Advanced Practice Provider Care Team Models: Best Practices From an Academic Medical Center.

Health care leaders must be innovative to meet the demands of patient access and cost efficiency, all while never compromising patient safety or experience. A clear understanding of the care team model with optimal utilization of all team members is paramount to success. This article discusses 5 nurse practitioner and physician assistant (collectively called advanced practice providers) care team models that regularly occur in health care organizations across the country.

Obesity and Nonalcoholic Fatty Liver Disease.

Obesity and nonalcoholic fatty liver disease (NAFLD) have a significant global impact, and their complications are quickly becoming a reason for primary care visits and hospitalizations. This article provides an overview of NAFLD and obesity, pathogenesis of NAFLD and nonalcoholic steatohepatitis, clinical presentation and diagnostic criteria, and a review of practice guidelines. The current mainstay of treatment for NAFLD are lifestyle modifications and include a plan to eat, move, and change behavior.

A Review for the Practicing Clinician: Hepatorenal Syndrome, a Form of Acute Kidney Injury, in Patients with Cirrhosis.

The hepatorenal syndrome type of acute kidney injury (HRS-AKI), formerly known as type 1 hepatorenal syndrome, is a rapidly progressing renal failure that occurs in many patients with advanced cirrhosis and ascites. Accumulating evidence has led to a recent evolution of diagnostic criteria for this serious complication of end-stage liver disease. The aim of this review is to provide an overview of disease-related characteristics and therapeutic management of patients with HRS-AKI.

Development of a Competency Model for Placement and Verification of Nasogastric and Nasoenteric Feeding Tubes for Adult Hospitalized Patients.

Nasogastric/nasoenteric (NG/NE) feeding tube placements are associated with adverse events and, without proper training, can lead to devastating and significant patient harm related to misplacement. Safe feeding tube placement practices and verification are critical. There are many procedures and techniques for placement and verification; this paper provides an overview and update of techniques to guide practitioners in making clinical decisions.

Nurse practitioner and physician assistant onboarding in a family medicine practice.

The nurse practitioner (NP) and physician assistant (PA) professions are rapidly growing. Historically, these professions have filled a health care delivery gap caused by lack of health care access and physician shortages. Many medical practices are more accustomed to adding new physicians as compared with adding new NPs or PAs.

Cirrhosis: An evidence-based approach.

The role of nurses in managing patients with cirrhosis is increasing due to the growing prevalence of the disease. This article reviews the pathophysiology, diagnosis, complications, and management of patients with cirrhosis, with an emphasis on interdisciplinary collaboration and evidence-based practice.

Nutritional Assessment and Malnutrition in Patients With Cirrhosis.

We sought to determine the incidence and outcomes of malnutrition in patients with cirrhosis. We performed a retrospective chart review of 134 patients listed for liver transplant (LT) to assess the presence and degree of malnutrition identified by the Subjective Global Assessment score at the time of initial transplant evaluation, follow-up nutrition visits, and at the time of transplant. Number of admissions/readmissions to the hospital, reason for hospitalization(s), and length of stay were determined.

Cirrhosis: An evidence-based treatment approach.

The NP's role in managing cirrhosis is increasing due to the growing prevalence of the disease. The purpose of this article is to review the pathophysiology, diagnosis, and management of patients with cirrhosis with an emphasis on interdisciplinary collaboration and evidence-based practice. Cirrhosis complications are also discussed.

The Emerging Role of Nurse Practitioners and Physician Assistants in Liver Transplantation.

The evolving role of nurse practitioners (NPs) and physician assistants (PAs) in the United States continues to progress. NP and PA responsibilities have expanded from primary care practices to medical and surgical specialties. They provide acute care in hospitals and intensive care units, and they serve as educators, lobbyists, and researchers.

Caring for patients with chronic hepatitis C infection.

Hepatitis C virus (HCV) infection is the most common chronic bloodborne infection in the US. This article discusses the pathophysiology of HCV infection, new treatment options, and nursing care and patient teaching for patients with chronic HCV infection.

The Benefit of Supplemental Nutrition Education for Severely Malnourished Patients Awaiting Liver Transplant.

Introduction: Nutritional interventions improve patient outcomes and reduce mortality in patients with cirrhosis by reducing infection risk, ascites, length of stay in hospital and intensive care unit, and mortality. Follow-up phone calls have been found to be useful in improving patient adherence to therapy.

Problem: The purpose of this quality improvement project was to determine whether supplemental nutrition education would improve nutrition and outcomes among patients with cirrhosis who are undergoing a liver transplant evaluation.

Role Development of Nurse Practitioners and Physician Assistants in Liver Transplantation.

Background: Nurse practitioners (NPs) and physician assistants (PAs) are increasingly utilized in health care. However, their roles in liver transplantation (LT) have not been investigated.

Materials And Methods: In this study, we reviewed the employment and development of NPs and PAs and their impact on our deceased-donor LT (DDLT) program.

Treating the patient with nonalcoholic fatty liver disease.

Nonalcoholic fatty liver disease (NAFLD) is becoming a worldwide health crisis. It is important for NPs to understand the spectrum of NAFLD. Although lifestyle modifications are the first-line treatment, the NP should be aware of current and future medication management to help the patient live a healthy life.

EFFECTIVENESS AND OUTCOMES OF CURRENT PRACTICE IN TREATING VITAMIN D DEFICIENCY IN PATIENTS LISTED FOR LIVER TRANSPLANTATION.

Objective: Vitamin D deficiency is prevalent in cirrhotic patients awaiting liver transplantation (LT). Optimal vitamin D management for these patients remains undefined. We sought to determine the effectiveness of our practice in addressing vitamin D deficiency in LT patients.

Primary care management of vitamin D deficiency and liver disease.

Purpose: Vitamin D deficiency is one of the most common medical conditions. Up to 96% of patients with liver disease have this deficiency. The purpose of this manuscript is to educate primary care nurse practitioners (NPs) of vitamin D deficiency and its proper management in patients with liver disease.

Primary care management of the liver transplant patient.

There are over 65,000 people in the United States who have received a liver transplant. In primary care practice, nurse practitioners must be aware of the special considerations necessary for this population.