Nurse Practitioner Program Research Articles

Intensive care nurse practitioners in Australia: A description of a service model in an adult tertiary intensive care unit

BackgroundAlthough well-established internationally, nurse practitioners (NPs) in Australian adult intensive care units (ICUs) are rare. Australian literature clearly highlights the importance of creating ICU NP roles to meet emerging demands. An ICU NP model of care at a metropolitan hospital in Sydney provides care in four core practice areas: complex case management, vascular access, tracheostomy management, and intrahospital transport of critically ill patients. The ICU NPs also provide training and assessment for ICU nurses and medical officers in these same core practice areas and can efficiently meet service gaps in crisis such as the most recent COVID-19 pandemic. ResultsThe ICU NP program described is an innovative model of care that has demonstrated potential benefits to patients and their families. Potential benefits to the healthcare system including supporting advanced practice nursing development in regional and rural Australia and in addressing future ICU workforce issues are also identified. This model of care provides a clear role and structure for the integration of NPs in the adult ICU. Research to evaluate the impact of the role is required and is underway. ConclusionsThis model is being used to develop a national adult ICU NP fellowship training program for ICU transitional NPs preparing for endorsement or endorsed NPs who require additional ICU-specific training. This immersive clinical training program combined with didactic learning modules offers a framework to support the implementation of the adult ICU NP role as well as a framework for NP fellowship programs in other specialties.

Strategies for successfully completing a DNP final project.

Completion of a final project is an essential component of Doctor of Nursing Practice programs. Strategies for successful project planning, implementation, and evaluation are outlined, from identifying an evidence-based practice or quality improvement project, advisor, and practice mentor through completion, presentation, and dissemination of your work.

Effect of In-School Geriatric Nursing Practice Program on Attitude & Behavior Towards Elderly, Geriatric Nursing Practice, and Dementia Attitudes in the Context of COVID-19

Effect of In-School Geriatric Nursing Practice Program on Attitude & Behavior Towards Elderly, Geriatric Nursing Practice, and Dementia Attitudes in the Context of COVID-19

The Experience of Gaining Admission in Graduate School Advanced Practice Nursing Programs during the COVID-19 era

The Experience of Gaining Admission in Graduate School Advanced Practice Nursing Programs during the COVID-19 era

Recommendations for evolving a doctor of nursing practice program.

As Doctor of Nursing Practice (DNP) programs have evolved within the nursing profession and nursing academia over the last 20years, pedagogy and curriculum in DNP education have also continued to evolve. Educational innovation requires continuous assessment to ensure quality and efficacy are maintained. Using the Knowledge to Action (KTA) framework, we adapted the knowledge regarding best practices in a DNP program to fit our College of Nursing needs, our community of learners, and sustain this process improvement by implementing programmatic changes that enhanced the quality and rigor of the DNP program. A newly formed task force identified barriers and opportunities including lack of DNP-prepared faculty, changes needed to the scholarly project paper, revision of the DNP curricula, and a need for a mentor group model to replace the traditional committee structure. Recommendations to strengthen DNP programs include choosing a process model or framework to serve as a guideline for program evaluation and improvement, create a faculty-led task force that continuously monitors program elements, and conduct annual mini retreats to facilitate faculty discussion and review of program elements.

Addressing telehealth education in a family nurse practitioner program through simulation-based learning.

Telehealth usage increased because of the COVID-19 pandemic. Health care agencies responded by increasing existing platforms and implementing new telehealth platforms. Despite the demand, health care providers may have had little training in the telehealth care delivery model in the workplace or embedded in school. Based on educational theory, evidence, and best practice, the authors crafted a learning module that focused on telehealth medical skills followed by a summative standardized patient simulation. This article describes the development, implementation, and evaluation of the learning module and the summative simulation assessment. The learning module and the simulation provided a teaching strategy that resulted in an objective measurement of student clinical performance, which may be elusive in a traditional face-to-face practicum. Additionally, the simulation-based learning resulted in increased student satisfaction with simulation and increased self-confidence to apply the information in the clinical setting.

Promoting understanding of medical decision-making coding for nurse practitioner students.

Nurse practitioners (NPs) are often responsible for coding patient encounters for reimbursement. Students should learn the basics of this skill during their educational preparation. On January 1, 2021, the American Medical Association and the Centers for Medicare & Medicaid Services implemented new guidelines to the evaluation and management office appointment documentation and coding. The new medical decision-making (MDM) guidelines created a learning curve for NP students, faculty, and preceptors. An additional obstacle was encountered when on-campus preclinical intensives, which included a coding practice session, were canceled due to the COVID-19 pandemic. The faculty of an NP program identified MDM coding as a difficult concept to teach in an asynchronous learning environment. In response, the faculty developed and implemented synchronous online case study sessions that incorporated active student participation and real-time feedback, thus increasing engagement with peers, faculty, and the MDM concepts. The purpose of this article was to present a synchronous method for teaching MDM coding to NP students, and the outcomes, lessons learned, and implications for nursing education and practice.

Advanced nursing practice model for head and neck cancer: A practice development project

Advanced nursing practice model for head and neck cancer: A practice development project Abstract. Background: Head and neck cancer confronts patients and their families with big challenges due to complex treatments as well as changes in vital functions and appearance. They require multifaceted support and benefit from coordinated, interprofessional collaboration and advanced nursing practice. Problem/aim: In a tertiary head and neck cancer center, a coordinating contact person was missing for patients, families and the care team. Therefore, a project was launched to develop an advanced nursing practice program. Methods: Methods included an advanced nursing practice concept, approaches for practice development, and action research. The project consisted of four phases: Stakeholder analysis and literature review were followed by the definition of the advanced nursing practice program, which was then tested during a pilot phase, and evaluated using structural/process data and stakeholder interviews. Results: Evidence-based, continuous, person-centered care was improved across the care continuum for patients/families. The nurses' expertise was supported and the collaboration with internal/external clinicians was facilitated. Patients/families valued the continuity offered by the advanced practice nurse. Discussion: The methodological approaches supported a goal-oriented approach; especially participatory practice development helped to address employees' concerns. Limitations/transfer: To date, a sustainable program cannot yet be warranted. For similar projects, an approach with stakeholder analysis, multidisciplinary focus, and early evaluation planning is recommended.

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

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

Whose Oxygen Mask Goes on First?

When my spouse and I decided to start our family, breastfeeding was in the plan. As a nurse practitioner (NP) who was already a specialist in women’s health, who had best practices in breastfeeding included in my NP program and continuing education, and supported many mothers in initiating and maintaining breastfeeding, I felt well prepared and competent to nurse my own children. For our first child, everything went smoothly. It was an uncomplicated birth and all the “golden hour” recommendations for initiating breastfeeding were followed. 1 International Federation of Gynecology and ObstetricsFIGO Statement—Harnessing the golden hour: breastfeeding recommended within first hour of life. https://www.figo.org/resources/figo-statements/harnessing-golden-hour-breastfeeding-recommended-within-first-hour-lifeDate: 2022 Date accessed: August 16, 2022 Google Scholar The baby was a good nurser and latch on tenderness resolved in about a week. The next birth and breastfeeding experience was the same up until the baby was 2 weeks old, when the “spitting up” started. At first I didn’t think much of it because the first baby did the same thing until 6 months of age. The volume and force gradually increased; I thought it was because my milk was plentiful and the baby was overfull. I tried nursing more frequently with shorter times at the breast. When fever and lethargy appeared, we went straight to the emergency department. During the 4 days it took to diagnose the cause, our little one was NPO (taking nothing by mouth) and on intravenous fluids. Surgery at 3 weeks and 5 days of age to correct the problem was followed by bottle-feeding breast milk to facilitate documenting intake. By the time we were cleared to resume direct breastfeeding, the baby absolutely refused to nurse at the breast, with screaming, crying, and back arching. I bottle-fed pumped milk but my milk dwindled. So, it was formula from then on. With the trauma of our tiny baby being ill, then surgery, the usual postpartum baby blues, and now “failing” at breastfeeding, I was discouraged and anxious. Section Editor Denise Link, PhD, WHNP-BC, FAAN, FAANP, is a clinical professor emerita at Arizona State University Edson College of Nursing and Health Innovation, Phoenix, AZ. She can be reached at [email protected]

Applying Nurse Practitioner Student Reflections in Design of Telehealth Curricula

Telehealth demand increased precipitously among all populations, particularly Medicare beneficiaries with complex care needs, during the coronavirus disease 2019 pandemic. Current nurse practitioner (NP) graduates require practice readiness in telehealth when transitioning to advanced practice. Competency-based education models integrate progressive, multimodal evaluation of core practice competencies, including telehealth. Self-reflection supports student acquisition of new competencies. Thematic analysis of guided reflections after a pilot gerontologic robot-enabled telehealth simulation identified curricular opportunities in a primary care NP program. NP students’ perceived challenges in communication and adaptation to virtual patient presence were considered in building integrated telehealth curricula in clinical courses applying the 4Ps of Telehealth Education (Planning, Preparing; Providing; and Performance Improvement) framework.

Incorporating climate change into Doctor of Nursing Practice curricula.

Climate change is a global crisis with major impacts on planetary health and quality of life. Nurses are well positioned to recognize the major health consequences of climate change on health. Therefore, highlighting nurses' active engagement in mitigating climate change impact and resilience efforts is essential. However, there is little evidence of climate change content in nursing curricula. Climate change/planetary health content could be integrated into existing Doctor of Nursing Practice programs so that graduates, as influential leaders, are equipped to meet the challenges ahead. The domains, competencies and sub-competencies outlined in the Essentials: Core competencies for professional nursing education (American Association of Colleges of Nursing (AACN), 2021) are proposed as a curricular scaffold to integrate climate change content in DNP curricula. Climate change content matched to the AACN domains and competencies could be included in many existing DNP courses. Climate change would become a consistent concept throughout all DNP curricular programs rather than a specified course addressing climate change. The curricular structure presented would provide a foundation for enhancing DNP students' knowledge, attitudes and skills related to climate change. These students and future graduates would be well prepared to introduce changes in practices and policies at the local, national, and global levels.

Adult-Gerontology Nurse Practitioners: A Discussion of Scope and Expertise

Adult-gerontology primary care nurse practitioners (NPs) deliver longitudinal primary care in outpatient settings from adolescence to older adulthood, and adult-gerontology acute care NPs provide care to critically ill adults and older adults. Family NP programs vastly outnumber adult-gerontology NP programs nationwide, despite a rapidly aging population. This report discusses the differences in education and scope of practice of adult-gerontology primary care NPs, adult-gerontology acute care NPs, and family NPs and highlights the crucial and unique assets adult-gerontology NPs bring to any health care system or practice. Differences in competencies, certification examinations, and practice settings are discussed in depth.

Critical Appraisal of Clinical Practice Guidelines (CPG) Training for Graduate Student Nurses: Exemplar of a CPG for the Management of Post-Traumatic Stress Disorder (PTSD)

Background: Clinical practice guidelines serve as a framework for clinical decisions supporting best practices to optimize patient care. Critical appraisal of a clinical practice guideline is an important clinical skill for advanced practice nurses and other advanced healthcare professionals. Hence, advanced practice nursing students should receive appraisal training of clinical practice guidelines to develop their critical skills in determining their quality and potential incorporation into evidence-based clinical practice. Objective: This paper describes the incorporation of a critical appraisal of a clinical practice guideline in a graduate nursing program for advanced nursing practice. As an exemplar of the appraisal process, the clinical practice guideline from the United States (US) Department of Veterans Affairs and the Department of Defense (VA/DoD) on the management of post-traumatic stress disorder and acute stress disorder was critically appraised. Methodology: Students enrolled in a graduate nursing course were formed into groups of 3-4, and selected a clinical practice guideline according to their specialty. A group of four students enrolled in the Psychiatric and Mental Health Nurse Practitioner program critically appraised the VA/DoD clinical practice related to the management of posttraumatic stress disorder and acute stress disorder using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument. Students’ performance and feedback were evaluated. Results: The students viewed the course activity positively and appreciated learning the CPG appraisal process and its use in practice. The VA/DoD clinical practice guideline was deemed of high quality and user-friendly for practitioners’ use in clinical decision-making despite minor limitations. Conclusion and recommendations: Incorporation of clinical practice guideline assessment using the AGREE II Instrument in the advanced practice nursing curriculum should be considered. Participating graduate students considered the skill needed for their future advanced practice. Regular updates of clinical practice guidelines and their appraisals are also recommended.

A Qualitative Analysis of Postgraduate Training Programs for Family Nurse Practitioners

Introduction: Family nurse practitioners (FNPs) are registered nurses who are trained at the master’s level and manage the care of patients in the primary care setting. FNP postgraduate training programs further prepare them and ease their transition from education to practice. Although these programs are emerging and relatively new, they are becoming more common as graduates and employers seek further preparation to practice in the primary care setting. Methods: Interview questions were developed using guidelines from the Consolidated Framework for Implementation Research. Participants were selected using convenience sampling. Fourteen semi-structured interviews with key informants were conducted between July 2021 and August 2021. Interviews were recorded and transcribed using Zoom. Data were analyzed using thematic analysis, and key themes were identified. Results: Key informants had similarities in their responses. Themes identified through analysis included program implementation, resident selection, funding sources, and program evaluation. Discussion: The network of FNP postgraduate training programs is growing. Program directors are eager to share their progress with others and willing to collaborate with those seeking to implement programs. Given the evolving complexity of patients in the primary care setting, the increasing responsibility of FNPs, and the rise in postgraduate training opportunities, FNP postgraduate training programs are emerging as a means of bridging education to practice. Conclusions: The findings of this research indicate commonalities between programs and suggest long-term program standardization. The unique combination of emerging federal grant funding, accreditation options, and a stronger support network among participants suggest potential for future program creation and expansion.

Facilitators and barriers in implementing the nurse practitioner role in Japan: A cross-sectional descriptive study.

To investigate the distribution of nurse practitioners (NPs) across Japan and their perceived facilitators and barriers to NP implementation in Japan. NP certification examinations have been conducted in Japan since 2011, and by 2020, there were 487 NPs in the country. The momentum of NP implementation is slower in Japan compared with other countries. A cross-sectional descriptive study, following the STROBE guidelines, was conducted. Web-based survey questionnaires, developed by the authors, were administered to 248 NPs whose email addresses were maintained by the certification management body. Valid responses were obtained from 101 NPs (response rate: 40.7%), of which 34% were male. The respondents had more than 12 years of registered nurse experience on an average before enrolling in the graduate NP program. 53% were employed as NPs from the beginning, while 25% were initially employed as registered nurses and later advanced to NPs, and 11% still worked as RNs. A majority worked in hospitals with beds. Many NPs perceived the lack of NP national licensure and reimbursement benefits as barriers to NP implementation, whereas recognition from superiors and organizations was considered facilitators. Despite their small numbers in Japan, NPs take on crucial tasks and contribute to the appropriate distribution of medical resources. The NP licensure system and recognition from superiors and organizations may be necessary to promote NP roles in Japan. Some certified NPs still work as registered nurses. Recognition from nursing and organization administrators is critical to implementing NPs. To this end, a reimbursement system benefiting the organizations and a legislation facilitating NP employment are required.

Implementation of a Standardized National HIV Curriculum in a Primary Care Nurse Practitioner Program.

Although efforts have been made to improve and integrate an HIV curriculum in schools of nursing, little has been done to standardize the integration of competencies related to HIV care in primary care nurse practitioner (NP) programs. The purpose of this study was to understand the effect of integrating the 6 core competencies from the National HIV Curriculum (NHC) on NP students' perceived knowledge about HIV care. This was a quasi-experimental study with a pre/posttest design that measured NP students' self-perceived knowledge of the 6 core competencies from the NHC. A total of 375 student NHC training sessions were implemented across 5 semesters (fall 2019 through fall 2021 academic years). In each of the 3 courses that integrated the NHC, there were statistically significant increases in student knowledge from pre- to posttest for each of the 6 competencies. This project supports using a standardized HIV curriculum as part of primary care NP curricula.

Nurse practitioner programs: Selection factors and the student experience.

Nurse practitioner (NP) education has faced numerous challenges related to the changing healthcare landscape, shortages of faculty, and limited resources to meet the needs of NP students. The changes within NP education have impacted students, both positively and negatively. This purpose of this review of the literature is to gain an understanding of the primary care NP student perspective related to selecting a NP program, faculty and peer relationships, program success versus attrition, clinical experiences, and transition to practice. Gaps in the literature encompassing NP education will be reviewed. Finally, recommendations will be given for prospective NP students as well as NP educators.

I Get by With a Little Help From My Peers: Mindfulness and Peer Support for Doctor of Nursing Practice Students.

Graduate nursing students faced numerous stressors while pursuing their education during the COVID-19 pandemic, with many working clinically while studying. The purpose of this pilot was to explore support strategies and decrease stress in first-year students enrolled in a doctor of nursing practice program during a time of uncertainty and crisis. Graduate students were assigned to practice a three-minute mindfulness activity and connect with a fellow student for a month. Students reported mindfulness benefits and social support. Modeling healthy practices is critical to support mastery of skills that will promote positive reactions to challenges in their future practice settings.

Integration of a Simulation Curriculum Across Semesters in an Acute Care Pediatric Nurse Practitioner Program

Simulation is a common strategy for health care education. Research regarding simulation for nurse practitioner education is sparse. This paper describes the integration of a nine simulation session curriculum into a nurse practitioner program, including motivating factors, process description, and lessons learned. Students report high satisfaction and improved perception of confidence and competence of knowledge, skills, and performance. Integrated learning experiences and outcomes that span an educational program are needed in thetransition to competency-based education. This description serves as a guide for other programs seeking to incorporate simulation-based education.