HCA Healthc J Med
October 2024
Description Advanced practice registered nurses (APRNs) are key health care providers in a variety of settings. Often APRNs are grouped in a collective category, along with physician assistants, and referred to collectively as advanced practice providers. As APRNs assume an increasing role in patient care management in hospital, outpatient, and community settings, such as clinics and rural practices, measuring the impact of their care on patient outcomes and quality of care becomes a necessary component of performance evaluation.
View Article and Find Full Text PDFBackground: The quest for full practice authority (FPA) for Tennessee Advanced Practice Registered Nurses (APRNs) began with promise in the late 1960s. However, progress has stalled in the ensuing time, and prospects for advancing FPA do not look promising.
Purpose: The purpose of this article is to chronicle the pursuit of FPA in Tennessee, offer reflections on what has transpired to date, and suggest a path forward.
Background: Implementing music in the intensive care unit has increased in popularity because the environment can be stressful and anxiety inducing for many patients. In hospital settings, therapeutic music can be beneficial for patients' well-being and recovery. Although live music typically involves a face-to-face encounter between the musician and patient, the COVID-19 pandemic has prompted a change to virtual live therapeutic music, using technology to present music in real time (eg, with a tablet computer).
View Article and Find Full Text PDFAdvanced practice registered nurses and physician assistants, collectively termed advanced practice providers (APPs), have been part of telehealth for many years. During the COVID-19 pandemic, APPs experienced the growth in roles, responsibilities, and tools used for telehealth care delivery. This article uses examples from 3 health systems to highlight the ways in which telehealth use was expanded due to the pandemic, how APP roles were altered across the United States during and after the pandemic, and implications for future practice.
View Article and Find Full Text PDFJ Am Assoc Nurse Pract
October 2023
Ten years after the publication of a landmark article in AACN Advanced Critical Care, alarm fatigue continues to be an issue that researchers, clinicians, and organizations aim to remediate. Alarm fatigue contributes to missed alarms and medical errors that result in patient death, increased clinical workload and burnout, and interference with patient recovery. Led by the American Association of Critical-Care Nurses, national patient safety organizations continue to prioritize efforts to battle alarm fatigue and have proposed alarm management strategies to mitigate the effects of alarm fatigue.
View Article and Find Full Text PDFAdvanced practice registered nurses (APRNs) play a pivotal role in providing healthcare, including preventive care services, to the public. However, barriers to APRN practice exist that impact the provision of vital healthcare services that APRNs are authorized to provide based on their education, training, licensure, and certification. This article provides an overview of APRN barriers to practice, including in the face of the COVID-19 pandemic, and discusses key policy and regulatory implications.
View Article and Find Full Text PDFDespite the frequent hospitalizations and readmissions of persons living with dementia (PLWD), no telehealth transitional care interventions focus on PLWDs' unpaid caregivers. Tele-Savvy Caregiver Program is a 43-day evidence-based online psychoeducational intervention for PLWDs' caregivers. The aim of this formative evaluation was to explore caregivers' acceptability of and experience with their participation in Tele-Savvy after their PLWDs' hospital discharge.
View Article and Find Full Text PDFPurpose: To examine the status of critical care nursing internationally, assess the impact of the COVID-19 pandemic, and identify research priorities by surveying professional critical care nursing organizations (CCNOs) worldwide.
Design: A descriptive survey methodology was used. This study is the sixth worldwide quadrennial review to assess international critical care nursing needs and provide evidence to inform critical care nursing policy, practice and research priorities globally.
The sudden, expanded need for telehealth during the COVID-19 pandemic added to the challenges advanced practice RNs face in the United States. The purposes of this article are to summarize advanced practice RNs' responses about the use of telehealth before and during the pandemic and to analyze free-text comments about how the use of telehealth changed during the pandemic. A 20-item survey was distributed using convenience sampling to advanced practice RNs from June 1 to September 23, 2020.
View Article and Find Full Text PDFSepsis is a life-threatening illness that affects millions of people worldwide. Early recognition and timely treatment are essential for decreasing mortality from sepsis. The Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021, the fifth iteration of the guidelines, was released in October 2021 and includes 93 recommendations for the management of sepsis.
View Article and Find Full Text PDFBackground: Across disciplines and within higher educational systems, assessing postgraduate outcomes is essential for evaluating doctoral programs, including research-intensive nursing science doctoral programs. However, there are limited reports regarding methods and metrics related to postgraduate longitudinal evaluation of research-focused nursing doctoral programs.
Purpose: The purpose of this paper is to summarize studies in the area of postgraduate outcome assessment and provide recommendations regarding outcome methods and metrics for evaluating the effectiveness of research-focused nursing doctoral programs.
Background: The COVID-19 pandemic has challenged health care professionals, especially those working in intensive care units (ICUs).
Objectives: To explore critical care nurses' experiences with and perceptions of the COVID-19 pandemic during the early phases of the pandemic.
Methods: Data were from national surveys conducted during March and April 2020 to assess ICU providers' perceptions of the initial phases of the pandemic.
Advanced practice registered nurses (APRNs) significantly contribute to health promotion, disease prevention, and disease management. Yet, barriers to APRN practice exist, including regulatory, state, and institutional barriers, that hinder their ability to practice to the full extent of their education, licensure, and certification. Nurse leaders can play an important role in helping reduce unnecessary institutional barriers to APRN practice.
View Article and Find Full Text PDFBackground: In response to the COVID-19 pandemic, Tennessee's Governor issued executive orders temporarily suspending certain practice restrictions on advanced practice registered nurses (APRN), which expired after 2 months as the pandemic worsened.
Purpose: This purpose of this qualitative study was to analyze APRN interview data to evaluate how prepandemic APRN practice barriers, executive orders, and the pandemic affected APRN practice in Tennessee.
Methods: Fifteen Tennessee APRNs who completed the National APRN Practice and Pandemic study also completed follow-up interviews via a HIPAA-compliant Zoom platform.
Background: Based on clinical staff safety within a learning healthcare system, the purpose of this study was to test an innovative model of care for addressing disruptive behaviour in hospitalised patients to determine whether it should be scaled up at the system level.
Methods: The Disruptive bEhaviour manageMEnt ANd prevention in hospitalised patients using a behaviOuRal (DEMEANOR) intervention team was a pragmatic, cluster, cross-over trial. A behavioural intervention team (BIT) with a psychiatric mental health advanced practice nurse and a social worker, with psychiatrist consultation, switched between units each month and occurrences of disruptive behaviours (eg, documented violence control measures, violence risk) compared.
Limited information is available on the barriers to practice for advanced practice registered nurses (APRNs) among states with full, restricted, and reduced practice. The purpose of this study is to identify practice barriers in relationship to United States (U.S.
View Article and Find Full Text PDFDuring the current COVID-19 pandemic, health-care workers and uninfected patients in intensive care units (ICUs) are at risk of being infected with SARS-CoV-2 as a result of transmission from infected patients and health-care workers. In the absence of high-quality evidence on the transmission of SARS-CoV-2, clinical practice of infection control and prevention in ICUs varies widely. Using a Delphi process, international experts in intensive care, infectious diseases, and infection control developed consensus statements on infection control for SARS-CoV-2 in an ICU.
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