Implications for cardiology nurse practitioner billing: a comparison of hospital versus office practice.

Purpose: To discuss the implications for cardiology nurse practitioner (NP) billing and compare and contrast inpatient Medicare billing practices versus outpatient Medicare billing practices.

Data Sources: Selected articles, text books, and government websites.

Conclusions: In today's complex and expensive healthcare system, there has been a steady decline in the reimbursement rate for professional services to hospitals and physicians.

Confronting conflict: addressing institutional conflicts of interest in academic medical centers.

Individual conflicts of interest are rife in healthcare, and substantial attention has been given to address them. Yet a more substantive concern-institutional conflicts of interest ("ICOIs") in academic medical centers ("AMCs") engaged in research and clinical care-have yet to garner sufficient attention, despite their higher stakes for patient safety and welfare. ICOIs are standard in AMCs, are virtually unregulated, and have led to patient deaths.

Searching for safety: addressing search engine, website, and provider accountability for illicit online drug sales.

Online sales of pharmaceuticals are a rapidly growing phenomenon. Yet despite the dangers of purchasing drugs over the Internet, sales continue to escalate. These dangers include patient harm from fake or tainted drugs, lack of clinical oversight, and financial loss.

National consensus on data elements for nurse managed health centers.

This report presents a summary of the findings from the National Network for Nurse Managed Health Centers Data Consensus Conference. Nationally, nurse-managed health centers are increasingly offering communities another option for access to high-quality primary care. The lack of agreed upon, standardized data elements for these centers has limited the ability to present clear information about their contributions as well as to inform policy related to their support and development.

Quality improvement and changes in diabetic patient outcomes in an academic nurse practitioner primary care practice.

Purpose: To examine a set of system interventions in the management of patients with diabetes and the outcomes of their care.

Data Sources: Preintervention and postintervention data collected from electronic medical records.

Conclusions: The sample size was smaller than expected, contributing to a lack of statistical significance from preintervention to postintervention in the patient outcome measures.

Conjugation of lentivirus to paramagnetic particles via nonviral proteins allows efficient concentration and infection of primary acute myeloid leukemia cells.

Nonviral producer cell proteins incorporated into retroviral vector surfaces profoundly influence infectivity and in vivo half-life. We report the purification and concentration of lentiviral vectors using these surface proteins as an efficient gene transduction strategy. Biotinylation of these proteins and streptavidin paramagnetic particle concentration enhances titer 400- to 2,500-fold (to 10(9) CFU/ml for vesicular stomatitis virus G protein and 5 x 10(8) for amphotropic murine leukemia virus envelope).

A global survey of occupational health competencies and curriculum.

The World Health Organization has identified a worldwide shortage of occupational health professionals, but evidence suggests that the work and education of these professionals vary across countries. This survey examined the professional development of occupational physicians, occupational nurses, industrial hygienists, and ergonomists in terms of practice competencies and academic curriculum. Of 89 countries that received the survey, 48 (54%) responded.

A policy analysis of funding for ambitious interventional gerontology: the possibility of rejuvenation research at the National Institute on Aging.

Issues related to the development of ambitious interventional gerontology-rejuvenation research-at the National Institute on Aging (NIA) within the National Institutes of Health (NIH) are discussed. Creating a separate branch for rejuvenation research within the NIA is probably neither feasible nor desirable at this time. However, it may be both feasible and desirable to begin rejuvenation research by establishing a bioengineering laboratory offering technologies that complement the disease-orientated focus of other NIA intramural laboratories.

Using FTE and RVU performance measures to assess financial viability of academic nurse-managed centers.

Financial performance measures are essential to improve the fiscal management of academic nurse-managed centers (ANMCs). Measures are compared among six ANMCs in a consortium and against an external, self-sustainable, profitable ANMC and national data for family practice physicians. Performance measures help identify a center's strengths and weaknesses facilitating the development of strategies aimed at a variety of targets (business practices related to revenue and costs) to improve financial viability.

Outsourcing issues for nurse practitioner practices.

Nurse practitioner managed practices face multiple business and clinical processes. While most practice managers are prepared as clinicians, they are not well prepared to deal with the daily multiple business infrastructure issues they face. To provide for increased efficiency and effectiveness, nurse practitioner practices should consider outsourcing context business functions.

An ethical assessment of anti-aging medicine.

This assessment presents and evaluates various ethical arguments for and against anti-aging medicine. After briefly defining human aging and how it could be viewed as a medical problem, the paper reviews scientific evidence that indicates that medical intervention could substantially change the rate of human aging in the foreseeable future. This evidence includes research in biochemistry, cell, and molecular biology (including research on mitochondrial DNA and oxidative stress as well as research on cellular and molecular replacement interventions), non-human animal studies, and human studies.

Occupational health nurses' educational needs: what do they want?

Educational preferences, impediments to obtaining an education, and the needs of occupational health nurses are not well understood. The purposes of this regional study were to determine the graduate and continuing educational preferences, impediments, and needs of occupational health nurses in the states of Texas, New Mexico, Arkansas, Louisiana, and Oklahoma. Questionnaires (1,172) were mailed to all occupational health nurses identified by the respective state boards of nursing (N = 5).

Evaluation of an evidence-based nursing tool for acute hospitals.

Routine documentation of nursing care is an important part of everyday nursing practice. Evaluation of a new evidenced-based nursing assessment tool--the Gloucester patient profile--was carried out in six ward areas in an acute hospital setting. Non-participant observation and nominal group evaluations showed that the new assessment tool took longer to complete than the traditional record, but reduced the amount of paperwork.

Quality indicators for academic nursing primary care centers.

ANCs, by definition, deliver more than clinical services to patients and communities. The unique identifier that separates ANCs from other primary care/ambulatory care centers is the educational service they offer to students and other faculty in the school of nursing to which they belong. Therefore, measuring the quality of an ANC must include a measurement of the educational properties that it possesses in addition to the usual quality measurements by such organizations as AAAHC, JCAHO, CHAP, and AAACN.

Wait time and satisfaction with care and service at a nurse practitioner managed clinic.

Purpose: To examine the relationships among the various times patients wait for health care and patient satisfaction with nurse practitioner (NP) care and the service component of care in a NP developed and managed clinic.

Data Sources: Forty-seven patients (78% response rate) responded anonymously to a 15-item questionnaire that measured satisfaction with NP care and an additional 15 items that measured satisfaction with the service component of care. Actual clock times were recorded on a flow sheet that corresponded to the system of care at this clinic.

Evaluation of training designed to prevent and manage patient violence.

This study was designed to determine whether the test responses of mental health care workers (n = 118) showed significant improvement after attending a training session about managing violence. Four variables (knowledge, attitude, self-efficacy, and behavioral intention) were measured before and after staff attended a training program that consisted of two commercial programs: the Nonviolent Crisis Intervention (CPI) and Handle with Care. The Nonviolent Crisis Intervention is designed to teach staff how to prevent and control disruptive behavior of clients.