Aim: To explore the role of nurse practitioners (NPs) in delivering models of acute and urgent care in local communities informing the development of NPs as a solution to providing sustainable and effective healthcare in these settings.
Design: Descriptive qualitative multicase study.
Methods: The study population comprised NPs, clinic managers and general practitioners from NP-led acute and urgent care clinics across urban and rural Aotearoa New Zealand. Data were gathered from 20 semistructured interviews across seven sites. Data were thematically analysed to identify themes. Clinic-level operational data relating to the governance, team structures, and service delivery models were also collated and content from these data was integrated into the analysis and findings.
Results: Five key themes were identified: meeting the needs of the community; development of NP-led acute care services; NPs as part of the healthcare team; training and support systems and supporting junior NPs and NP candidates.
Conclusion: Nurse practitioners have a valuable role to play in delivering acute and urgent care services to local communities. Increasing awareness of the NP role, the prioritisation of community needs and strengthening training and support structures at both a workforce and clinic level were key findings from this research.
Implications For The Profession And/or Patient Care: Findings from this research guided the development of a set of recommendations which consider community, clinic and wider national perspectives and aim to support the future growth of NP-led community acute/urgent care.
Reporting Method: This research has adhered to the Standards for Reporting Qualitative Research (SRQR) guidelines.
Patient Or Public Contribution: The authors have nothing to report.
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http://dx.doi.org/10.1111/jocn.17592 | DOI Listing |
J Urol
January 2025
Department of Population Health, NYU Grossman School of Medicine, New York, New York.
Purpose: We aimed to determine whether implementation of clinical decision support (CDS) tool integrated into the electronic health record (EHR) of a multi-site academic medical center increased the proportion of patients with American Urological Association (AUA) "high risk" microscopic hematuria (MH) who receive guideline concordant evaluations.
Materials And Methods: We conducted a two-arm cluster randomized quality improvement project in which 202 ambulatory sites from a large health system were randomized to either have their physicians receive at time of test results an automated CDS alert for patients with 'high-risk' MH with associated recommendations for imaging and cystoscopy (intervention) or usual care (control). Primary outcome was met if a patient underwent both imaging and cystoscopy within 180 days from MH result.
PLoS One
January 2025
Discipline of Pharmaceutical Sciences, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
Background: Diabetes mellitus (DM) is a global health problem. Adherence to intensive insulin therapy is necessary to achieve better glycemic control in types 1 and 2 DM. This study aimed to evaluate the extent of adherence to insulin therapy, its predictors and to identify barriers to its adherence.
View Article and Find Full Text PDFEur J Emerg Med
January 2025
Université Paris Cité, ECEVE, UMR 1123 Unit, Inserm.
Background And Importance: Access to healthcare remains a persistent challenge. Socially disadvantaged populations often encounter barriers to care and may frequently seek out emergency departments (EDs), including for nonurgent medical care.
Objective: The objective of this study is to study the association between nonurgent presentations to pediatric EDs and patients' socioeconomic environment in an urban setting.
Egypt Heart J
January 2025
Intensivista Pediátrico, Fundación Clínica Infantil Club Noel, Cali, Colombia.
Background: The mitroaortic intervalvular fibrosa is an avascular structure near the left ventricular outflow tract, between the mitral and aortic valves. Mitroaortic intervalvular fibrosa complications, such as tamponade, hemopericardium, and abscesses, are rare and often diagnosed postmortem. On the other hand, the COVID-19 pandemic notably impacted pediatric patients with congenital heart diseases, who frequently presented cardiac complications including arrhythmias, elevated troponins, myocarditis, and heart failure.
View Article and Find Full Text PDFPediatr Surg Int
January 2025
Department of Paediatric Surgery and Urology, Southampton Children's Hospital, Southampton, UK.
Purpose: Recent efforts have sought to streamline gastrostomy insertion care, particularly length of stay (LOS). We report our initial experience with day-case gastrostomy (DCG) insertion.
Method: Retrospective review (April 2018-2024) of all primary gastrostomy insertions.
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