Family Nurse Practitioner Research Articles

Family Nurse Practitioner Autonomy and Physician Collaboration in Rural vs Urban Settings

Family Nurse Practitioner Autonomy and Physician Collaboration in Rural vs Urban Settings

Enhancing Knowledge and Attitudes Regarding Opioid Use Disorder Among Private Primary Care Clinics: A Quality Improvement Project.

Opioid use disorder (OUD) continues to impact communities worldwide. British Columbia specifically declared a public health emergency in April 2016. It is known that patients with OUD often experience barriers in access to care, including limited knowledge and training among providers, as well as persisting stigma in the medical community. The Doctor of Nursing Practice quality improvement project sought to provide barrier-targeted OUD education while using multiple effective teaching methods, such as test-enhanced learning, to family nurse practitioners (FNPs) working among private primary care clinics to assess the impact on knowledge and attitudes. In review of an experience survey, zero participants had received prior education on OUD (N = 7). The Drug and Drug Problems Perceptions Questionnaire was used to assess attitudes. In review of the data, attitudes before receiving education (Mdn = 74) improved after receiving barrier-targeted education (Mdn = 66), W = 0, p < .05. Knowledge was tested at three time points. After a review of unique identifiers, four participant tests were successfully linked. It was found that knowledge after receiving education (M = 7.75, Mdn = 7.5) improved in comparison with baseline knowledge (M = 6, Mdn = 6) and further improved after a 1-month time frame (M = 8.5, Mdn = 8.5). Although the project was limited by sample size, providing education to FNPs who have not received prior education on OUD, and using modalities such as test-enhanced learning, showed a favorable impact on knowledge and attitudes. In light of the opioid epidemic, nursing leaders must continue to actively engage practicing FNPs and students with OUD education. FNPs are well positioned to be champions in this area and may mobilize teams to overcome barriers among private primary care clinics and increase access to care.

Medications for opioid use disorder: An interactive educational program developed for the nurse practitioner curriculum.

Opioid overdose deaths remain a major public health concern in the United States and led to the recent changes in regulations that allow nurse practitioners (NPs) to prescribe buprenorphine without the previously required Drug Addiction Treatment Act waiver. Previously, waiver requirements included 24 hours of opioid use disorder (OUD) and medications for OUD (MOUD) training. Although this training is no longer required, NPs need education related to providing nonstigmatizing care to individuals with OUD and safe MOUD prescribing practices. A combination of online didactic modules, in-person simulation activities, and experiential learning was provided to psychiatric mental health NP (PMHNP) and family NP (FNP) students enrolled in a Doctor of Nursing Practice (DNP) program. OUD was presented through a chronic care lens to normalize treatment and decrease stigma, and harm reduction principles were included to increase safe prescribing of MOUD. Fifty-six students completed the didactic training, 51 students participated in the simulation, and 11 students completed shadowing experiences with an experienced MOUD provider. Psychiatric mental health NP and FNP graduates of this DNP program have the knowledge and skills to provide MOUD to individuals struggling with OUD, thus potentially increasing access to care and decreasing overdose deaths.

Developing Family Nurse Practitioner Student Competencies: A Two-Part Mental Health-Focused Telehealth Education Activity

Telehealth is becoming a vital option for increasing access to health care. Family Nurse Practitioners (FNPs) are often the primary providers for rural and disadvantaged populations. They may be the first to encounter patients experiencing depression and other psychiatric problems. This article describes a two-part simulated telehealth education initiative to build FNP student competencies in the use of telehealth technology to interview clients with depressive symptoms.In Part 1, students completed didactic modules that introduced them to telehealth concepts. In Part 2, they participated in a simulated telehealth encounter with a standardized patient experiencing depression. Preparation included a review of care of patients with depression and focused content on telehealth etiquette. After the encounter, they received feedback from the standardized patient, debriefed with faculty, and documented their simulated telehealth visit. The activity was evaluated through post-education surveys and a one-time focus group.Students were overwhelmingly positive regarding the relevance of the educational activity to their graduate preparation and future practice. Many shared suggestions for refinement of the activity. Integration into the current curriculum and use of existing resources increased the feasibility, cost-effectiveness, and potential for long-term sustainability of the educational initiative.

Successful development and implementation of a clinical practice site with community partners to engage family nurse practitioner students in health equity.

Family nurse practitioner (FNP) student clinical practice site availability is limited. Concurrently, many populations lack healthcare access, a common health inequity. Collaboration with community partners to develop clinical practice sites offer students active learning opportunities to increase their engagement and understanding of health equity. Using community collaboration, develop and implement an FNP student clinical practice site that can provide learning opportunities in addressing health equity. Local health data was reviewed, and health gaps were associated with social determinant of health inequities. A community partner was identified with the goal of facilitating students to provide proactive health care to homeless women. Health promotion and disease identification has been the focus of care provided by FNP students and faculty during an early-program clinical course, increasing access to care for an underserved population. A community-academic partnership has developed where FNP students provide health promotion and safety net health care to homeless women since 2017. Student reflections have shown a positive impact on their understanding of health equity. The community partner has identified positive impacts to client health. This partnership has impacted health equity by increasing healthcare access for an underserved population while facilitating FNP student learning.

The Heart of Cardiovascular Disease in Women

Heart disease is the leading cause of death (LCOD) for both men and women in the United States and kills approximately 1 in every 4 women. 1 Tsao C.W. Aday A.W. Almarzooq Z.I. et al. on behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2023 update: a report from the American Heart Association. Circulation. 2023; 147: e93-e621https://doi.org/10.1161/CIR.0000000000001123 Crossref PubMed Scopus (57) Google Scholar Despite widespread dissemination of staggering statistics, focused interventions, and national advocacy campaigns promoting cardiovascular disease (CVD) awareness, it is reported that only 45% to 56% of women identify CVD as the LCOD. 2 Bairey Merz C.N. Andersen H. Sprague E. et al. Knowledge, attitudes, and beliefs regarding cardiovascular disease in women: the Women's Heart Alliance. J Am Coll Cardiol. 2017; 70: 1106-1107https://doi.org/10.1016/j.jacc.2017.07.721 Crossref Scopus (0) Google Scholar Also troubling is the downward trend of women identifying CVD as the LCOD as reported in the 2019 American Heart Association survey in which the percent dropped from 64.8% in 2009 to only 43.7% in 2019. 3 Cushman M. Shay C.M. Howard V.J. et al. Ten-year differences in women's awareness related to coronary heart disease: results of the 2019 American Heart Association National Survey: a special report From the American Heart Association. Circulation. 2021; 143: e239-e248https://doi.org/10.1161/CIR.0000000000000907 Crossref PubMed Scopus (85) Google Scholar Previously excluded from clinical studies that inform best practice guidelines today, women continue to face historically rooted gender inequities resulting in suboptimal screening, inaccurate risk stratification, and a delay in diagnosis and management. 2 Bairey Merz C.N. Andersen H. Sprague E. et al. Knowledge, attitudes, and beliefs regarding cardiovascular disease in women: the Women's Heart Alliance. J Am Coll Cardiol. 2017; 70: 1106-1107https://doi.org/10.1016/j.jacc.2017.07.721 Crossref Scopus (0) Google Scholar ,4 Shaw L.J. Pepine C.J. Xie J. et al. Quality and equitable health care gaps for women: attributions to sex differences in cardiovascular medicine. J Am Coll Cardiol. 2017; 70: 373-388https://doi.org/10.1016/j.jacc.2017.05.051 Crossref PubMed Scopus (69) Google Scholar Women experience gender and sex-mediated risk factors for CVD and are disproportionally affected by traditional risk factors because of physiologic differences. 5 Cho L. Davis M. Elgendy I. et al. Summary of updated recommendations for primary prevention of cardiovascular disease in women: JACC state-of-the-art review. J Am Coll Cardiol. 2020; 75: 2602-2618https://doi.org/10.1016/j.jacc.2020.03.060 Crossref PubMed Scopus (104) Google Scholar Although this is well-documented in the health care literature, nurse practitioners (NPs) and other clinicians report a lack of high-level confidence and comfort in screening women who may be at risk for CVD. 2 Bairey Merz C.N. Andersen H. Sprague E. et al. Knowledge, attitudes, and beliefs regarding cardiovascular disease in women: the Women's Heart Alliance. J Am Coll Cardiol. 2017; 70: 1106-1107https://doi.org/10.1016/j.jacc.2017.07.721 Crossref Scopus (0) Google Scholar ,4 Shaw L.J. Pepine C.J. Xie J. et al. Quality and equitable health care gaps for women: attributions to sex differences in cardiovascular medicine. J Am Coll Cardiol. 2017; 70: 373-388https://doi.org/10.1016/j.jacc.2017.05.051 Crossref PubMed Scopus (69) Google Scholar Catherine Nadeau, DNP, APRN, FNP-BC, CNE, is an assistant professor and concentration director of the Family Nurse Practitioner Program at the University of South Florida in Tampa. Dr Nadeau can be reached at [email protected] Christina Cardy, DNP, APRN, AGACNP-BC, is an assistant professor and concentration director of the Adult Gerontology Acute Care Nurse Practitioner Program at the University of South Florida. Elizabeth Remo, DNP, APRN, FNP-BC, is an assistant professor at the University of South Florida. Anthony W. McGuire, PhD, ACNP-BC, ACNPC, FAHA, is an associate professor at the University of South Florida. Andrea Efre, DNP, APRN, ANP, FNP-C, is an assistant professor at the University of South Florida. Christina Bricker, PhD, APRN, FNP-BC, FAHA, is an associate professor at the University of South Florida.

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

Interprofessional Experiences of Family Nurse Practitioner Students During a Military Field Practicum.

Team building is a real-world necessity in military and civilian health care settings. Interprofessional education (IPE) is therefore an essential component of health care education. At the Uniformed Services University, there are continued, deliberate attempts for IPE to occur to successfully prepare students to work together and adapt to ever-changing contexts. Although past quantitative research has analyzed interprofessional collaboration among military medical students, this study explores the interprofessional experiences of family nurse practitioner (FNP) students during a military medical field practicum. This study was reviewed by the Uniformed Services University Human Research Protections Program Office (Protocol DBS.2021.257). We used the qualitative transcendental phenomenological approach to design our study. We analyzed the reflection papers of 20 family nurse practitioner students who participated in Operation Bushmaster in order to explore their interprofessional experiences. Our research team coded and categorized the data, developing textural and structural descriptions of these categories, which served as the results of our study. We present the study's three key findings that students expressed and include perspectives from their viewpoints to illustrate each theme. The three themes related to IPE are (1) quality of integration determines perception of experience, (2) challenges inspire continued growth, and (3) increased self-awareness of one's own strengths. It is important for educators and leaders to find ways to allow for positive team integration and cohesion so that students do not feel overwhelmed by their perceived lack of knowledge or experience. Educators can use that perception to motivate a growth mindset so that they can continually seek out ways to improve and grow. Additionally, educators can prepare students with adequate knowledge to ensure that each team member meets mission success. Finally, to continually develop, students need to have awareness of their own strengths as well as areas for growth to enhance their own performance as well as that of the military interprofessional health care teams.

Optimizing Care for Military Women: The Value of the Dual-Certified Family and Women's Health Nurse Practitioner.

The number of women in the military has more than tripled over the past 50 years, increasing from 5% in the 1970s to 17% in 2023, making them essential for global health engagement and military operations. Provider competence and confidence are barriers to the consistent availability of preventive, gynecologic, and reproductive services for women across service locations and duty platforms. The Defense Health Board recommends standardizing services and improving the availability and scope of services for women at every point of care. In direct conflict with these recommendations, however, is a congressional call for a drawdown of medical forces, which creates a need for operationally trained clinicians with a broad skill set including comprehensive care for women. Advanced practice registered nurses, such as family and women's health nurse practitioners, are key assets to fill this gap on military medical health-care teams. At the request of the U.S. Air Force, the Graduate School of Nursing at the Uniformed Services University began offering a Women's Health Nurse Practitioner (WHNP) program in 2014. The WHNP curriculum was layered onto the existing Family Nurse Practitioner program so that Family Nurse Practitioner students receive enhanced education in women's health and WHNP students are prepared to meet the holistic, primary care needs of patients across the lifespan in addition to caring for women with obstetric and urogenital health concerns. This article highlights the value of dual-certified Family Nurse Practitioners and WHNPs in the military health-care system. These Uniformed Services University alumni are uniquely prepared to provide comprehensive primary and specialty care for female warfighters across the lifecycle from stable, well-resourced duty stations to austere, operational settings or deployment platforms.

A Virtual Longitudinal Prenatal Standardized Patient Simulation for Nurse Practitioner Students

Prenatal care is a core competency of family nurse practitioners (FNPs). However, it is often difficult for FNP faculty to locate women’s health providers to precept FNP students. This problem was exacerbated by the COVID-19 pandemic, as many sites limited the number of students to provide appropriate social distancing. A series of virtual longitudinal standardized patient prenatal scenarios was created for FNP students. The scenarios, 1 per semester, follow a patient through her pregnancy and review core prenatal concepts. The scenarios supplement women’s health clinical rotations and provide standardization of experiences for FNP students

Experiences in the training of specialist family and community nurses: a qualitative study.

The specialist Family and Community Nurse Practitioner (FCNP) is a professional who, after a period of training, is qualified to be part of multidisciplinary teams in primary care. The aim of this study was to describe and understand the experiences of nurses during their training process in the specialty of Family and Community Nursing in Spain. A descriptive qualitative study was carried out. Participants were recruited by means of convenience sampling from January to April 2022. Sixteen specialist nurses in Family and Community Nursing from different autonomous communities in Spain participated in the study. Twelve individual interviews and one focus group were conducted. Data were analyzed following a thematic analysis method in ATLAS.ti 9. The results showed two themes and six subthemes: (1) Residency period, more than a training: (a) Training during the residency period; (b) Specializing through a constant struggle; (c) Moderate optimism about the future of the specialty; and (2) A journey from illusion to disappointment: (a) Beginning of the residency: feeling special; (b) During the residency: between satisfaction and misunderstanding; (c) At the end of the residency: power and frustration. The residency period is important in the training and acquisition of competencies for the Family and Community Nurse Practitioner. Improvements are needed to ensure quality training during residency and to help give visibility to the specialty.

An Educational Initiative for Family Nurse Practitioners to Detect Melanoma Skin Cancer

Background Skin cancer is the most common type of cancer in the United States. Melanoma skin cancer is the deadliest form of skin cancer. In the United States, the rates of melanoma skin cancer continue to rise more than any other type of cancer. Local Problem Nurse practitioners play an important role in early detection of skin cancer; however, minimal time is spent on dermatology training in current nurse practitioner programs to sufficiently prepare nurse practitioners to identify melanoma skin cancer. Early detection of melanoma skin cancer leads to decreased mortality. Methodology There were approximately 75 family nurse practitioners eligible to participate. The potential participants were asked to complete the online demographic survey and a pretest questionnaire. After intervention, the participants were asked to complete a posttest questionnaire. Intervention A web-based educational tool regarding identification of melanoma skin cancer was developed. The family nurse practitioners viewed the web-based educational module regarding melanoma skin cancer. Results A comparison of pretest and posttest means from the questionnaire was analyzed using a t test. Thirty-three family nurse practitioners showed statistically significant improvements in knowledge after the educational intervention. In addition, confidence increased in their ability to detect melanoma skin cancer. Conclusions This project has shown that a web-based educational module can improve family nurse practitioners' ability and confidence to detect melanoma skin cancer. This educational module was statistically effective and provides an educational framework that can be adopted by other healthcare organizations to improve nurse practitioner knowledge surrounding melanoma detection.

Teaching Family Nurse Practitioner Students to Treat Common Mental Health Problems

Family nurse practitioners (FNPs) face challenges in delivering mental health services in the primary care setting, where >70% of mental health services are now provided. The goal is to present a mental health course that teaches FNP students to provide quality, essential mental health treatment in the primary care setting. A detailed description of a stand-alone 3-credit mental health course for FNP students, “Mental Health for Family Nurse Practitioners,” is presented. Case study examples are provided, and a case study is thoroughly analyzed to demonstrate the unique features of mental health case analysis.

Family Nurse Practitioners: an exploratory study.

To understand Family Nurse Practitioners' practice, educational process and policy in the United States. This is an exploratory, quantitative and qualitative study, developed in 2019 based on clinical observations and interviews with seven Family Nurse Practitioners in the state of New York. The interviews were transcribed and analyzed by the researcher through the observations made and also by the Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires software. The research was approved under Opinion IRB19-49. Three content partitions emerged in the Descending Hierarchical Classification: 1) Being a nurse practitioner; 2) Educational paths and possibilities for action; and 3) Being political: a path to transformation. It was possible to describe skills and competencies considered outstanding in relation to other professional categories, points of improvement in their educational background and the importance of political representation and being active in role performance. This study highlights the similarities with the nurse working in Primary Care in Brazil and serves as a subsidy in the process of implementing this category in Brazilian Primary Care.

Family Nurse Practitioner Students' Readiness for Board Certification Utilizing a Full Board Review Course and Simulation.

The aim of this project was to determine if the implementation of a three-tiered model consisting of a full board review course, round table case analysis, and on call scenarios in the final clinical course of the Family Nurse Practitioner Doctor of Nursing Practice program improved readiness for board certification testing for graduating students. An anonymous pre- and post-survey design was utilized. Institutional Review Board (IRB) approval was obtained prior to implementation. A full board review course, including a predictor exit exam component, was utilized in this cohort's final clinical course. Additionally, in-class case review and "on-call" scenarios were facilitated by the faculty to simulate critical decision-making scenarios. A 58% survey response rate was elicited. Prior to the full board review, 16% of respondents felt ready to answer general board-style questions as compared to 100% following the review. Thirty three percent of respondents felt ready to prescribe and provide evidence-based care prior to the project, following the project, 100% of respondents felt ready. Open-ended questions revealed positive feedback for the course and simulated scenarios, however students did feel overwhelmed by the amount of work the course entailed over the course the semester. Quantitative and Qualitative results indicated positive outcomes and provide support for adoption of the full board review, case-based simulation, and on-call scenarios for all practicum courses at the university. Adjustment of the time requirement and expectations should be reviewed prior to further implementation. In addition, limitations included a small cohort of students in this study; additional studies should be implemented before generalization can occur.

AN AGE-FRIENDLY COURSE ADOPTING THE 4M GERIATRIC MODEL IN A PRIMARY CARE NURSE PRACTITIONER PROGRAM

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.

CHANGING AGING MYTHS AND READINESS FOR INTERPROFESSIONAL EDUCATION IN FAMILY NURSE PRACTITIONER STUDENTS

Abstract The preparation of Family Nurse Practitioner (FNP) students caring for the older adult population is inadequate. The design was a quasi-experimental pilot study (N = 30) to assess change in myths about aging and readiness for interprofessional education (IPE) in FNP students near graduation. The Woolf Aging Quiz (WAQ) containing 24 true-false myths about older adults, and the Readiness for Interprofessional Learning Scale (RIPLS) containing 19 items rated on a 5-point Likert scale (high score indicates more readiness), were completed at baseline and post-intervention. The intervention consisted of 4-weeks of education on normal aging, agism, age friendly healthcare, and IPE using online weekly brief video presentations and peer discussion. Thirty FNP students, mean age 43.5 years, 80.6% (N = 25) female, 19.4% (N = 6) male. A paired t-test showed no significant pre-post difference in the WAQ (t = -1.388, p &amp;lt; .05). McNemar crosstab analysis of the WAQ items indicated 14 aging myths where students chose the wrong answer pre and post intervention. In addition, the RIPLS showed no significant change (t = .793, p &amp;lt; .05) from pre-intervention (mean = 35.87) to post-intervention (mean = 34.42). FNP students near graduation held strong ageist beliefs, reflected in the WAQ, and were unprepared for IPE. Both of these results were resistant to change. The data suggests that FNP programs need to address aging and IPE content earlier and provide students with exposure to older adults that addresses myths about aging affords both theoretical and practical opportunities for interprofessional learning.

Community Paramedicine Clinical Experience for Family Nurse Practitioner Students

Community Paramedicine Clinical Experience for Family Nurse Practitioner Students

Approach to advanced practice nursing student clinical during COVID-19.

Approach to advanced practice nursing student clinical during COVID-19.

Interprofessional Education Innovation: Telehealth Objective Structured Clinical Examination With Family Nurse Practitioner and Pharmacy Students.

Interprofessional education (IPE) is required in the advanced nursing practice curriculum to promote collaboration between health care professionals. Time constraints, accessibility, and geographical locations are common barriers to overcome when considering implementing IPE experiences. Utilizing virtual modalities to develop these experiences can increase IPE opportunities. An innovative approach was taken to incorporate a telehealth Objective Structured Clinical Examination involving family nurse practitioner and pharmacy students from different academic institutions for an IPE virtual simulation. Faculty evaluated student performance based on competencies. Faculty and student feedback regarding the IPE experience was positive.