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Статті в журналах з теми "Nurse practitioners Attitudes"

Автор: Grafiati

Опубліковано: 10 грудня 2022

Оновлено: 20 лютого 2023

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1

Gooden, Janet M., and Elaine Jackson. "Attitudes of Registered Nurses Toward Nurse Practitioners." Journal of the American Academy of Nurse Practitioners 16, no. 8 (August 2004): 360–64. http://dx.doi.org/10.1111/j.1745-7599.2004.tb00459.x.

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2

Famuyide, Mobolaji, Caroline Compretta, and Melanie Ellis. "Neonatal nurse practitioner ethics knowledge and attitudes." Nursing Ethics 26, no. 7-8 (October 14, 2018): 2247–58. http://dx.doi.org/10.1177/0969733018800772.

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Background: Neonatal nurse practitioners have become the frontline staff exposed to a myriad of ethical issues that arise in the day-to-day environment of the neonatal intensive care unit. However, ethics competency at the time of graduation and after years of practice has not been described. Research aim: To examine the ethics knowledge base of neonatal nurse practitioners as this knowledge relates to decision making in the neonatal intensive care unit and to determine whether this knowledge is reflected in attitudes toward ethical dilemmas in the neonatal intensive care unit. Research design: This was a prospective cohort study that examined decision making at the threshold of viability, life-sustaining therapies for sick neonates, and a ranking of the five most impactful ethical issues. Participants and research context: All 47 neonatal nurse practitioners who had an active license in the State of Mississippi were contacted via e-mail. Surveys were completed online using Survey Monkey software. Ethical considerations: The study was approved by the University of Mississippi Medical Center Institutional Review Board (IRB; #2015-0189). Findings: Of the neonatal nurse practitioners who completed the survey, 87.5% stated that their religious practices affected their ethical decision making and 76% felt that decisions regarding life-sustaining treatment for a neonate should not involve consultation with the hospital’s legal team or risk management. Only 11% indicated that the consent process involved patient understanding of possible procedures. Participating in the continuation or escalation of care for infants at the threshold of viability was the top ethical issue encountered by neonatal nurse practitioners. Discussion: Our findings reflect deficiencies in the neonatal nurse practitioner knowledge base concerning ethical decision making, informed consent/permission, and the continuation/escalation of care. Conclusion: In addition to continuing education highlighting ethics concepts, exploring the influence of religion in making decisions and knowing the most prominent dilemmas faced by neonatal nurse practitioners in the neonatal intensive care unit may lead to insights into potential solutions.

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3

Butler, Kathy Diane. "Nurse Practitioners and Evidence-Based Nursing Practice." Clinical Scholars Review 4, no. 1 (2011): 53–57. http://dx.doi.org/10.1891/1939-2095.4.1.53.

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The objectives of this study were to assess nurse practitioners’ (NP) beliefs and attitudes about evidence-based nursing practice (EBNP) and their implementation of EBNP. This exploratory descriptive study surveyed NPs in Tennessee. Most of the respondents were White females, 42 years of age, with a master’s degree as a family nurse practitioner (FNP), practicing in primary care for a mean of 7.9 years. The respondents tended to have positive beliefs and attitudes about EBNP, but their implementation of EBNP was not consistent with their beliefs. The findings of this survey emphasize the need for EBNP in NP education curricula and continuing education programs and for NP access to evidence-based information at point of care to improve the care provided to patients.

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4

Abbo, Lilian, Laura Smith, Margaret Pereyra, Mary Wyckoff, and Thomas M. Hooton. "Nurse Practitioners' Attitudes, Perceptions, and Knowledge About Antimicrobial Stewardship." Journal for Nurse Practitioners 8, no. 5 (May 2012): 370–76. http://dx.doi.org/10.1016/j.nurpra.2012.01.023.

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5

Reeve, Kathleen, Theresa Byrd, and Beth E. Quill. "Health Promotion Attitudes and Practices of Texas Nurse Practitioners." Journal of the American Academy of Nurse Practitioners 16, no. 3 (March 2004): 125–33. http://dx.doi.org/10.1111/j.1745-7599.2004.tb00383.x.

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6

Jones, Ellen D., Susan Letvak, and Thomas P. McCoy. "Reliability and Validity of the Jefferson Scale of Attitudes Toward Physician–Nurse Collaboration for Nurse Practitioners." Journal of Nursing Measurement 21, no. 3 (2013): 463–76. http://dx.doi.org/10.1891/1061-3749.21.3.463.

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Background: The Jefferson Scale of Attitudes Toward Physician–Nurse Collaboration (JSATPNC) has been used to measure attitudes regarding nurse–physician collaboration. However, psychometric evaluation is lacking for the nurse practitioner (NP) population. Purpose: This study details a confirmatory approach in testing the factor analytic structure of the JSATPNC against previously reported structures. Methods: A Web survey invited 4,673 licensed NPs where 915 responded. Confirmatory factor analysis (CFA) was performed to assess factorial validity. Results: A previously proposed 3-factor model based had significantly better fit compared to a 1-factor structure (Δχ2 = 165.3, Δdf = 3, p < .0001). Cronbach’s alpha for the 3 subscales were 0.61, 0.62, and 0.54. Reliability with all 15 items was .72. Conclusions: Three collaboration subscales could have use in measuring attitudes toward physician–NP collaboration.

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Gualano, Maria R., Fabrizio Bert, Valeria Adige, Robin Thomas, Gitana Scozzari, and Roberta Siliquini. "Attitudes of medical doctors and nurses towards the role of the nurses in the primary care unit in Italy." Primary Health Care Research & Development 19, no. 04 (December 22, 2017): 407–15. http://dx.doi.org/10.1017/s1463423617000846.

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AimAim of the present study was to assess the knowledge of the potential role of nurses in the primary care setting and to analyse the attitudes towards their utilization by nurses and General Practitioners (GPs) in a region of Italy.BackgroundNowadays, in Italy, the role of the nurse in primary care is still under-recognized and most primary care medical offices are managed individually by a physician.MethodsThe study consists of a questionnaire-based cross-sectional survey carried out in Piedmont, Italy, between February and September 2015.FindingsWe included 105 participants, 57 nurses and 48 physicians. The presence of a nurse working together with the GP was defined as ‘useful’ by 54.4% of nurses (versus 60.4% of physicians), as ‘essential’ by 45.6% of nurses (versus 25.0% of physicians), as ‘marginal’ by no nurses (versus 14.6% of physicians) and as ‘unimportant’ by none (P=0.002). Thus, physicians seemed to be less favorable towards a full collaboration and power-sharing with nurses. Furthermore, GPs and nurses showed a different attitude towards the role of nurses in primary care: while nurses highlighted their clinical value, physicians tended rather to recognize them a ‘supportive’ role. Moreover, only 20.8% of the physicians interviewed stated that they worked with a nurse. At the multivariate analysis, the age class resulted to be a significant predictor of the perception that the presence of a nurse working with the GP is essential: participants >50 years had an OR of 0.03 (P=0.028). Although the primary care organization appears still largely based on a traditional physician-centric care model, the positive attitude of nurses and young GPs towards a more collaborative model of primary care might represent a promising starting point.

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8

Kaminskiy, Emma, Simon Senner, and Johannes Hamann. "Attitudes towards shared decision making in mental health: a qualitative synthesis." Mental Health Review Journal 22, no. 3 (September 11, 2017): 233–56. http://dx.doi.org/10.1108/mhrj-01-2017-0003.

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Purpose Shared decision making (SDM) prioritises joint deliberation between practitioner and service user, and a respect for service-users’ experiential knowledge, values and preferences. The purpose of this paper is to review the existing literature pertaining to key stakeholders’ attitudes towards SDM in mental health. It examines whether perceived barriers and facilitators differ by group (e.g. service user, psychiatrist, nurse and social worker) and includes views of what facilitates and hinders the process for service users and practitioners. Design/methodology/approach This review adopts the principles of a qualitative research synthesis. A key word search of research published between 1990 and 2016 was undertaken. Qualitative, quantitative and mixed methods studies were included. Findings In total, 43 papers were included and several themes identified for service user and practitioner perspectives. Both practitioners and service users see SDM as an ethical imperative, and both groups highlight the need to be flexible in implementing SDM, suggesting it is context dependent. A range of challenges and barriers are presented by both practitioners and service users reflecting complex contextual and cultural features within which interactions in mental health take place. There were qualitative differences in what service users and practitioners describe as preventing or enabling SDM. The differences highlighted point towards different challenges and priorities in SDM for service users and practitioners. Originality/value The presentation of nuanced views and attitudes that practitioners and service users hold represent an important and under reported area and offer insight into the reasons for the gap between idealised policy and actual practice of SDM in mental health settings.

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9

Geller, G., B. A. Bernhardt, T. Doksum, K. J. Helzlsouer, P. Wilcox, and N. A. Holtzman. "Decision-making about breast cancer susceptibility testing: how similar are the attitudes of physicians, nurse practitioners, and at-risk women?" Journal of Clinical Oncology 16, no. 8 (August 1998): 2868–76. http://dx.doi.org/10.1200/jco.1998.16.8.2868.

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PURPOSE To determine what consumers and providers would want to discuss about breast cancer susceptibility testing (BCST) and their preferred role in testing decisions. METHODS We surveyed 426 at-risk women, 143 nurse practitioners, and 296 physicians in five specialties in Maryland. RESULTS All groups believe it is important to discuss how the chance of breast cancer can be reduced and what the chances are of getting breast cancer if the test is positive. Both provider groups attributed more importance than consumers to discussing whether cancer can occur if the test is negative. Discussing the risk of depression and anxiety was more important to providers than consumers. Eighty-two percent of women would want their providers to make a recommendation about testing, but only 43% of nurse practitioners and 68% of physicians would do so. Eighteen percent of physicians underestimated the importance of informed consent for testing and 34% of discussing the risk of insurance discrimination. Fewer than 6% of women, if found to have a mutation, would be likely to undergo prophylactic mastectomy, whereas 12% of nurse practitioners and 34% of physicians would be likely to recommend such surgery. One third of respondents in all three groups supported testing a 13-year old daughter of a mutation-carrier. CONCLUSION Physicians should place greater value on informed consent and discussing practical aspects of testing, and physicians and nurse practitioners should pay more attention to the limitations of testing children, insurance discrimination, and consumers' desire for provider recommendations. In light of the limited discordance between nurse practitioners and consumers, nurse practitioners can play an increasing role in education and counseling about BCST.

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10

Brennan, Siobhán, Elizabeth Walters, Sydney E. Browder, Ravi Jhaveri, and Zach Willis. "91. Knowledge, Attitudes, and Practice of Antibiotic Prescribing among Nurse Practitioners." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S160—S161. http://dx.doi.org/10.1093/ofid/ofab466.293.

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Abstract Background Antibiotic overuse (AO) in ambulatory care is an important public health problem. Nurse practitioners (NPs) account for a growing proportion of outpatient antibiotic prescriptions: 14.6% in 2016. Our objective was to assess NPs’ attitudes about antibiotic prescribing practices and knowledge and use of antibiotic prescribing guidelines (APG) in their practice. Methods We distributed a survey via email to NPs listed as licensed by the North Carolina Board of Nursing. Surveys were distributed three times; duplicate responses were not permitted. Respondents who reported not prescribing antibiotics in the outpatient setting were ineligible. Three randomly selected respondents received gift cards. Questions assessed degree type, practice type, years in practice, and attitudes about antibiotic prescribing practices antibiotic stewardship. Respondents answered four questions assessing knowledge of APG. Analyses were descriptive; scores on knowledge questions were compared using T-tests. Results Survey requests were sent to 10,094 listed NPs; there were 846 completed responses (8.4%), of which 672 respondents (79.4%) reported prescribing antibiotics in outpatient care. Of those, 595 (88.5%) treat adult patients. Most respondents agreed that AO is a problem in their state (84.5%); 41.3% agreed that it was a problem in their practice. Patient/family satisfaction was the most frequently reported driver of AO (90.1%). Most respondents agreed that national APG are appropriate (95.4%) and that quality improvement (QI) is warranted (93.4%). Respondents reported following APG always (18.5%) or more than half the time (61.0%). Respondents answered a mean of 1.89 out of 4 knowledge questions correctly, with higher scores among those reporting following APG more than half the time (1.97 vs 1.58, p< 0.0001). Overall attitudes about antibiotic prescribing, antibiotic prescribing guidelines, and acceptance of Quality Improvement. N=595. Respondents’ reported drivers of antibiotic overuse. Respondents were permitted to select more than one driver. Content question performance by self-reported guideline compliance; scores represent the number correct out of four questions. Conclusion Respondents agree that AO is a problem but place responsibility externally. Confidence in APG was high; most respondents endorsed following APG most of the time. Performance on knowledge questions suggests a need for education. Most respondents would welcome QI focused on AO, including education and personalized feedback. Similar work is needed in other regions and among other prescriber groups. The results will inform outpatient antibiotic stewardship. Disclosures Elizabeth Walters, DNP, CPNP-PC, RN, Merck (Consultant, Other Financial or Material Support, I am a trainer for the Nexplanon product.) Ravi Jhaveri, MD, AstraZeneca (Consultant)Dynavax (Consultant)Elsevier (Other Financial or Material Support, Editorial Stipend as Co-editor in Chief, Clinical Therapeutics)Seqirus (Consultant)

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11

Haefner, Judy, and Marilyn Filter. "Educating Mental Health Nurse Practitioners on Interprofessional Collaboration and Preparing Them for Collaborative Practice." Journal of Doctoral Nursing Practice 15, no. 1 (February 1, 2022): 3–10. http://dx.doi.org/10.1891/jdnp-2021-0006.

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BackgroundAlthough interprofessional collaboration (IPC) has been discussed for over 40 years, in nursing education as well as the majority of health professionals, education continues to primarily take place in silos with curricula that is discipline specific. Educators need to implement models of education that are linked to collaborative practice and team-based care.ObjectivesTo introduce the principles from the Core Competencies for Interprofessional Collaborative Practice, the American Association of Colleges of Nursing Essentials of Doctoral Education for Advanced Nursing Practice and the National Organization of Nurse Practitioners Faculties Nurse Practitioner Core Competencies into the coursework. To demonstrate an application process for incorporating collaboration in their future nurse practitioner roles.MethodStudents in the Doctor of Nursing Practice mental health nurse practitioner program participated in a set of assignments to develop essential knowledge and skills for integration of IPC into practice. A pretest–posttest design was used to evaluate student attitudes towards IPC following immersion in IPC subject matter and experiential learning with other healthcare providers working together to coordinate patient care.ResultsThere were significant findings for six of the 18 survey questions. This project can serve as an example for successful implementation of IPE in the nursing curricula.

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12

Hessler, Karen, and Mary Siegrist. "Nurse practitioner attitudes and treatment practices for childhood overweight: How do rural and urban practitioners differ?" Journal of the American Academy of Nurse Practitioners 24, no. 2 (November 27, 2011): 97–106. http://dx.doi.org/10.1111/j.1745-7599.2011.00673.x.

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13

Trowbridge, Frederick L., Denise Sofka, Katrina Holt, and Sarah E. Barlow. "Management of Child and Adolescent Obesity: Study Design and Practitioner Characteristics." Pediatrics 110, Supplement_1 (July 1, 2002): 205–9. http://dx.doi.org/10.1542/peds.110.s1.205.

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Objective. A study was undertaken to examine the attitudes and practices of health care providers in the assessment and treatment of overweight and obese children and adolescents. This study describes the study design and the practice settings and person characteristics of the practitioners included in this study. Methods. A needs assessment questionnaire was developed by a working group consisting of researchers, clinicians, educators, and representatives of the Maternal and Child Health Bureau, Health Resources and Services Administration (Department of Health and Human Services), National Center for Education in Maternal and Child Health, International Life Sciences Institute, and Harris Interactive, Inc. The questionnaire consisted of 35 questions divided into 3 topic areas and was disseminated to a sample of pediatricians (n = 1088), pediatric nurse practitioners (n = 879), and registered dietitians (n = 1652). Results. Despite a low response rate (33% for pediatric nurse practitioners, 27% for registered dieticians, and 19% for pediatricians), descriptive data were obtained about a variety of practitioner characteristics. Some significant differences were observed across practitioner groups and between genders in regard to years in practice, body mass index, and dietary and physical activity behaviors. Significant relationships were also observed in some practitioner groups between body mass index and compliance with dietary and physical activity guidelines. Conclusions. Our data show there is a wide variance in practitioner characteristics, particularly in regard to gender, years of practice, body mass index, and obesity-related behaviors. It is hoped the analyses presented in this and in the subsequent articles will provide useful information on current attitudes and practices and will contribute to improvements in the treatment of overweight children and adolescents.

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Tedesco, Alissa, Jocelyn Brown, Breffni Hannon, Lauren Hutton, and Jenny Lau. "Managing Opioids and Mitigating Risk: A Survey of Attitudes, Confidence and Practices of Oncology Health Care Professionals." Current Oncology 28, no. 1 (February 12, 2021): 873–78. http://dx.doi.org/10.3390/curroncol28010086.

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In response to Canada’s opioid crisis, national strategies and guidelines have been developed but primarily focus on opioid use for chronic noncancer pain. Despite the well-established utility of opioids in cancer care, and the growing emphasis on early palliative care, little attention has been paid to opioid risk in this population, where evidence increasingly shows a higher risk of opioid-related harms than was previously thought. The primary objective of this study was to assess oncology clinicians’ attitudes, confidence, and practices in managing opioids in outpatients with cancer. This was explored using pilot-tested, profession-specific surveys for physicians/nurse practitioners, nurses and pharmacists. Descriptive analyses were conducted in aggregate and separately based on discipline. Univariate and multiple linear regression analyses were performed to explore relationships between confidence and practices within and across disciplines. The survey was distributed to approximately 400 clinicians in January 2019. Sixty-five responses (27 physicians/nurse practitioners, 31 nurses, 7 pharmacists) were received. Participants endorsed low confidence, differing attitudes, and limited and varied practice in managing and mitigating opioid risks in the cancer population. This study provides valuable insights into knowledge gaps and clinical practices of oncology healthcare professionals in managing opioids and mitigating associated risks for patients with cancer.

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15

Footracer, K., M. Monaghan, N. Piette, and E. Mandel. "Attitudes and Practices of Complementary and Alternative Medicine Practitioners as Related to Western/Allopathic Medicine." Journal of the American Academy of Physician Assistants 21, no. 6 (June 2008): 1. http://dx.doi.org/10.1097/01720610-200806000-00057.

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16

Watters, Liam, Miriam Gannon, and Denis Murphy. "Attitudes of general practitioners to the psychiatric services." Irish Journal of Psychological Medicine 11, no. 1 (March 1994): 44–46. http://dx.doi.org/10.1017/s0790966700016074.

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Structural AbstractObjective: General practitioners play a crucial role in the delivery of psychiatric treatment to patients who have many similarities to those attending the general psychiatric services. The purpose of this study was to elicit attitudes of general practitioners to an existing local service. Methods: We used an anonymous questionaire hand delivered to 54 general practitioners with practices in the catchment area of one of Dublin's psychiatric hospitals. Results: We received responses from 40 of the GP's indicating a high level of psychiatric morbidity in the primary care setting, a moderate level of satisfaction with psychiatric service, a low level of knowledge of the catchment area system, limited interest in taking on an increased role in the care of psychiatric patients and a high popularity rating for the community psychiatric nurse. Conclusions: This study confirms previous estimates of psychiatric morbidity in general practice, a need for improved communication between psychiatrists and general practitioners to identify more realistic expectations on both sides of the equation, and a huge potential for the expanding community psychiatric services to improve liaison between general practitioners and psychiatrists and yield considerable patient and doctor gains.

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Bender, Melissa A., C. Holly A. Andrilla, Rashmi K. Sharma, Caroline Hurd, Nicole Solvang, and Laura Mae-Baldwin. "Moral Distress and Attitudes About Timing Related to Comfort Care for Hospitalized Patients: A Survey of Inpatient Providers and Nurses." American Journal of Hospice and Palliative Medicine® 36, no. 11 (April 9, 2019): 967–73. http://dx.doi.org/10.1177/1049909119843136.

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Context: Providing nonbeneficial care at the end of life and delays in initiating comfort care have been associated with provider and nurse moral distress. Objective: Evaluate provider and nurse moral distress when using a comfort care order set and attitudes about timing of initiating comfort care for hospitalized patients. Methods: Cross-sectional survey of providers (physicians, nurse practitioners, and physician assistants) and nurses at 2 large academic hospitals in 2015. Providers and nurses were surveyed about their experiences providing comfort care in an inpatient setting. Results: Two hundred five nurse and 124 provider surveys were analyzed. A greater proportion of nurses compared to providers reported experiencing moral distress “some, most, or all of the time” when using the comfort care order set (40.5% and 19.4%, respectively, P = .002). Over 60% of nurses and providers reported comfort care was generally started too late in a patient’s course, with physician trainees (81.4%), as well as providers (80.9%) and nurses (84.0%) < 5 years from graduating professional school most likely to report that comfort care is generally started too late. Conclusions: The majority of providers and nurses reported that comfort care was started too late in a patient’s course. Nurses experienced higher levels of moral distress than providers when caring for patients using a comfort care order set. Further research is needed to determine what is driving this moral distress in order to tailor interventions for nurses and providers.

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Empleo-Frazier, Ophelia, Ami Marshall, Margaret Doyle, Andrea Rink, Noelle Gallant, Barry Wu, and Richard Marottoli. "AN AGE-FRIENDLY COURSE ADOPTING THE 4M GERIATRIC MODEL IN A PRIMARY CARE NURSE PRACTITIONER PROGRAM." Innovation in Aging 6, Supplement_1 (November 1, 2022): 755. http://dx.doi.org/10.1093/geroni/igac059.2741.

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Abstract Training nurse practitioners to assume an expanded role in management of geriatric patients is key to addressing the care needs of a growing older adult population. To that end, the Yale School of Nursing revised geriatric coursework required of family nurse practitioner (FNP) and adult geriatric nurse practitioners (AGNP) to ensure the curriculum was sufficiently in-depth, engaging, and inclusive. Revisions included a new course, “Advanced Primary Care of the Older Adult” which focuses on the role of the nurse practitioner in the assessment, diagnosis, and management of primary geriatric syndromes. The 4M model (Medications, Mentation, Mobility, and what Matters most) provided the framework. Additionally, faculty added expert speakers, interactive dementia animated videos, book and movie discussions and a geriatric telehealth simulation component. Content was guided by training needs data collected from prior nurse practitioner students. At the end of each course, students were surveyed to assess attitudes towards geriatric care and satisfaction with the course. We compared survey responses pre (academic year 2019–2020, Nf18, response rate=53%) and post (academic years 2020–2021 and 2021–2022, Nf28, response rate=44%) rollout. In multivariate regression analyses adjusted for differences in age, gender, race, program (AGNP and FNP) and previous geriatric experience, we found significant improvement in measures of both confidence in providing geriatric care and satisfaction with course content. Analysis of qualitative data confirmed student satisfaction with the new course. Future work will include expansion and more rigorous evaluation of the program, including measures of student knowledge of best practices and increasing survey participation rates.

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Phillips, Carol Y., C. Virginia Palmer, Vicki S. Wettig, and James W. Fenwick. "Attitudes Toward Nurse Practitioners: Influence of Gender, Age, Ethnicity, Education and Income." Journal of the American Academy of Nurse Practitioners 12, no. 7 (July 2000): 255–59. http://dx.doi.org/10.1111/j.1745-7599.2000.tb00301.x.

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Mays, Rose M., and Gregory D. Zimet. "Recommending STI Vaccination to Parents of Adolescents: The Attitudes of Nurse Practitioners." Sexually Transmitted Diseases 31, no. 7 (July 2004): 428–32. http://dx.doi.org/10.1097/01.olq.0000130536.71812.e5.

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Brzezinski, Lisa, Nancy Mimm, and Sallie Porter. "Pediatric Nurse Practitioner Barriers to Supporting Breastfeeding by Mothers and Infants." Journal of Perinatal Education 27, no. 4 (October 2018): 207–19. http://dx.doi.org/10.1891/1058-1243.27.4.207.

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Infant health and development outcomes are positively affected by breastfeeding. Despite the multitude of breastfeeding benefits to mothers and infants along with strong recommendations for exclusive breastfeeding from government agencies and professional associations, the rate of exclusive breastfeeding during the first six months of life remains low. Strongly positive attitudes make pediatric nurse practitioners, especially those in primary care settings, ideally positioned to encourage, support, and provide breastfeeding management to mothers and infants. However, pediatric nurse practitioners may report breastfeeding education and breastfeeding skills deficits along with other barriers to optimal breastfeeding care.

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Sharoff, Leighsa. "A snapshot of nurses’ understanding, perceptions and comfort level of genomics." Journal of Nursing Education and Practice 11, no. 12 (July 27, 2021): 1. http://dx.doi.org/10.5430/jnep.v11n12p1.

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Objective: The primary aim of this study explored holistic nurses’ self-perceived genomic knowledge, perceptions, attitude and comfort of genomics. A second aim compared results to previous findings of nurse educators and advanced degree practicing registered nurses’ genomic knowledge utilizing the same survey instruments.Methods: Design: Recruitment of participants, through the American Holistic Nurses Association (AHNA), was achieved via an anonymous Survey Monkey link of the Genetic and Genomic Literacy Assessment (GGLA) survey. The GGLA survey comprised three aspects: Self-Perceived Genomic Knowledge Survey; Perceptions and Attitudes about Genomics Integration into Nursing Practice Survey and the Comfort Level of Genomics Survey. Method: The GGLA survey link was made available via the AHNA newsletter.Results: Holistic nurses (n = 41) self-perceived genomic knowledge level demonstrated a knowledge base gap in their comprehension and ability to explain genomic concepts to their patients. Majority of holistic nurses were significantly not comfortable with their genomic knowledge (90% or greater). Comparison with nurse educators (n = 53) and advanced degree practicing registered nurses’ (n = 36) genomic knowledge provided additional insight.Conclusions: A significant majority of nurses are unprepared to adopt genomics into their practice whilst experiencing a lack comfort and confidence. The global success of nursing practice resides with its’ practitioners being fully informed and competent with all required competencies, especially if nursing is to remain prevalent within personalized healthcare.

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Hua, Yun, Qin Zhang, Wang Ting, Rong Qiu, Wen-yan Yao, and Xiao-li Chen. "Pediatric Nurse Practitioners' Knowledge and Attitudes Regarding Pain Management Study in Central China." Journal of Continuing Education in Nursing 50, no. 6 (June 1, 2019): 275–81. http://dx.doi.org/10.3928/00220124-20190516-08.

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24

Stranahan, Susan. "Spiritual Perception, Attitudes about Spiritual Care, and Spiritual Care Practices among Nurse Practitioners." Western Journal of Nursing Research 23, no. 1 (February 2001): 90–104. http://dx.doi.org/10.1177/01939450122044970.

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Bergeson, Jeanette, Richard Cash, James Boulger, and Dale Bergeron. "The Attitudes of Rural Minnesota Family Physicians Toward Nurse Practitioners and Physician Assistants." Journal of Rural Health 13, no. 3 (June 1997): 196–205. http://dx.doi.org/10.1111/j.1748-0361.1997.tb00843.x.

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O’Laughlen, Mary C., Karen Rance, Virginia Rovnyak, Patricia J. Hollen, and Michael D. Cabana. "National Asthma Education Prevention Program: Survey of Nurse Practitioners’ Knowledge, Attitudes, and Behaviors." Journal of Pediatric Health Care 27, no. 2 (March 2013): e17-e24. http://dx.doi.org/10.1016/j.pedhc.2011.07.005.

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Ulrich, Connie M., Quiping Zhou, Sarah J. Ratcliffe, Lichuan Ye, Christine Grady, and Deborah Watkins-Bruner. "Nurse Practitioners' attitudes about cancer clinical trials and willingness to recommend research participation." Contemporary Clinical Trials 33, no. 1 (January 2012): 76–84. http://dx.doi.org/10.1016/j.cct.2011.09.005.

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Lawvere, Silvana, Martin C. Mahoney, Jessica J. Englert, Jill M. Murphy, Andrew Hyland, Susan B. Klein, and Greg M. Loewen. "Nurse Practitioners' Knowledge, Practice and Attitudes About Tobacco Cessation & Lung Cancer Screening." Journal of the American Academy of Nurse Practitioners 15, no. 8 (August 2003): 376–81. http://dx.doi.org/10.1111/j.1745-7599.2003.tb00411.x.

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Meng, Xiaoxian, R. Paul Duncan, Colleen K. Porter, Qing Li, and Scott L. Tomar. "Florida nurse practitioners’ attitudes and practices regarding oral cancer prevention and early detection." Journal of the American Academy of Nurse Practitioners 19, no. 12 (December 2007): 668–75. http://dx.doi.org/10.1111/j.1745-7599.2007.00274.x.

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Brzostek, Tomasz, Wim Dekkers, Zbigniew Zalewski, Anna Januszewska, and Maciej Górkiewicz. "Perception of Palliative Care and Euthanasia Among Recently Graduated and Experienced Nurses." Nursing Ethics 15, no. 6 (November 2008): 761–76. http://dx.doi.org/10.1177/0969733008095386.

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Palliative care and euthanasia have become the subject of ethical and political debate in Poland. However, the voice of nurses is rarely heard. The aim of this study is to explore the perception of palliative care and euthanasia among recent university bachelor degree graduates and experienced nurses in Poland. Specific objectives include: self-assessment of the understanding of these terms, recognition of clinical cases, potential acceptability of euthanasia, and an evaluation of attitudes towards palliative care and euthanasia. This is an exploratory study. A convenience sample of 206 recent graduates and 252 experienced nurse practitioners were interviewed. A structured questionnaire was used for collecting and interpreting data. Subjective perception of the terms `palliative care' and `euthanasia' was high and consistent with the recognition of clinical cases. The majority of the nurses excluded euthanasia from palliative care. They recognized personal philosophy of life as the most influential factor affecting attitudes towards euthanasia. The importance of the law was valued more highly by the experienced nurses.

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Cecil, Elizabeth, Lindsay Helen Dewa, Richard Ma, Azeem Majeed, and Paul Aylin. "General practitioner and nurse practitioner attitudes towards electronic reminders in primary care: a qualitative analysis." BMJ Open 11, no. 7 (July 2021): e045050. http://dx.doi.org/10.1136/bmjopen-2020-045050.

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ObjectivesReminders in primary care administrative systems aim to help clinicians provide evidence-based care, prescribe safely and save money. However, increased use of reminders can lead to alert fatigue. Our study aimed to assess general practitioners’ (GPs) and nurse practitioners’ (NPs) views on electronic reminders in primary care.DesignA qualitative analysis using semistructured interviews.Setting and participantsFifteen GPs and NP based in general practices located in North-West London and Yorkshire, England.MethodsWe collected data on participants’ views on: (1) perceptions of the value of information provided; (2) reminder-related behaviours and (3) how to improve reminders. We carried out a thematic analysis.ResultsParticipants were familiar with reminders in their clinical systems and felt many were important to support their clinical work. However, participants reported, on average, 70% of reminders were ignored. Four major themes emerged: (1) reaction to a reminder, which was mixed and varied by situation. (2) Factors influencing the decision to act on reminders, often related to experience, consultation styles and interests of participants. Time constraints, alert design, inappropriate presentation and litigation were also factors. (3) Negative consequences of using reminders were increased workload or costs and compromising GP and NPs behaviour. (4) Factors relating to improving users’ engagement with reminders were prevention of unnecessary reminders through data linkage across healthcare administrative systems or the development of more intelligent algorithms. Participants felt training was vital to effectively manage reminders.ConclusionsGPs and NPs believe reminders are useful in supporting the provision of good quality patient care. Improving GPs and NPs’ engagement with reminders centres on further developing their relevance to their clinical practice, which is personalised, considers cognitive workflow and suppresses inappropriate presentation.

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Meng, Xiaoxian, and Scott Tomar. "Attitudes and Practices of Florida Nurse Practitioners on Oral Cancer Prevention and Early Detection." Journal of Cancer Education 23, no. 1 (January 2008): 57–62. http://dx.doi.org/10.1080/08858190701634722.

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Studts, Jamie L., Sarah McQueary Flynn, Tiffany Cross Dill, S. Lee Ridner, Celeste T. Worth, Sarah E. Walsh, and Connie L. Sorrell. "Nurse Practitioners' Knowledge, Attitudes, and Clinical Practices Regarding Treatment of Tobacco Use and Dependence." Journal for Nurse Practitioners 6, no. 3 (March 2010): 212–19. http://dx.doi.org/10.1016/j.nurpra.2009.06.003.

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Totney, Andrea, Michelle Grummisch, Grainne Lowe, and Melanie Price. "Emergency Nurse Practitioners—A review of role perceptions and staff attitudes in the workplace." Australasian Emergency Nursing Journal 14 (January 2011): S37. http://dx.doi.org/10.1016/j.aenj.2011.09.092.

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Street, Debra, and Jeralynn S. Cossman. "Does familiarity breed respect? Physician attitudes toward nurse practitioners in a medically underserved state." Journal of the American Academy of Nurse Practitioners 22, no. 8 (July 29, 2010): 431–39. http://dx.doi.org/10.1111/j.1745-7599.2010.00531.x.

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Poynton, Amanda, and Peter Higgins. "Role of General Practitioners in Care of Long-Term Mentally Ill Patients." British Journal of Psychiatry 159, no. 5 (November 1991): 703–6. http://dx.doi.org/10.1192/bjp.159.5.703.

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“Objective – To assess general practitioners' involvement with long term mentally ill patients and attitudes towards their care.Design – Postal questionnaire survey.Setting – General practices in South West Thames region.Subjects – 507 general practitioners, 369 (73%) of whom returned the questionnaire.Main outcome measures – The number of adult long term mentally ill patients whom general practitioners estimate they have on their lists and general practitioners' willingness to take responsibility for them.Results – 110 respondents had noticed an effect of the discharge of adult long term mentally ill patients on their practices. Most (225) respondents estimated that they had 10 or fewer such patients each on their lists. Having higher numbers was significantly associated with practising in Greater London or within three miles of a large mental hospital and having contact with a psychiatrist visiting the practice. 333 general practitioners would agree to share the care of long term mentally ill patients with the psychiatrist by taking responsibility for the patients' physical problems. Only 59 would agree to act as a key worker, 308 preferring the community psychiatric nurse to do it. Only nine had specific practice policies for looking after long term mentally ill patients and 287 agreed that such patients often come to their general practitioner's attention only when there is a crisis.Conclusions – The uneven distribution of long term mentally ill patients suggests that community psychiatric resources might be better targeted at those practices with higher numbers of such patients. Most general practitioners seem to be receptive to a shared care plan where the consultant takes responsibility for monitoring psychiatric health with the community nurse as key worker. The lack of practice policies for reviewing the care of long term mentally ill patients must limit general practitioners' ability to prevent crises developing in their care.”

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Braun-Inglis, DNP, APRN, FNP-BC, AOCNP, Christa, Leigh M. Boehmer, PharmD, BCOP, Laura J. Zitella, MS, RN, ACNP-BC, AOCN, Brianna Hoffner, MSN, ANP-BC, AOCNP, Yurii B. Shvetsov, PhD, Jeffrey L. Berenberg, MD, Randall A. Oyer, MD, and Al B. Benson III, MD. "Role of Oncology Advanced Practitioners to Enhance Clinical Research." Journal of the Advanced Practitioner in Oncology 13, no. 2 (March 1, 2022): 107–19. http://dx.doi.org/10.6004/jadpro.2022.13.2.2.

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Background: Oncology advanced practitioners (APs), including nurse practitioners, clinical nurse specialists, physician assistants, and clinical pharmacists contribute significantly to quality cancer care. Advanced practitioners enhance value across the spectrum of cancer care. Research is an underdeveloped component of quality care, as well as an underdeveloped component of AP practice. Understanding research-related attitudes and roles of APs could lead to enhanced clinical trial accrual, conduct, and protocol development. Methods: A nationwide survey addressing attitudes, beliefs, and roles of APs regarding clinical research was distributed by the Association of Community Cancer Centers (ACCC) and Harborside in early 2020. Results: 408 oncology APs completed the survey. Thirty-five percent practice in an academic setting and 62% in the community. Nearly all respondents believe clinical trials are important to improve care, and over 90% report clinical trials are available at their practice. About 80% report being comfortable discussing the topic of clinical trials with patients and are involved in the care of trial participants. Sixty percent are comfortable discussing available trials, and 38% routinely explore available trials with patients. While 70% report approaching eligible patients about trials, only 20% report doing so “a great deal” or “a lot.” Ninety percent report that APs should play a role in clinical research, and 73% want to be more involved. Barriers identified to greater AP clinical trial involvement include lack of time, inadequate awareness of trial specifics, and a lack of a formal role in protocol development and leadership. Conclusions: Advanced practitioners are engaged and interested in clinical trials and believe clinical research is important to improve cancer care. Multidisciplinary team integration, trials-related education, and policy change are needed to employ APs to their full potential within cancer clinical trials.

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Story, Mary T., Dianne R. Neumark-Stzainer, Nancy E. Sherwood, Katrina Holt, Denise Sofka, Frederick L. Trowbridge, and Sarah E. Barlow. "Management of Child and Adolescent Obesity: Attitudes, Barriers, Skills, and Training Needs Among Health Care Professionals." Pediatrics 110, Supplement_1 (July 1, 2002): 210–14. http://dx.doi.org/10.1542/peds.110.s1.210.

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Objective. The primary aim of this study was to evaluate among health care professionals their attitudes, perceived barriers, perceived skill level, and training needs in the management of child and adolescent obesity. Methods. A national needs assessment consisting of a mailed questionnaire was conducted among a random sample of health care professionals. The survey was completed by 202 pediatricians, 293 pediatric nurse practitioners, and 444 registered dietitians. Results. The majority of all respondents felt that childhood obesity was a condition that needs treatment (75%–93%), and affects chronic disease risk (76%–89%) and future quality of life (83%–93%). The most frequent barriers were lack of parent involvement, lack of patient motivation, and lack of support services. Registered dietitians were less likely to identify barriers to treatment compared with pediatricians or pediatric nurse practitioners. The most common areas of self-perceived low proficiency were in the use of behavioral management strategies, guidance in parenting techniques, and addressing family conflicts. All 3 groups expressed high interest in additional training on obesity management of children and adolescents, especially in the area of behavioral management strategies and parenting techniques. Those practitioners with >10 years of practice reported the greatest interest in training. Conclusions. Pediatric practitioners view child and adolescent obesity with concern and feel that intervention is important. However, several important barriers interfere with treatment efforts and will need to be addressed. There is also a need for increased training opportunities related to obesity prevention and treatment. The results of this study provide directions and priorities for training, education, and advocacy efforts.

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Soh, Sze-Ee, Renata Morello, Sheral Rifat, Caroline Brand, and Anna Barker. "Nurse perceptions of safety climate in Australian acute hospitals: a cross-sectional survey." Australian Health Review 42, no. 2 (2018): 203. http://dx.doi.org/10.1071/ah16172.

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Objectives The aim of the present study was to explore nurse perceptions of safety climate in acute Australian hospitals. Methods Participants included 420 nurses who have worked on 24 acute wards from six Australian hospitals. The Safety Attitudes Questionnaire (SAQ) Short Form was used to quantify nurse perceptions of safety climate and benchmarked against international data. Generalised linear mixed models were used to explore factors that may influence safety climate. Results On average, 53.5% of nurses held positive attitudes towards job satisfaction followed by teamwork climate (50.5%). There was variability in SAQ domain scores across hospitals. The safety climate and perceptions of hospital management domains also varied across wards within a hospital. Nurses who had worked longer at a hospital were more likely to have poorer perceptions of hospital management (β = –5.2; P = 0.014). Overall, nurse perceptions of safety climate appeared higher than international data. Conclusions The perceptions of nurses working in acute Victorian and New South Wales hospitals varied between hospitals as well as across wards within each hospital. This highlights the importance of surveying all hospital wards and examining the results at the ward level when implementing strategies to improve patient safety and the culture of safety in organisations. What is known about the topic? Prior studies in American nursing samples have shown that hospitals with higher levels of safety climate have a lower relative incidence of preventable patient complications and adverse events. Developing a culture of safety in hospitals may be useful in targeting efforts to improve patient safety. What does this paper add? This paper has shown that the perceptions of safety climate among nurses working in acute Australian hospitals varied between hospitals and across wards within a hospital. Only half the nurses also reported positive attitudes towards job satisfaction and teamwork climate. What are the implications for practitioners? Programs or strategies that aim to enhance teamwork performance and skills may be beneficial to improving the culture of safety in hospitals. Wards may also have their own safety ‘subculture’ that is distinct from the overall hospital safety culture. This highlights the importance of tailoring and targeting quality improvement initiatives at the ward level.

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Wasylkiw, Louise, Odette N. Gould, and Dusty Johnstone. "Exploring Women’s Attitudes and Intentions to Seek Care from Nurse Practitioners across Different Age Groups." Canadian Journal on Aging / La Revue canadienne du vieillissement 28, no. 2 (June 2009): 177–83. http://dx.doi.org/10.1017/s071498080909014x.

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RÉSUMÉPuisque l’acceptation publique est essentielle à une intégration réussie des infirmières praticiennes dans le système de soins de santé canadien, la présente étude examine de quelle manière les femmes de différents groupes d’âge perçoivent les infirmières praticiennes. Les femmes d’âge moyen avaient généralement une opinion plus positive des professionnels de la santé et étaient plus enclines à indiquer qu’elles demanderaient de l’aide des infirmières praticiennes que les femmes plus âgées et plus jeunes qu’elles. Les répondants des trois groupes d’âge étaient davantage portés à consulter des médecins que des infirmières praticiennes, particulièrement en ce qui concerne les problèmes de santé aigus (par opposition aux questions préventives).

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Saposnik, Gustavo, Beatriz Del Río, Guillermo Bueno-Gil, Ángel P. Sempere, Alejandro Lendínez-Mesa, Alfredo Rodríguez-Antigüedad, María Terzaghi, Nicolás Medrano, and Jorge Maurino. "Behavioral aspects of nurse practitioners associated with optimal multiple sclerosis care in Spain." PLOS ONE 16, no. 12 (December 8, 2021): e0261050. http://dx.doi.org/10.1371/journal.pone.0261050.

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Background Nurse practitioners (NPs) play a critical role in the multidisciplinary management of patients with multiple sclerosis (MS). Neurologists´ behavioral characteristics have been associated with suboptimal clinical decisions. However, limited information is available on their impact among NPs involved in MS care. The aim of this study was to assess nurses´ therapeutic choices to understand behavioral factors influencing their decision making process. Methods A non-interventional, cross-sectional, web-based study was conducted. NPs actively involved in the care of patients with MS were invited to participate in the study by the Spanish Society of Neurology Nursing. Participants answered questions regarding their standard practice and therapeutic management of seven simulated relapsing-remitting MS (RRMS) case scenarios. A behavioral battery was used to measure participants´ life satisfaction, mood, positive social behaviors, feeling of helpfulness, attitudes toward adoption of evidence-based innovations, occupational burnout, and healthcare-related regret. The outcome of interest was therapeutic inertia (TI), defined as the lack of treatment escalation when there is clinical and radiological evidence of disease activity. A score to quantify TI was created based on the number of simulated scenarios where treatment intensification was warranted. Results Overall, 331 NPs were invited to participate, 130 initiated the study, and 96 (29%) completed the study. The mean age (SD) was 44.6 (9.8) years and 91.7% were female. Seventy-three participants (76.0%) felt their opinions had a significant influence on neurologists´ therapeutic decisions. Sixteen NPs (16.5%) showed severe emotional exhaustion related to work and 13 (13.5%) had depressive symptoms. The mean (SD) TI score was 0.97 (1.1). Fifty-six of NPs showed TI in at least one case scenario. Higher years of nursing experience (p = 0.014), feeling of helpfulness (p = 0.014), positive attitudes toward innovations (p = 0.046), and a higher intensity of care-related regret (p = 0.021) were associated with a lower risk of TI (adjusted R2 = 0.28). Burnout was associated with higher risk of TI (p = 0.001). Conclusions Although NPs cannot prescribe MS treatments in Spain, their behavioral characteristics may influence the management of patients with RRMS. Continuing education and specific strategies for reducing occupational burnout may lead to better management skills and improve MS care.

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van Hecke, Oliver, and Kay M. Jones. "The Attitudes and Practices of General Practitioners about the Use of Chaperones in Melbourne, Australia." International Journal of Family Medicine 2012 (August 17, 2012): 1–6. http://dx.doi.org/10.1155/2012/768461.

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Introduction. To consider the use of medical chaperones during certain clinical examinations is important whether one practises as a specialist, nurse, medical student, or generalist. Chaperones have been used by doctors conducting intimate examinations for many years but their true extent remains largely unknown. Until recently, there was no national guidance in Australia. Aim. To explore the attitudes and practices of general practitioners (GP) regarding their use of chaperones in urban Melbourne, Australia. Method. Qualitative two focus groups involving seventeen GPs from two locations. Discussions were audio-taped, transcribed verbatim and analysed. Results. Common themes and subthemes emerged which were grouped into three main areas: (a) practitioner-related, (b) patient-related and (c) practice related. Discussion. This is the first study from an Australian primary care perspective to gauge the attitudes and experiences of GPs on their use of chaperones. It will provide vital information to inform the next step of extending this research to a national GP audience. From an international perspective, this study provides an excellent template for other primary care clinicians to conduct research in this important field of doctor-patient relationship.

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Hämel, Kerstin, and Carina Vössing. "The collaboration of general practitioners and nurses in primary care: a comparative analysis of concepts and practices in Slovenia and Spain." Primary Health Care Research & Development 18, no. 05 (June 20, 2017): 492–506. http://dx.doi.org/10.1017/s1463423617000354.

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Aim A comparative analysis of concepts and practices of GP-nurse collaborations in primary health centres in Slovenia and Spain. Background Cross-professional collaboration is considered a key element for providing high-quality comprehensive care by combining the expertise of various professions. In many countries, nurses are also being given new and more extensive responsibilities. Implemented concepts of collaborative care need to be analysed within the context of care concepts, organisational structures, and effective collaboration. Methods Background review of primary care concepts (literature analysis, expert interviews), and evaluation of collaboration in ‘best practice’ health centres in certain regions of Slovenia and Spain. Qualitative content analysis of expert interviews, presentations, observations, and group discussions with professionals and health centre managers. Findings In Slovenian health centres, the collaboration between GPs and nurses has been strongly shaped by their organisation in separate care units and predominantly case-oriented functions. Conventional power structures between professions hinder effective collaboration. The introduction of a new cross-professional primary care concept has integrated advanced practice nurses into general practice. Conventional hierarchies still exist, but a shared vision of preventive care is gradually strengthening attitudes towards team-oriented care. Formal regulations or incentives for teamwork have yet to be implemented. In Spain, health centres were established along with a team-based care concept that encompasses close physician–nurse collaboration and an autonomous role for nurses in the care process. Nurses collaborate with GPs on more equal terms with conflicts centring on professional disagreements. Team development structures and financial incentives for team achievements have been implemented, encouraging teams to generate their own strategies to improve teamwork. Conclusion Clearly defined structures, shared visions of care and team development are important for implementing and maintaining a good collaboration. Central prerequisites are advanced nursing education and greater acceptance of advanced nursing practice.

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Cook, David A., Laurie J. Pencille, Denise M. Dupras, Jane A. Linderbaum, V. Shane Pankratz, and John M. Wilkinson. "Practice variation and practice guidelines: Attitudes of generalist and specialist physicians, nurse practitioners, and physician assistants." PLOS ONE 13, no. 1 (January 31, 2018): e0191943. http://dx.doi.org/10.1371/journal.pone.0191943.

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Blake, Jay L., and Linda Malone. "Current Behaviors, Attitudes, and Knowledge of Nurse Practitioners in Primary Care Toward Skin Cancer Screening/Prevention." Journal of the Dermatology Nurses’ Association 6, no. 2 (2014): 65–69. http://dx.doi.org/10.1097/jdn.0000000000000031.

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&NA;. "Current Behaviors, Attitudes, and Knowledge of Nurse Practitioners in Primary Care Toward Skin Cancer Screening/Prevention." Journal of the Dermatology Nurses’ Association 6, no. 2 (2014): 70–71. http://dx.doi.org/10.1097/jdn.0000000000000037.

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Packel, Laura J., Sarah Guerry, Heidi M. Bauer, Miriam Rhew, Joan Chow, Michael Samuel, and Gail Bolan. "Patient-Delivered Partner Therapy for Chlamydial Infections: Attitudes and Practices of California Physicians and Nurse Practitioners." Sexually Transmitted Diseases 33, no. 7 (July 2006): 458–63. http://dx.doi.org/10.1097/01.olq.0000219865.65253.29.

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Hallquist Viale, Pamela, and Deanna Sanchez Yamamoto. "The Attitudes and Beliefs of Oncology Nurse Practitioners Regarding Direct-to-Consumer Advertising of Prescription Medications." Oncology Nursing Forum 31, no. 4 (July 1, 2004): 777–83. http://dx.doi.org/10.1188/04.onf.777-783.

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Chacha-Mannie, Cindy, Ann Dewey, Penny Daniels, and Saseendran Pallikadavath. "Brief health promotion in urgent care centres: a qualitative study of patients’ and nurse practitioners’ attitudes." Primary Health Care 29, no. 6 (November 29, 2019): 28–34. http://dx.doi.org/10.7748/phc.2019.e1517.

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Warner, Lindsay L., Susan S. Moeschler, Thomas P. Pittelkow, and Jacob J. Strand. "Attitudes of Hospice Providers Regarding Intrathecal Targeted Drug Delivery for Patients With Cancer." American Journal of Hospice and Palliative Medicine® 36, no. 11 (May 27, 2019): 955–58. http://dx.doi.org/10.1177/1049909119852928.

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Pain is one of the most commonly experienced and feared symptoms faced by patients with a serious illness. For these patients, intrathecal drug delivery systems (IDDSs) provide greater potency and/or few systemic side effects. However, despite these benefits, the integration and management of IDDS for patients receiving hospice care has not been previous studied. An electronic, 18-question survey was sent to 200 hospice practitioners (physicians, nurse practitioners and nurses) in the state of Minnesota to explore their experience, confidence, and the perceived barriers to caring for patients with IDDS while being cared for on hospice. Providers were identified though mailing lists from the Minnesota Network of Hospice and Palliative Care organization. The survey was administered by the Mayo Clinic Survey Research Center with institutional review board approval. Slightly more than 50% of respondents have ever cared for a patient with an intrathecal pump. If a patient had a pump in place, only 28% of providers expressed confidence in managing their pain. Additionally, only 3 of 10 respondents felt that adjusting an intrathecal pump should be the first option when a patient with an IDDS in place had increased pain. Indeed, the vast majority (over 80%) of respondents preferred the use of systemic therapies for primary pain management. Access to IDDS vendors for changes/refills in the home is identified as another barrier with over 50% of respondents either unaware of an available vendor or reporting no vendor available. There are numerous self-reported barriers to ongoing use of IDDS with patients receiving hospice care.

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