Emergency Nurse Practitioners Research Articles

Breaking Barriers and Navigating the Future of Emergency Care: The Role of the Emergency Nurse Practitioner.

Over the past two decades, the emergency nurse practitioner (ENP) role has significantly enhanced emergency care in the United States. With the increasing complexity of emergency care, ENPs have expanded into nontraditional settings, necessitating regulatory updates to maintain patient safety. The Consensus Model for Advanced Practice Registered Nurse Regulation has influenced ENP practice, yet consistent regulatory recognition is still needed due to the marked evolution in ENP practice. Despite collaborative efforts to prepare the ENP workforce and ensure competency through standardized education, certification, and licensure, recent unethical publications and skewed statistics have threatened the specialty's progress. Addressing these challenges is crucial for advancing the ENP role and ensuring high-quality emergency care delivery.

The American Academy of Emergency Nurse Practitioners: The First Years.

In 2014, Dr. Elda Ramirez, alongside Dr. Arlo Weltge and Dr. Kyle Kincaid, founded the American Academy of Emergency Nurse Practitioners (AAENP) to support nurse practitioners working in emergency care. With initial support from 39 dedicated individuals, AAENP was incorporated in Texas and received pro bono management from an association management company. Over the years, AAENP has focused on defining the emergency nurse practitioner (ENP) role, developing a board certification examination, and creating standardized curricula for ENP programs. Strong collaborations with organizations such as the American Association of Nurse Practitioners (AANP) and the American College of Emergency Physicians (ACEP) have been pivotal. AAENP has grown significantly, now boasting over 1100 members, and has produced numerous evidence-based position statements and publications. This article highlights AAENP's achievements, and the challenges faced in its formative years, showcasing its commitment to advancing the ENP profession and ensuring quality care in emergency settings.

Founding a Professional Organization: An Interview with American Academy of Emergency Nurse Practitioners' Founder, Dr. Elda Ramirez.

The creation of the American Academy of Emergency Nurse Practitioners (AAENP) marked a significant milestone in the professionalization of emergency nurse practitioners (ENPs). This interview with Dr. Elda Ramirez, the founder of AAENP, explores the critical moments and challenges that led to the establishment of the organization. Driven by the need for a dedicated body to advocate for the unique role of ENPs, AAENP was founded to address gaps in regulatory recognition and professional standards within the broader nursing profession. The manuscript delves into the origins of AAENP, highlighting the pivotal roles of co-founders Drs. Arlo Weltge and Kyle Kincaid, and discusses the organization's early achievements, including the development of a specialized certification exam. AAENP's journey underscores the importance of professional societies in advancing specialty practices and advocating for the interests of their members.

The Path to Certification for Emergency Nurse Practitioners.

Certification serves to validate the knowledge, skills, and experience required for clinical practice. Availability of a certification for emergency nurse practitioners (ENPs) has had an arduous path. This article examines the history of ENP certification in the United States, its territories and Canada, and how the certification examination has arrived at its current state.

Historical Evolution of Emergency Nurse Practitioner Education: A Comprehensive Review.

Historical Evolution of Emergency Nurse Practitioner Education: A Comprehensive Review.

A Tribute to the Founders of the American Academy of Emergency Nurse Practitioners.

A Tribute to the Founders of the American Academy of Emergency Nurse Practitioners.

10th Anniversary of the American Academy of Emergency Nurse Practitioners.

10th Anniversary of the American Academy of Emergency Nurse Practitioners.

The Evolution of the Emergency Nurse Practitioner Role: A Historical Review.

The history of emergency nurse practitioners (ENPs) is one of evolution and adaptation in response to changing healthcare demands. The role of nurse practitioners (NPs) in emergency departments (EDs) has undergone significant evolution since the 1970s. This historical narrative traces the historical development of ENPs, focusing on their roles, training, and impact on patient care. It explores early experimental programs, academic training, and the increasing integration of NPs into emergency care settings.

Executive Leadership and Entrepreneurship of Emergency Nurse Practitioners: Pioneering Pathways in Emergency Care.

For more than five decades, emergency nurse practitioners have developed partnerships and led improvements in emergency care delivery. Through these endeavors the quality of patient care has been amplified and access to emergency care has been augmented. Nurse practitioners providing emergency care possess fundamental leadership qualities necessary for leading teams in delivery of exceptional care. Though advanced practice nurse entrepreneurship is relatively new, engagement of emergency nurse practitioners in business ventures continues to evolve and expand. This article showcases the work of five emergency nurse practitioners whose leadership and entrepreneurship have elevated emergency care bringing recognition to the aptitude and versatility of the emergency nurse practitioner specialty.

Historical Evolution of Emergency Nurse Practitioner Education: A Comprehensive Review.

This manuscript explores the historical evolution of emergency nurse practitioner (ENP) education from its inception to its current state. It discusses key milestones, innovative leaders, curricular approaches and current program characteristics. The paper concludes with a review of the current state of ENP education, persistent challenges, and future directions. Professional organizations that have shaped both the ENP role and education over time are also considered. By examining the historical context, this review provides insights into the evolution of ENP education, contributing to a deeper understanding of the ENP role and education's significance in emergency care.

Validation of Emergency Nurse Practitioner Competencies: Patient Complexity and Clinical Decision Making

IntroductionOver the past 15 years, the emergency nurse practitioner has been recognized as a nursing specialty role with dedicated scope and standards of practice. However, a paucity of objective data exists to validate the actual practice of emergency nurse practitioners in the emergency care setting. The purpose of this pilot study was to describe the initial acuity of patients assigned to emergency nurse practitioners, actions, decisional complexity, and disposition decisions of advanced practice nurses as they function in emergency departments in a single system. MethodsThis descriptive exploratory study used retrospective chart data to gain understanding. ResultsThe most common Emergency Severity Index level seen by emergency nurse practitioners was Emergency Severity Index 3. Of 8513 encounters with Emergency Severity Index level data, 21% were triaged at Emergency Severity Index 2, 56% at Emergency Severity Index 3, 21% at Emergency Severity Index 4, and only 2% at Emergency Severity Index 5. Half of encounters resulted in a Current Procedural Terminology code of 99825 or higher and 94% were coded at 99824 or higher. There were a high percentage of admissions including intensive care unit admissions. DiscussionAlthough descriptive, this study is highly illustrative of the broad scope of complex skills and clinical decision making required to perform as an advanced practice nurse in the emergency department. Further examination of education and training is warranted.

Point of Care Ultrasonography to Confirm Endotracheal Tube Placement: A Review for the Emergency Nurse Practitioner

Point of Care Ultrasonography to Confirm Endotracheal Tube Placement: A Review for the Emergency Nurse Practitioner

Point-of-Care Ultrasonography to Confirm Endotracheal Tube Placement: A Review for the Emergency Nurse Practitioner.

Ensuring correct placement of the endotracheal tube (ETT) during intubation is an important step to avoid complications. Appropriate placement of the ETT can be challenging and, if done incorrectly, can lead to complications such as hypoxemia, atelectasis, hyperinflation, barotrauma, cardiovascular instability, end organ damage, and even death. Although several procedures exist to help assess ETT confirmation, all have limitations, are not always reliable, and vary in their degree of accuracy. Point-of-care ultrasound (POCUS) has emerged as a useful tool in the emergency department for quick diagnosis and treatment of many emergency conditions (Gonzalez et al., 2020). The purpose of this paper is to describe a systematic approach for the emergency nurse practitioner to use POCUS to assess proper endotracheal placement and the positioning within the trachea based on prior studies that compare this modality to traditional ones.

Emergency Medicine Case Study on Local Anesthetic Systemic Toxicity.

The purpose of this case study on local anesthetic systemic toxicity (LAST), a potentially life-threatening complication of local anesthetic, is to ensure that emergency nurse practitioners (ENPs) are knowledgeable on this disease process. Local anesthetics are used frequently, often daily, by ENPs, as well as multiple other health care providers for various procedures. They should be knowledgeable of the steps to resuscitate a patient who may have severe LAST. This case study reviews the emergency management of LAST, including pharmacologic treatment, deviations from routine advanced resuscitative guidelines, and disposition of the patient upon successful resuscitation. Additionally, risk assessment and clinical manifestations will be discussed. After reviewing this case study, ENPs should be able to recognize the presentation of LAST and provide emergent management to reduce complications, comorbidities, and death.

Implementation of an Evidence-Based Medicine Curriculum for Postgraduate Emergency Medicine Physician Assistant and Nurse Practitioner Fellows.

Within physician assistant (PA) education, the inclusion of evidence-based medicine (EBM) is mandatory. Despite existing literature on EBM training methodologies for PA students and emergency medicine (EM) physician residents, there exists a dearth of published data concerning EBM instruction within postgraduate PA EM programs. A pilot study is described providing an overview of implementation of an EBM curriculum in a single-institution postgraduate physician assistant and nurse practitioner emergency medicine fellowship. Quantitative data using pre-curriculum and post-curriculum surveys were collected. The curriculum included statistical concept screencasts, required attendance at a journal club with assigned topics for discussion, and used a critical appraisal tool designed to help fellows better analyze and understand the articles being reviewed. Upon graduation, fellows participated in structured interviews to collect qualitative data about the curriculum and application of learned concepts to the clinical setting. There was a statistically significant improvement in fellows' reported confidence in discussing the medical literature with practicing providers ( P = .02). However, there was no difference in prescores and postscores on EBM knowledge questions or on fellows' feelings of importance of EBM to clinical practice. Qualitative data revealed several themes, including helpfulness of tools provided in the curriculum, appreciation of curricular changes made secondary to fellow suggestions, and reports of improvement in reviewing medical literature and comfort in participation in local journal clubs upon graduation from the fellowship program. Limitations, including small sample size and validity concerns, are discussed. Positive changes were made to the curriculum based on qualitative data collected. The authors advocate for subsequent investigations into this subject within a multi-institutional and multispecialty context, thereby enhancing the breadth of the findings. Nevertheless, this study furnishes the initial accessible substantiation of the viability of introducing an EBM curriculum within this specific demographic.

Recognition of Cutaneous Symptoms of Common Tick-Borne Illness in the Emergency Department.

Tick-borne diseases occur throughout the United States, with a disease burden that ranges from mild to severe. As temperatures rise with climate change, the active season for ticks increases, and more tick-borne illness is seen (Centers for Disease Control and Prevention, 2022a). Many patients present to the ED for suspected tick bites, rashes, and generalized medical complaints that may be related to a tick-borne disease, so it is important for the emergency nurse practitioner (ENP) to accurately diagnose these conditions. Because of this increasing disease burden, it has become vital for these illnesses to be recognized early, as early diagnosis can reduce possible complications of chronic illness. Familiarity with the cutaneous rashes present in several tick-borne diseases can aid the ENP to effectively diagnose and treat these conditions.

The influence of practice experiences on feelings of role proficiency in emergency nurse practitioners: A phenomenological study

IntroductionThis research explores how emergency nurse practitioners (ENPs) become role proficient given experience variation and lack of role standardisation. AimTo understand how ENPs experiences in practice influence their feelings of role proficiency. MethodsA hermeneutic phenomenological study was undertaken utilizing an interpretive standpoint. A two-phase approach was adopted with ten participants using a digital diary informing a semi-structured interview. A three-stage data analysis approach was applied. FindingsSix themes emerged: the meaning of role proficiency, relationships, confidence, learning and knowledge, exposure and experience, and care. Models of proficiency and its development are presented. DiscussionProficiency is defined where confidence in the components that proficiency consists of and their application to each clinical presentation is required. Proficiency is a continuum supported by regulatory mode theory. Inconsistency of role understanding gives rise to three ENP groups, resistors, maintainers, and innovators. ConclusionRole clarity is required to establish a consistent culture within organisations founded on the voice of the ENP as captured in this research. This model of proficiency be incorporated in ENP role development for current and future ENPs.

Supporting Emergency Care Delivery Through Updated Emergency Nurse Practitioner Competencies

As multidisciplinary emergency care becomes increasingly complex, all team members must be aware of their respective roles and responsibilities. In the emergency department, nurse practitioners are integral members of the team. They possess a wide range of clinical and leadership competencies that allow them to perform specific and differentiated tasks within the emergency department. A well-defined competency not only contributes to the promotion of a positive work culture but also clarifies performance expectations, identifies skill gaps, and supports team development. Furthermore, it allows the nurse practitioner to adapt to changing conditions while maintaining patient safety. The competencies of emergency nurse practitioners have evolved over the past 2 decades. The authors discuss the importance of establishing clear expectations for emergency nurse practitioner practice in this article and the alignment of competencies with organizational culture and objectives.

Exposing research misconduct and data misrepresentation targeting nurse practitioners in emergency care

Davis, Wesley D. DNP, ENP-C, FNP-C, AGACNP-BC, CEN, FAANP, FAEN (Family & Emergency Nurse Practitioner Track Coordinator & Assistant Professor)1; Schumann, Lorna PhD, FNP-C, ACNS-BC, ENP-C, FAAN, FAANP (Commission Chair)2; Evans, Dian Dowling PhD, FNP-BC, ENP-C, FAAN, FAANP (Professor Emeritus, Emergency Nurse Practitioner Program)3; Ramirez, Elda PhD, FNP-BC, ENP-C, FAANP, FAEN, FAAN (Professor of Clinical Nursing, Founder)4; Wilbeck, Jennifer DNP, ACNP-BC, FNP-BC, ENP-C, FAANP, FAAN (Emergency Nurse Practitioner Program Director & Professor)6 Author Information

Aligning Emergency Nurse Practitioner Programs Using a National Validation Process

The Consensus Model for APRN Regulation tasks nurse practitioner (NP) specialty organizations to develop and uphold the specialty practice. Through an innovative process, the American Academy of Emergency Nurse Practitioners incorporated data from a national practice analysis of NPs working in emergency care into a validation process to align emergency NPs education and training with current practice. As organizations and educators support expanding NP specialty practice, this novel process of academic program validation provides an opportunity for replication to ensure alignment of education, certification, and practice among unregulated specialty NP programs.