patients and carers, and to adopt a hybrid patient-centred style combining the nursing ideology of holism and their knowledge of biomedicine. This form of communication has been characterised as a stylistic exemplar for good consultation communication practice, which potentially facilitates shared decision-making. This research has resulted in new knowledge of the communication processes and social interactions used in nurse practitioner consultations, which demonstrates the importance of clinicians giving precedence to how they communicate and interact with patients so as to optimise their therapeutic outcomes without compromising the duration of consultations.
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Campbell, Kami S. "Enhancing Interest and Knowledge of How to Start a Nurse Practitioner-Led Clinic." Otterbein University / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1461151661.
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Revely, Shirley. "Introducing the nurse practitioner into a group general medical practice : operational and theoretical perspectives on the role." Thesis, Lancaster University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.310358.
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Farus-Brown, Susan Janette. "Prevention, Recognition, and Treatment of Pediatric Obesity in the Ambulatory Care Setting." Otterbein University / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1399452773.
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Birch, Michele Renee, and Michele Renee Birch. "Reducing Hospital Readmissions Using a Nurse Practitioner Led Interprofessional Collaborative Management Model of Caring: A Feasibility Study." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/626637.
Повний текст джерелаАнотація:
The purpose of this DNP project was to determine the feasibility of implementing a nurse practitioner led interprofessional collaborative management model of caring for patients with complex medical conditions who are at high risk for ED and hospital readmission. The target of the feasibility study was an accountable care organization (ACO) in Idaho. The ACO assumes greater financial risk for providing care to a population that includes Medicare Advantage patients - dual insured Medicare/Medicaid patients. The care management teams are currently led by physicians.
The members of the population that suffer most from multiple chronic conditions often encounter barriers to accessing high quality primary care, in particular when transitioning between different levels of care. Interprofessional collaborative team based care coordination can address medical and social issues that can affect a patient’s ability to achieve/maintain wellness. The literature suggests that nurse practitioners are ideally suited to lead those teams
Approval was given by leadership in the ACO to accomplish a study to determine the feasibility of successfully implementing an innovative NP led interprofessional collaborative care management model: the AEIØOU Bundle of Care Practices. Principles of qualitative descriptive methodology, using content analysis, were applied to explore the responses provided at individual interviews by thirteen key stakeholders. The data collected were not intended to be generalized, but rather to evaluate the potential for implementation of a new model of interprofessional collaborative care within the ACO.
Findings suggest that implementation of this model is feasible within the ACO. Common themes uncovered include: (a) change is challenging, (b) coordinated patient care aligns with organizational goals, (c) success requires cost analysis, a comprehensive business plan, buy-in from primary care physicians, and a pilot program, and (d) strong support among all participants for NP and RN home visits was notable.
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Housden, Laura Michelle. "Examining the impact of nurse practitioner-led group medical visits for patients with chronic conditions in primary care." Thesis, University of British Columbia, 2016. http://hdl.handle.net/2429/60176.
Повний текст джерелаАнотація:
The aging Canadian population, increasing incidence of chronic conditions, and rising healthcare costs have contributed to concerns that the current healthcare system may not meet healthcare needs. Canada has sought innovative ways to meet patients’ healthcare needs through reforms such as group medical visits (GMVs) and care by nurse practitioners (NPs). While studies have shown that care with NPs and GMVs is effective, there is limited evidence examining how NPs engage in innovative care delivery. The purpose of this study was to examine the impact of NP-led GMVs for patients with chronic conditions in primary care. This study used multiple methods, including a systematic review and meta- analysis and a multisite case study (N=3). The systematic review and meta-analysis included studies published between 1947 and 2012 for patients with type 1 or 2 diabetes who attended GMVs. Of the 94 studies identified, 13 met final inclusion criteria. Group medical visits had a positive effect on clinical and patient-reported outcomes, with significant reductions in glycated hemoglobin (HbA1c reduction −0.46%, 95% confidence interval −0.80% to −0.31%).
The case study consisted of two cases where NPs were using GMVs and one where NPs were not using GMVs. Open-ended interviews with patients (N=12), providers (N=14) and 10 hours of direct observation were completed. Analysis of the data suggests that GMVs facilitated an environment that was patient centered, interprofessional and increased patients’ confidence managing chronic conditions. Furthermore, the processes of care within the GMVs disrupted power differentials in primary care, between patients and providers and amongst healthcare providers.
Yet, these same power differentials constrained NPs’ ability to adopt GMVs, with NPs indicating that they had limited agency to diffuse healthcare innovations. Unique contributions of this study were a systematic review and meta-analysis of GMVs among those with diabetes and new knowledge on how power differentials influence the diffusion of innovations in primary care. These findings demonstrate that GMVs provide opportunities to meet clinical, team-based, and patient-centered healthcare objectives. Ongoing research that considers the context of practice environments, power differentials, and conditions that limit NPs ability to diffuse healthcare innovative is needed.Applied Science, Faculty of
Nursing, School of
Graduate
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Stock, Nancy Jean. "A Transition-to-Practice Residency That Supports the Nurse Practitioner in a Critical Access Hospital." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/404.
Повний текст джерелаАнотація:
Access to health care in rural communities is challenged by workforce shortages. Nurse practitioners (NPs) have been filling the gap created by physician migration into specialty areas. Flex hospital legislation allows critical access hospitals (CAHs) to staff the emergency department with NPs or physician assistants without on-site physicians. NP education often lacks emergency and trauma curriculum, resulting in gaps in education and practice expectations and leading to significant role transition stress and turnover. The purpose of this project was to construct an evidence-based transition-to-practice residency program to support NPs providing emergency department care in the CAH. Theoretical frameworks used to guide the project include rural health theory, novice to expert, and from limbo to legitimacy frameworks. Global outcomes include increased quality of care, patient safety, NP job satisfaction, and decreased turnover. The quality improvement initiative engaged an interprofessional team of institutional and community stakeholders (n = 10) to develop primary products including the residency program, curriculum modules, and the secondary products necessary to implement and evaluate the project. Implementation will consist of a pilot followed by expansion throughout the rural health network. Evaluation will involve the CAH dashboard to monitor patient outcomes, Misener NP job satisfaction scale, and employee turnover rates. The project expands understanding of the on-boarding needs of rural NPs. The results of this project will serve as a guide to publish outcome data and collaborate with higher education to develop programs to award academic credit for paid clinical experiences leading to academic degrees.
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Mitchell, Robyn R. "Nurse Practitioner Use of Thoracic Pocus Using a Handheld Ultrasound Device in the COVID-19 Pandemic." Kent State University / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=kent1615666639927353.
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McLaughlin, Sarah J. "Nurse Practitioners' Discussion Of Sexual Identity, Attraction And Behavior." ScholarWorks @ UVM, 2016. http://scholarworks.uvm.edu/graddis/443.
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ABSTRACT
Background: Sexual orientation is comprised of distinct components, including sexual identity, sexual attraction and sexual behavior. Lesbian, gay and bisexual adolescents are at an increased risk of experiencing poor health outcomes compared to non-sexual minority youth. Health care professional organizations recommend that health care providers discuss each component of sexual orientation at every adolescent health supervision visits in order to best assess the adolescent's health risks and needs for intervention and education.
Objective: This survey assessed the frequency with which nurse practitioners (NPs) in the state of Vermont discussed sexual identity, attraction and behavior with adolescents during annual health supervision visits.
Design: A cross sectional study that analyzed descriptive statistics of a small convenience sample of Vermont NPs.
Setting and Participants: Attendees of the Vermont Nurse Practitioner Association 2015 annual conference. Participants in the study were licensed, practicing NPs in the state of Vermont responsible for the health supervision of adolescents.
Results: Participants were overwhelmingly female (93%), with a median age between 40-49 years old, and a median length of years in practice of six to ten years. Sixty-two percent of respondents specialized in family practice. Respondents reported that they always asked adolescents about the sex of sexual partners at 49% of health supervision visits. Respondents always discussed sexual attraction and sexual identity at 31% and 24% of health supervision visits, respectively. Twenty percent of respondents reported rarely or never discussing sexual attraction, and 38% reported rarely or never discussing sexual identity.
Conclusions: The Vermont NPs who participated in this survey were demographically similar to national NP cohorts. Vermont NPs discussed the adolescent's sexual behavior at health supervision visits as frequently as health care providers nationally, and Vermont NPs discussed sexual attraction and sexual identity more frequently than providers nationally. However, Vermont NPs discussed sexual attraction and identity much less frequently than they discussed sexual behavior. Results of this survey illustrate that there is substantial room for improvement regarding the frequency with which Vermont NPs discuss the three components of sexual orientation with adolescents, particularly the components of sexual identity and attraction.
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Rees, Sharon. "The role of nurses in general practice: general practitioners' and practice nurses' perceptions." University of Southern Queensland, Faculty of Sciences, 2004. http://eprints.usq.edu.au/archive/00001489/.
Повний текст джерелаАнотація:
The role of nurses in general practice: General Practitioners' and Practice Nurses' perceptions is a study that identifies the beliefs of Practice Nurses (PNs) and General Practitioners (GPs) of the PN role and how those roles impact on the general practice. Ethnographic techniquess were used for this study, with data collected through interviews, observation and questionnaires. Interviews were conducted with four PNs and four GPs in practices that employed nurses in an increased role similar to that described in the Nursing in General Practice Fact Sheets (Royal College of Nursing Australia, 2002). Two practices were observed to identify work practices and the nurses' interaction within the practice. The main finding of the study was the importance placed on the general practice team. Both GPs and PNs believed that working as a team was vital. They indicated that working together provided holistic care and enabled the practice to provide quality care. The role of the PN in this study was consistent with other studies in Australia. However, the nurses in this study appeared to have more autonomy in regard to care of people with chronic illness and the aged. Continuing education was considered important for the further development of the PN role. However, participants believed that the PN also needed to have considerable and varied experience together with good people skills. To further develop the PN role innovative ways of providing education to PNs should be investigated to ensure nurses have the necessary skills to undertake their role. Payment issues in general practice should also be examined and addressed to ensure that PNs are able to be employed, and receive remuneration appropriate for their experience and job description.
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Wilson, Kendra Marie. "Improving the Rate of Diabetes Preventative Care Practices in a Nurse Practitioner Owned Family Clinic: A Quality Improvement Project." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/612952.
Повний текст джерелаАнотація:
Background: Type 2 diabetes mellitus (T2DM) is a complex health condition that impacts multiple organ systems and contributes to both acute and chronic health problems. In the United States (U.S.), T2DM is a growing health concern with increasing prevalence among both adult and pediatric populations (American Diabetes Association [ADA], 2015; Dea, 2011). Developing a comprehensive plan of care that incorporates a multifaceted treatment and prevention plan is necessary to address this growing health concern and reduce overall morbidity and mortality. Problem: The Edmund Primary Care (EPC) practice data for routine annual diabetic foot exams, annual eye exams, annual urine microalbumin, smoking cessation education and recommendations for pneumococcal polysaccharide do not meet the ADA (American Diabetes Association, 2015) recommendations for patients with T2DM.Design: Quality improvement (QI) project applying the Plan-Do-Study-Act (PDSA) cycle to develop a process change to improve diabetic preventative care measures for hemoglobin A1C, urine microalbumin, diabetic foot exams, and optometry referrals. Setting: A small, nurse practitioner owned, family practice clinic targeting patients 18 years and older with a diagnosis of T2DM.Intervention: A fishbone diagram to conduct a root cause analysis led to identification of key factors contributing to the problem. A comprehensive process change integrating a Diabetic Assessment Flow Sheet (DAFS) and diabetic foot exam sheet was developed to address the problem. Expected Outcome: Increase in rates of completion to at least 90% over eight weeks. Results: Analyzed with run charts demonstrating an increase in rates of completion to 100% for A1C, urine microalbumin, diabetic foot exams, and optometry referrals. A positive percent of change for each measure is as follows: A1C 7%; urine microalbumin 43%; diabetic foot exams 150%; and referrals to optometrist 43%. Significance: This QI project emphasizes the importance of implementing a system to evaluate the quality of care being delivered. It also highlights the usefulness of the PDSA cycle as a method to implementing quality improvement measures in health care. Lastly, this QI project demonstrated the effectiveness of flow sheets in improving the quality of care delivered to patients with T2DM.
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Bickerton, Jane E. "Videos of communication in primary care : a study exploring nurse practitioner and patient consultations in a walk-in centre." Thesis, City University London, 2015. http://openaccess.city.ac.uk/14541/.
Повний текст джерелаАнотація:
The researcher (an experienced advanced nurse practitioner) examined and interpreted twenty videos of consultations between six nurse practitioners and patients aged between 18 and 65 years. A qualitative visual research method (VS) was used drawing on phenomenology, video elicitation, reflexivity, and narrative hermeneutics. The findings demonstrated shared verbal and visual aspects of conversations. The majority of the videos elicited knowledge-based, rather than predominately emotion or movement-based conversations with both parties both empathic and engaged or task focused. The consultation dynamic in most interviews was harmonious rather than in tension, although there were occasions where the nature of the communication varied during the consultation. Furthermore, each NP demonstrated preferences for one of the three different conversation styles (i.e. knowledge, emotion or movement), as well as different ways of responding to patients who were either active or passively involved in an interaction. This theoretically derived video schema was further developed into a video tool (a process and coding guide along with a coding form). The video tool (VT) provided evidence of good video coding interrater reliability when compared with the results of the VS. The study recommends that WiC NPs could use the video schema to reflect on their personal consultation styles as there is potential to develop greater awareness of emotion, movement and knowledge in shared conversations, and a facilitative approach that asks open questions and encourages active shared and flexible approaches to consultation communication. Additionally, research using the video tool could further investigate the psychometric properties of the VT and ultimately the effect of the different styles on patient outcomes such as compliance and satisfaction.
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Scott, Beverley Margaret. "Situational Positioning: A Grounded Theory of Registered Nurse Decision-making in Western Australian Nursing Homes." Thesis, Curtin University, 2003. http://hdl.handle.net/20.500.11937/1940.
Повний текст джерелаАнотація:
This grounded theory study investigated how registered nurses (RNs) managed problem-solving and decision-making in residential aged care facilities (nursing homes) in Western Australia. The outcome of the study was the substantive theory of situational positioning, the process used by the RN participants when they were trying to get things right .In-depth interviews were conducted with 25 purposefully selected registered nurses and nursing home management staff. The interviews were transcribed verbatim, and analysed using the constant comparative method. Other sources of data. guided by theoretical sampling. were selected documents such as government reports regarding aged care, and some field observations. Situational positioning was a process that involved physical. cognitive, emotional, and moral dimensions, and reflected how the RN participants acted and responded when dealing with situations at work. Situational positioning was conceptualised as occurring along two intersecting continua of behaviours, and these behaviours emerged from the data as four interrelated categories. Yielding and confronting represented the poles on a continuum of action-oriented behaviour, with being flexible and being rigid on a continuum that reflected more affective or attitudinal responses. The four categories that made up the positioning continua had both positive and negative meanings in relation to the actions and responses of the participants, depending on the particular situation. Yielding was a conceptual category that reflected participants' comments about stopping a particular action and trying something else or giving up completely and even leaving the situation. f he term confronting was used to describe participants' actions that were based on assertiveness that was seen as a constructive behaviour, or anger that tended to be non-productive.Being flexible meant that the participants were responsive to changing situational variables, and this was usually seen as a desirable attribute of effective nursing practice in aged care. However, it could also mean being pliant and ready to compromise in order to get through situations when the participants realised that they would be unable to get things right. At the other end of the response axis, the term being rigid was defined as the opposite of being flexible, that is, having firmly fixed or set ways of responding. or a tendency to respond to situations in the same way in all circumstances. The basic psychosocial problem, being unable to get things right, had two properties. One property was temporal, in that the problem occurred when the participants were getting behind or running late because of having insufficient time. usually due to interruptions. The second property of the problem was more qualitative in that contextual and intervening conditions led the participants to feel that they were not doing things properly because of adverse conditions. Conditions that varied .situational positioning were those that led to the participants being unable to get things right, such as having insufficient time. working with unqualified carers. and trying to meet the differing expectations of various stakeholders. Situations that were easy for the participants to manage involved known routines and few, if any. interruptions. In those circumstances, si uational positioning was intuitive and the phases of recognising, prioritizing, and moving on were negotiated quickly. In more complex situations, or when significant interruptions occurred, the participants followed an alternative pathway, which involved recognising that something in the situation changed. then compromising. that is. choosing a new course of action.Compromising required tolerance, as the participants adjusted their expectations of what could be achieved in the circumstances. Repositioning then occurred belore they moved on to the next task or to the end of their shifts. Moving on. the third phase in the process, involved persevering as they continued trying to get things right. The adverse conditions that prevailed in nursing homes during the time of this study impeded nursing practice and the delivery of consistently good standards of care for all residents. Situational positioning enabled the participants to persevere in their efforts to try to get things right, but their capacity to maintain the effort was eroded by the apparently unrelenting nature of the adverse conditions that existed in nursing homes. The main conclusion of this study was that the RN role in nursing homes in Western Australia was ill-defined, and inefficient in terms of best utilisation of nursing time. Recommendations included a review of the RN role in aged care and implementation of strategies that would enable aged care RNs to focus on their clinical roles.
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Lasiter, Rita Sue. "Older adults' perception of feeling safe in an intensive care unit." Diss., Columbia, Mo. : University of Missouri-Columbia, 2008. http://hdl.handle.net/10355/5583.
Повний текст джерелаАнотація:
Thesis (Ph.D.)--University of Missouri-Columbia, 2008.The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Vita. "December 2008" Includes bibliographical references.
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Salako, Abiodun. "The impact of state nurse practitioner scope-of-practice regulations on access to primary care in health professional shortage areas." Diss., University of Iowa, 2019. https://ir.uiowa.edu/etd/7025.
Повний текст джерелаАнотація:
Primary care physician (PCP) shortages have been a barrier to accessing care for millions of Americans, particularly those living in areas facing the worst shortages - primary care health professional shortage areas (HPSAs). Increased use of nurse practitioners (NPs) has been proposed as a solution to the shortages as NPs can effectively substitute for PCPs. However, this proposal has been hampered by regulatory restrictions on NP scope-of-practice (SOP) that exist in many states. While some states permit NPs to practice and prescribe medications independent of physicians (NP independence), others require extensive physician supervision that limit NPs ability to provide care and substitute for PCPs. Despite the limitations that restrictive regulations pose to improving access to primary care, research evidence of their effect on access in primary care HPSAs is limited. This dissertation fills this gap in the literature.
Using individual-level data from the Medical Expenditure Panel Surveys (1996-2015) and a difference-in-differences approach, I exploit variation in NP independence across states and over time to evaluate the impact of NP independence on access to primary care in HPSAs Further, I examined for heterogeneity in the effect of NP independence between HPSAs and non-HPSAs as well as effect heterogeneity in HPSAs based on individual (age, insurance status, and insurance type) and health system characteristics (availability of primary care facilities and NP Medicaid reimbursement rate)
I find that NP independence led to a 5% increase in the number of individuals with a primary care provider and a 2% increase in the use of non-physicians (relative to physicians) as the primary care provider in HPSAs. However, non-HPSAs experienced no significant changes in access to care. Further, I find evidence of heterogeneity in the effect of NP independence in HPSAs for all three individual characteristics but find no significant effect heterogeneity for any of the health system characteristics. Non-elderly individuals experienced greater improvements in access following NP independence compared to their elderly counterparts, and while both insured and uninsured individuals experienced improvements in access to care, uninsured individuals benefitted more from NP independence. Further, I find evidence of greater improvements in access to care among Medicaid beneficiaries relative to their privately insured and Medicare counterparts.
These findings imply that removing regulatory restrictions on NP SOP could be an effective policy strategy for mitigating the effects of PCP shortages and improving access to care in HPSAs. Further, they demonstrate that NP independence could be a viable tool for addressing access to care issues in two traditionally underserved populations – the uninsured and Medicaid beneficiaries. Beyond addressing access issues, NP independence could also mitigate rising health care costs. The finding of increased use of lower-cost non-physicians rather than their more costly physician counterparts after NP independence indicates that this policy change could also bring about cost savings for society.
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Ayoub, Abby. "Exploring the Barriers and Facilitators to the Integration of the Nurse Practitioner as Most Responsible Provider Model of Care in a Hospital Setting." Thesis, Université d'Ottawa / University of Ottawa, 2021. http://hdl.handle.net/10393/42152.
Повний текст джерелаАнотація:
Background: Since 2012, nurse practitioners (NPs) in Ontario have the professional capacity to assume the role of the most responsible provider (MRP) in hospitals; however, few have implemented this model. Aim: To explore the barriers and facilitators to the integration of the NP as MRP model of care in a hospital setting. Methods: A qualitative descriptive design with secondary data collected from a larger study, was used with principles from integrated knowledge translation. Findings: Thirteen barriers and eleven facilitators were found, such as: (i) challenges with off hour coverage; (ii) funding and remuneration; (iii) discrepancies in the employment standards regulations; and (iv) lack of a critical mass. Facilitators included the plan for role implementation, establishment of trust and leadership from the team. Conclusion: Many barriers, predominantly at the healthcare system-level, make it difficult to integrate the NP as MRP model of care in hospitals.
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Marshall, Ashley M. "Development of a Practice Guideline for DNP Prepared Nurse Practitoners Working in Long-Term Care Facilities." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2093.
Повний текст джерелаАнотація:
Clinical evidence-based practice guidelines providing recommendations for health care decision making have become vital components of long-term health care practice in the United States. Frequently changing guidelines have complicated nurse practitioners' (NPs) efforts to implement evidence-based practice into the daily care that they provide to patients. The purpose of this project was to develop an evidence-based practice guideline for doctoral-prepared NPs working in long-term care facilities. This project is important because practitioners use practice guidelines to provide patients with the most appropriate, evidence-based care. Kolcaba's comfort theory was used to guide this project. Kolcaba's theory holds that comfort exists in 3 forms: relief, ease, and transcendence. Comfort theory, with its emphasis on physical, psychospiritual, sociocultural, and environmental aspects of comfort, will lead to a proactive, diverse, and multifaceted approach to providing patient care. A complete practice guideline was developed for doctoral-prepared NPs. For the review of the scholarly evidence, an electronic search that yielded 34 articles was completed. Twenty-six of these articles were excluded because the articles were more than 20 years old and/or focused on a specialty. Findings from the 8 articles were used to develop the practice guideline, which was reviewed by an advisory committee of 7 experts. The AGREE tool was used by the advisory committee to provide feedback on the quality of the practice guideline. Implementation of the practice guideline will take place in a facility in Indiana that currently uses 3 NPs. A doctoral-prepared NP will evaluate the practice guideline annually for patient trends including hospital readmission and infection rates.
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Rogers, Melanie. "Spiritual dimensions of advanced nurse practitioner consultations in primary care through the lens of availability and vulnerability : a hermeneutic enquiry." Thesis, University of Huddersfield, 2016. http://eprints.hud.ac.uk/id/eprint/28469/.
Повний текст джерелаАнотація:
Introduction: There is a scarcity of research examining spirituality and spiritual dimensions of Advanced Nurse Practitioner practice. This thesis explores the findings of a hermeneutic enquiry into the spiritual dimensions of Advanced Nurse Practitioner consultations in Primary Care through the lens of Availability and Vulnerability. The findings include Advanced Nurse Practitioners’ understandings and conceptualisation of spirituality, the place of spirituality in practice and some of the concerns related to integration in practice. The participants’ interviews explored their own personal and professional experiences which added to their conceptualisation of spirituality. The lens of Availability and Vulnerability (A&V) was used intentionally and openly to explore, in depth, spiritual dimension of practice with the participants. The utility and effectiveness of the concepts of A&V in this context was explored. Methods/Methodology: A hermeneutic phenomenological enquiry was chosen to explore spirituality through the lived experiences of the Advanced Nurse Practitioners (ANPs). Eight participants were interviewed face to face during 2 in-depth interviews spaced 18 months apart. The concepts of A&V were introduced to the participants before the second interviews. The lens of A&V was utilised within these interviews to discover whether or not these concepts were helpful for operationalising spirituality in practice. The prolonged engagement allowed dialogue to occur between the researcher and participants allowing data to be captured which provided a thick description of the phenomenon of spirituality. A thematic analysis was chosen to interpret the data in order to enable a deeper understanding of the spiritual dimensions of ANP consultations to be gained. Findings The participants recognised that spirituality can be difficult to conceptualise and operationalise in practice. However, many of the participants were able to articulate the meaning of spirituality for themselves and gave examples of when they had witnessed a spiritual dimension occurring in practice. Particular themes were expressed in the interviews in relationship to spirituality. These included the context for spirituality to be integrated into care, the emotional engagement needed and the emotional impact on the ANP and the patient. Having introduced the concepts of A&V to the participants, after deep exploration, they recognised and identified that A&V were concepts which could be a useful lens for understanding spirituality in ANP consultations. Conclusion This study has uncovered new knowledge and understanding in the realm of spirituality in ANP consultations in Primary Care. The conceptual understanding of spirituality and the framework of Availability and Vulnerability provides a new approach to spirituality within ANP consultations in Primary Care.
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Larsson, Mauleon Annika. "Care for the elderly : a challenge in the anaesthesia context /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-209-8/.
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Shelby, Debra Michelle. "Knowledge, Attitudes, and Practice of Primary Care Nurse Practitioners Regarding Skin Cancer Assessmnets: Validity and Reliability of a New Instrument." Scholar Commons, 2014. https://scholarcommons.usf.edu/etd/5124.
Повний текст джерелаАнотація:
Abstract
Background: Despite the rise in the occurrence of skin cancer, primary care nurse practitioners are reluctant to perform skin cancer assessments during patient visits. Melanoma is almost always curable if detected in the early stages, but invasive disease accounts for 9,000 deaths per year (American Cancer Society, 2013). Changing knowledge, attitudes and practice regarding skin cancer assessments potentially leads to early detection and treatment of skin cancers and impacts patient outcomes. However, in order to change knowledge and attitudes, we must first assess them. Purpose: The purpose of this research was to validate a new skin cancer assessment tool instrument called KAP-SCA to measure knowledge, attitude, and practice in primary care NPs. Methods: Sequential mixed methods were used. First, focus group interviews with 14 primary care nurse practitioners were conducted during Phase I. Interviews were audio-recorded then transcribed verbatim and imported into ATLAS.ti. Phase II involved instrument development from a blueprint and calculation of content validity indexes (CVI) for items and
subscales. Phase III of this study included testing the validity and reliability of a KAP instrument using quantitative methods. This new instrument assesses primary care nurse practitioner knowledge, attitudes, and practice regarding skin cancer assessment. Results: Content validity for the subscales was evaluated by CVI ranged from .90 to .95. The Cronbach's alpha was highest for the practice subscale (alpha =.89) while the lowest was seen with the knowledge subscales (alpha =.50). Construct validity assessed by exploratory factor analysis indicated the presence of three underlying factors, confidence in practice, confidence relating to education and NP role in practice. Implications for Practice: Interventions need to be developed based on the knowledge deficits and barriers to practice identified by these NPs including educational programs that focus on increasing primary care NPs' knowledge and confidence levels regarding skin cancer assessments and identification of malignant lesions. Conclusion: Beginning evidence of validity and reliability were found for the Knowledge, Attitudes and Practice-Skin Cancer Assessments (KAP-SCA), however further studies are warranted.
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Alhaj, Ali Abeer A. Ph D. "The Impact of High Fidelity Simulation Debriefing Modalities on Cardiac Emergency Knowledge & Leadership Skills among Acute Care Nurse Practitioner Students." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1522164911599868.
Повний текст джерела
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Viljoen, Myra Elizabeth. "Strategies to enhance attendance of a continuous professional development programme for critical care nurse practitioners at a private hospital in Gauteng." Diss., University of Pretoria, 2013. http://hdl.handle.net/2263/43935.
Повний текст джерелаАнотація:
The public’s demand for competent and safe health care obligates the profession to
meet the challenges of high quality care with current knowledge and skills. The
maintenance of competence and the participation in continuous professional
development (CPD) has firmly been established as a professional standard with the
purpose of ensuring the safety of the public. The enhancement and maintenance of
knowledge and skills can be obtained through participation in CPD programmes.
Despite the importance of CPD, not many critical care nurse practitioners avail
themselves of the opportunity to attend CPD programmes.
The overall aim of this research was to reach consensus regarding the reasons for the
unsatisfactory attendance of a CPD programme developed for critical care units in a
private hospital in Gauteng. A consensus methodology was used to involve the critical
care nurse practitioners in planning and prioritising strategies for a future continuous
professional development programme. Using the nominal group technique the critical
care nurse practitioners reflected on their experience related to the current CPD
programme and provided inputs and ranked priorities. Fourteen critical care nurse
practitioners participated in the nominal group session.
Consensus was reached regarding five priorities that should be implemented as
strategies to enhance attendance of future CPD programmes. In rank order these
priorities were communication, continuous professional development, clinical training,
time constraints and financial implications. A central theme “attitude” was included as
attitude has a powerful effect on all of the above mentioned priorities. In conclusion the
study focussed on identifying and discussing the reasons for unsatisfactory attendance
of a CPD programme. Based on the reasons identified priorities were set and strategies
were collaboratively developed to enhance future attendance of a CPD programme.Dissertation (MCur)--University of Pretoria, 2013.
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