Are Screening Guidelines Too Complicated?
Nurse practitioners (NPs) are prevention champions. Whether primary or secondary, by education, vaccination, or intervention, NPs have always recognized the importance of optimizing health. Our health care system in the United States has historically been oriented more toward diagnosis and treatment, relying heavily on medications and procedures, but that is changing. Increasingly, payors want to know how well we are screening our patients for preventable conditions. Meanwhile, the guidelines become more refined and increasingly require both expertise and experience to interpret them in ways that will benefit our patients ...
Source: The Journal for Nurse Practitioners - May 28, 2020 Category: Nursing Authors: Donald Gardenier, Myriam Jean Cadet Tags: Point/Counterpoint Source Type: research

Differences in Evaluating Fall Risk by Primary Care Provider Type
This study assessed differences in clinical fall risk assessment of older adults (aged 65 and older) and clinical resources used by primary care providers (PCP). Porter Novelli ’s 2016 DocStyles survey was used to examine clinical behavior data from PCPs (n = 1128). Compared with other practitioners, nurse practitioners (NP) reported that a higher percentage of their patients were older adults. The majority of NPs reported screening for falls risk routinely, but most di d not use standardized fall-risk assessments to assess risk factors. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 25, 2020 Category: Nursing Authors: Janice A. Mark, Yara K. Haddad, Elizabeth R. Burns Tags: Original Research Source Type: research

Letter to the Editor
We write in response to the “In My Opinion” commentary in the March 2020 issue of JNP: “Chaos Ensues on the First Day of Medication Assisted Treatment—Trying to Do Too Much,” by Dr Vonderhaar.1 We commend Dr Vonderhaar’s team for adding Medication Assisted Treatment (MAT) to their primary care services. We are also providers at a Federally Qualified Health Center and would like to offer an alternative view of MAT treatment initiation from the perspective of a clinic with a well-established MAT practice. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 24, 2020 Category: Nursing Authors: Martha M. Whitfield, Jeri B. Wohlberg, Catherine Whitaker Tags: Letter to the Editor Source Type: research

Supporting Advanced Practice Providers ’ Professional Advancement: The Implementation of a Professional Advancement Model at an Academic Medical Center
Organizational commitment to a structured professional advancement model (PAM) is critical for advanced practice provider (APP) development to promote and reward excellence, enhance job satisfaction, and improve retention and recruitment. A PAM may also serve as a motivational tool for personal and professional growth by developing and promoting a professional, evidence-based, collaborative practice environment. A voluntary PAM was implemented at a large Midwestern academic medical center to recognize experienced APPs, including certified nurse practitioners, certified nurse-midwives, and physician assistants. (Source: The...
Source: The Journal for Nurse Practitioners - May 23, 2020 Category: Nursing Authors: Elizabeth Arthur, Heather Brom, Jennifer Browning, Susan Bell, Amy Schueler, Robin Rosselet Tags: Featured Article Source Type: research

Evaluation of a Desensitization Program for Continuous Positive Airway Pressure –Intolerant Patients
This is a retrospective chart review evaluating the effectiveness of a nurse practitioner –implemented continuous positive airway pressure (CPAP) desensitization protocol on adherence in CPAP-intolerant OSA patients. CPAP adherence (use for ≥ 4 hours/night, ≥ 70% of nights) was calculated after 90 days of CPAP desensitization. The CPAP desensitization protocol resulted in a 1-hour increase in use in one-third of the patients. Only 4 of 22 (18%) patients achieved adequate adherence. Adherence was not associated with demographic, clinical, or polysomnographic variables. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 23, 2020 Category: Nursing Authors: Joseph Espiritu, Enrique Ordaz, Patricia Dettenmeier Tags: Brief Report Source Type: research

The One-Minute Preceptor: Evaluation of a Clinical Teaching Tool Training for Nurse Practitioner Preceptors
Health professionals cite a number of barriers to precepting nurse practitioner (NP) students, including lack of time and training. The primary aim of this study was to evaluate training of health professionals who teach NP students in a clinical teaching model, the One-Minute Preceptor (OMP). The OMP is a clinical teaching tool that has the potential to increase feedback to NP learners, improving their perceived clinical experience and learning opportunities. The secondary aim was to evaluate the impact of this training on perceived barriers to clinical teaching. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 22, 2020 Category: Nursing Authors: Elizabeth Gatewood, Jennie C. De Gagne, Angel C. Kuo, Patricia O ’Sullivan Tags: By Faculty For Faculty Source Type: research

Renin-Angiotensin-Aldosterone Inhibitors and COVID-19
The Corona Virus Disease 2019 (COVID-19) outbreak has rapidly spread throughout the world, accounting for significant morbidity and mortality. There is a concern that renin-angiotensin-aldosterone inhibitors increase susceptibility to COVID-19. Currently there are no clinical data demonstrating beneficial or adverse effects of these medications on COVID-19 outcomes. Renin-angiotensin-aldosterone inhibitors should be continued in patients in otherwise stable conditions who are at risk for or having COVID-19. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 19, 2020 Category: Nursing Authors: Irina Benenson, Frederick Waldron Tags: Prescription Pad Source Type: research

Benefits of Optimizing Heart Failure Medication Dosage
This report reviews the neurohormonal cascade that occurs in heart failure and the role of guideline-directed medical therapy based on the results of landmark trials. In addition, evidence-based strategies to up-titrate medications are described. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 17, 2020 Category: Nursing Authors: Sandra Oliver-McNeil, Margaret Bowers, Shane J. LaRue, Justin Vader, Adam D. DeVore, Bradi B. Granger Tags: Featured Article Source Type: research

Barriers and Recommendations Associated With Human Papillomavirus Vaccination Among College Students
Many college students are unimmunized against the human papillomavirus (HPV), and college health nurse practitioners (NPs) are in a unique position to provide catch-up vaccination. This is an NP-led quantitative study using a cross-sectional and descriptive survey design to assess perceived HPV vaccine barriers and effective vaccine recommendations among 627 United States college students. The most commonly reported barrier was the lack of a health care provider ’s recommendation followed by not knowing where to obtain the vaccine and a lack of self-perceived risks. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 15, 2020 Category: Nursing Authors: Maria Poggio D ’Errico, Wei-Chen Tung, Minggen Lu, Rhone D’Errico Tags: Original Research Source Type: research

When Home Is Not Safe for Mothers
Interpersonal violence, such as sexual assault and intimate partner violence (IPV), is a significant public health problem affecting the well-being of thousands of women during their reproductive years. An estimated 2% –35% of women experience physical IPV during pregnancy; 9%–40% experience sexual IPV.1 Pregnant women who experience any form of IPV are more likely to delay seeking prenatal care and are at higher risk for high blood pressure, vaginal bleeding, vomiting, dehydration, urinary tract infections, a nxiety, depression, and posttraumatic stress disorder. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 15, 2020 Category: Nursing Authors: Candice N. Selwyn Tags: Quality Care for Women ’s Health Source Type: research

Nurse Practitioners Leading Neonatal Transport Teams: A Proven Success
Historically in Australia, neonatal transport teams consisted of a physician training in pediatrics and a retrieval nurse. Even though nurse practitioners (NP) are used more commonly in retrieval services internationally, there is limited information about the effectiveness of the NP model of care in the neonatal emergency retrieval setting. In response to a key strategic goal by the management team, our regional pediatric emergency transport service introduced a retrieval NP into our neonatal emergency service team. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 14, 2020 Category: Nursing Authors: Catherine Fox, Michael Stewart, Fiona Newall Tags: Original Research Source Type: research

Back to the 4th Grade
A week in the life of a nurse practitioner legislator shows similarities to the everyday role of nurse practitioners. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 10, 2020 Category: Nursing Authors: Gale Adcock Tags: Under the Dome Source Type: research

Hormone Therapy for Transgender Women
Many transgender women seek hormone therapy to produce the feminizing characteristics of their self-identified gender. Clinical practice guidelines exist to make sure transgender women are receiving evidence-based treatment regimens. Therefore, nurse practitioners are at the forefront of ensuring medication safety and helping transgender women reduce modifiable risks for complications from long-term hormone therapy. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 10, 2020 Category: Nursing Authors: Jacqueline Francine Thomas, Jake Bush Tags: Prescription Pad Source Type: research

Reflections of a COVID-19 Graduate Nurse Student
In the midst of pandemic and chaos, the world did not cease. Although shelter-in-place was mandated, advance practice nursing students did not waiver. The Class of 2021 advance practice nurses will enter preventive and tertiary care with patience and resiliency. While healthcare facilities were limiting non-essential staff and visitors, the Class of 2021 did not stop. While working as full-time nurses and preparing our families for the worse care scenarios, we did not deter from our goals. Rather we found new goals through reflection and will be better prepared to face the unknown. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 10, 2020 Category: Nursing Authors: Vanessa N. d ’Aquin Tags: In My Opinion Source Type: research

Corona Virus 101
COVID-2019 emerged from China in late December of 2019. It follows 2 other coronavirus outbreaks, the SARS-CoV and the MERS-CoV. Coronaviruses usually circulate among animals but sometimes can jump to humans. These 3 strains have caused severe disease in humans and global transmission concerns. Symptoms of COVID-2019 include cough, fever, and shortness of breath. Related illnesses can range from mild to severe to fatal. Primary care providers must be alert to respiratory symptoms they encounter that are associated with pertinent travel history, be prepared to safely screen, examine, and possibly test and/or report suspicio...
Source: The Journal for Nurse Practitioners - May 7, 2020 Category: Nursing Authors: Barbara Holstein Tags: Featured Article Source Type: research

Roles of Nurse Practitioners: Health Consequences of Climate Change in Vulnerable Older Adults
Nurse practitioners (NPs) have key roles in addressing health consequences of climate change across the lifespan for patients, families, communities, and populations. The role of the NP in the health and well-being of vulnerable populations is critical in understanding the deleterious consequences of climate change. Older adults are considered a vulnerable population for health challenges in our climate-changing world. The link between climate and health via a systems approach includes engaging in health assessment, physical examination, differential diagnoses, and plans for interventions. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 6, 2020 Category: Nursing Authors: Patrice K. Nicholas, Suellen Breakey, Perry Blank Tags: Featured Article Source Type: research

DARE to Prescribe: Strategy to Guide Direct Oral Anticoagulant Therapy
Direct oral anticoagulants (DOACs) are widely used in nonvalvular atrial fibrillation and venous thromboembolism. As both research and real-world evidence on these drugs continue to emerge, new indications and insights provide opportunities to personalize DOAC therapy for individual patients. Knowledge gaps about DOACs remain a challenge that nurse practitioners (NPs) face in acute and primary care settings, resulting in lack of adherence, inappropriate dosing, or suboptimal anticoagulation. We created a mnemonic strategy to guide NPs to make benefit –risk assessments, better understand the differences between these ...
Source: The Journal for Nurse Practitioners - May 6, 2020 Category: Nursing Authors: Mohamed Toufic El Hussein, Alexander Cuncannon Tags: Featured Article Source Type: research

World Health Organization Human Immunodeficiency Oral Preexposure Prophylaxis Mobile App for Clinicians and Consumers
This department reviews the WHO HIV Oral PrEP mobile app for clinicians and consumers. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 6, 2020 Category: Nursing Authors: Patricia Biller Krauskopf Tags: Mobile Apps for NPs Source Type: research

The Rainbow in the Waiting Room
The lesbian, gay, bisexual, transgender, and questioning (LGBTQ) community has long been discriminated against and continues to face challenges that affect their health and quality of life. Between 2008 and 2016, the percentage of adults in the United States who identified as LGB grew from 2.7% to 5.4%, according to the General Social Survey.1 The percentage of Latinas, Asians, and women identifying as LGBT is rapidly growing.1 (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 5, 2020 Category: Nursing Authors: Elizabeth Wood, Denise Link Tags: Quality Care for Women ’s Health Source Type: research

Beware of the Possibility of Unreliability of A1c
This article describes a patient situation in which A1c was inaccurate in estimating mean serum glucose. Providers unknowingly based treatment plans on a false low A1c value. Comorbidities that can lead to false high or low A1c results are discussed with recommendations for using the A1c value to plan patient care decisions for people with diabetes. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 4, 2020 Category: Nursing Authors: Debbie Mahoney Tags: Featured Article Source Type: research

A Toddler With Sudden-Onset Tremors and Change in Temperament
A key focus after solid organ transplant is to return to baseline activities as soon as possible. Children are no different and often return to day care and school within a few weeks after discharge. They are exposed to a variety of childhood illnesses and often present to an emergency department for care. Distinguishing between typical pediatric illnesses and transplant-related complications can be challenging. This case describes an encounter involving a 14-month-old liver transplant recipient and highlights the importance of awareness of the complex health care maintenance needs in this population. (Source: The Journal ...
Source: The Journal for Nurse Practitioners - May 3, 2020 Category: Nursing Authors: Stacia M. Hays, Heather L. Johnson, Laura A. Taylor Tags: Case Challenge Source Type: research

A Scoping Review of Nurse Practitioner Roles in Immigrant Health
The objective of this scoping review is to examine the extent, range, nature, and characteristics of the literature for the nurse practitioner (NP) role in immigrant health. A search of 5 databases was completed, yielding 440 studies. After reviewing the abstracts and eliminating studies based on the inclusion and exclusion criteria, only 5 studies qualified for the scoping review. Given that scope of NPs ’ roles is expanding, this review reveals how NP care can improve immigrants’ health. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 3, 2020 Category: Nursing Authors: Olutosin Giwa, Bukola O. Salami, Tammy O ’Rourke Tags: Featured Article Source Type: research

Hereditary Cancer Syndrome Recognition and Testing: Beyond BRCA
This article focuses on 3 other syndromes, including Li-Fraumeni, Cowden, and Peutz-Jeghers. This article will help prepare nurse practitioners to recognize key clinical features of these syndromes and understand testing criteria. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 3, 2020 Category: Nursing Authors: Deborah O. Himes, Hanford B. Shuman Tags: Feature Article Source Type: research

May 2020 Continuing Education Credit Application
(Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 1, 2020 Category: Nursing Tags: CE Test and Application Source Type: research

AANP Forum
By Frank Harrington, JD, AANP Director of Reimbursement and Regulatory Affairs (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 1, 2020 Category: Nursing Tags: AANP Forum Source Type: research

Your NP Spirit Continues to Shine
The coronavirus pandemic continues to bring illness across this great country. We have all been displaced in one way or another. These months have not been easy for us as clinicians, educators, and administrators, and as individuals, parents, children, family members and friends. Our lives have changed dramatically in just a matter of months; however, our nurse practitioner (NP) spirit continues to shine. I listen to and read your stories each day. I learn about your innovation, your clinical experiences, your advocacy, and I also learn of your anxiety, heartbreak and fatigue. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - May 1, 2020 Category: Nursing Authors: Sophia L. Thomas Tags: From the AANP President Source Type: research

Hypodermoclysis in Long-term Care
Dehydration is a problem that negatively impacts patients, especially those in long-term care. These patients are often unable to rehydrate orally and require artificial means of achieving hemodynamic stability. Hypodermoclysis is a rehydration technique that is effective, safe, and comfortable for patients. The use of hypodermoclysis in long-term care may result in decreased costs, lowered nosocomial infections, decreased time from dehydration diagnosis to rehydration intervention, and improved overall outcomes for long-term care residents. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 22, 2020 Category: Nursing Authors: Stacie Ebersold, Jenny Monn Tags: Feature Article Source Type: research

Examining Oral Health Education for Nondental Providers
Poor oral health affects overall health and creates a financial burden for society. Education of prospective nondental providers to perform oral health prevention practices could improve early detection of oral health illnesses, making oral health care more accessible and affordable for patients. This literature review examined oral health knowledge and skills, along with oral health education among nondental providers. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 22, 2020 Category: Nursing Authors: Lesia Aungst, Beth Ann Swan Tags: By Faculty for Faculty Source Type: research

Patient With Questions About Cancer Risk
Primary care nurse practitioners routinely care for patients with personal or family histories of cancer. Approximately 5% to 10% of all cancers are related to hereditary cancer syndromes (HCSs),1 which cause an increased risk for developing more cancers and cancers at earlier ages than the general population. Nurse practitioners in primary care must become comfortable with identifying patients at risk for HCSs. Ordering genetic tests can be a challenge because the number of genetic tests available is growing at a rapid pace. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 21, 2020 Category: Nursing Authors: Deborah O. Himes, Jennie Vagher Tags: Case Challenge Source Type: research

When Your Patient Is a Farm Family: Challenges Farm Wives Perceive in Promoting Farm Family Health
This study explored farm wives ’ perceptions of the challenges they face in maintaining their family health. Farm wives from eastern North Carolina were interviewed. The overarching question was “How do farm families maintain and promote their health?” The Colaizzi method of data analysis for phenomenological studies was us ed to identify major themes in the data. The primary challenge to farm family health, according to farm wives, is stress arising from several factors. Some sources of stress, such as weather and market prices, are not amenable to control; others, however, are amenable to intervention f...
Source: The Journal for Nurse Practitioners - April 21, 2020 Category: Nursing Authors: Robin Webb Corbett, Mary Lisa Pories, Robin Tutor Marcom, Mary Ann Rose Tags: Featured Article Source Type: research

Do State and National Policy Initiatives Always Align?
Sometimes, as we slog through the Sisyphean work of policy change, I imagine that all the state legislatures in the land consist of a majority of nurse practitioners (NPs). Their decisions would be guided by ethics and beneficence. They would look at the evidence and then do what is in the best interests of their constituents. Nationwide, we NPs would be practicing to the full extent of our training, and patient outcomes, cost effectiveness, and interprofessional collegiality would all be so good that we could move on to other topics. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 17, 2020 Category: Nursing Authors: Donald Gardenier, Beth Haney, Thad Wilson Tags: Point/Counterpoint Source Type: research

Implementing an Annual Renal Function Screening Protocol in Primary Care
Early detection of renal damage in diabetic and hypertensive patients in the primary care setting was the focus of a quality improvement project. A protocol requiring renal function screening for 150 patients meeting the inclusion criteria was implemented in a southern, rural primary care clinic. A pre- and postintervention chart review determined if the intervention was significant in increasing the number of renal function screenings preformed. The results indicated that implementing the protocol did indeed increase the number of renal function screenings performed and identified undiagnosed chronic kidney disease. (Sour...
Source: The Journal for Nurse Practitioners - April 15, 2020 Category: Nursing Authors: Martha Ingram, F. David Jones, Aimee Holland Tags: Brief Report Source Type: research

Relief Central with Coronavirus Guidelines and CardioSmart Heart Explorer Apps
In this issue, the Relief Central with Coronavirus Guidelines app is reviewed for clinicians, and the CardioSmart Heart Explorer app is reviewed for patients and health care consumers using the NPMEDAPP criteria (https://doi.org/10.1016/j.nurpra.2015.10.005). The Relief Central app website is https://relief.unboundmedicine.com/relief. The CardioSmart Heart Explorer app can be located at https://medmovie.com/. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 13, 2020 Category: Nursing Authors: Patricia Biller Krauskopf Tags: Mobile Apps for NPs Source Type: research

Back With a Vengeance: The Reappearance of Methamphetamine and its Implications for Health Care Providers
A great deal of attention has been placed on the opioid epidemic that the United States is currently experiencing; however, a resurgence in methamphetamine (METH) use has been occurring during the past 5 years. METH is an addictive stimulant that primarily affects the central nervous system by increasing dopamine, norepinephrine, and serotonin. Ranking second to opioids, METH use has had a significant impact on mortality, morbidity, and health-related costs and remains a serious public health problem in the United States. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 13, 2020 Category: Nursing Authors: Deborah Salani, Beatriz Valdes, Joseph De Santis, Martin Zdanowicz Tags: Featured Article Source Type: research

Relief Central and CardioSmart Heart Explorer Apps
In this issue the Relief Central with Coronavirus Guidelines app will be reviewed for clinicians, and the CardioSmart Heart Explorer app will be reviewed for patients and health care consumers using the NPMEDAPP criteria (https://doi.org/10.1016/j.nurpra.2015.10.005). The Relief Central app website is https://relief.unboundmedicine.com/relief. The CardioSmart Heart Explorer app can be located at https://medmovie.com/. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 13, 2020 Category: Nursing Authors: Patricia Biller Krauskopf Tags: Mobile Apps for NPs Source Type: research

Awareness, Compliance, and Barriers of 1-Time Hepatitis C Screening in Hospital-Based Providers
This study surveyed 267 providers with primary contacts with this cohort to quantify awareness and compliance rates of this recommendation and to identify providers ’ perceived barriers to compliance. Results confirmed very low compliance rates, with 47.2% providers reporting “20% or lower” compliance. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 12, 2020 Category: Nursing Authors: Fiona B. Ju, Michelle L. Dumpe, Gerri B. Lane, Linda C. Shanks Tags: Brief Report Source Type: research

Postgraduate Inpatient Training in the Time COVID-19
Late February is always an exciting time for me as the codirector of the inpatient medicine Advanced Practice Fellowship (APF) at the University of Colorado Hospital. Six nurse practitioners and physician assistants were getting ready for their first day as fellows on March 1. Our leadership team was putting the final touches on our month-long boot camp while badges were printed and white coats were embroidered. Then on February 26, the first case of COVID-19 without a clear exposure was diagnosed in the United States. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 10, 2020 Category: Nursing Authors: Brian Wolfe Tags: In My Opinion Source Type: research

Asthma Health Policies in Schools: Implications for Nurse Practitioners
Asthma is the most common chronic illness of childhood; therefore, detailed school-based policies addressing the specific needs of children with asthma are essential to achieve optimal health and wellness outcomes. Nurse practitioners have a responsibility to support comprehensive school-based asthma policies and should support school personnel in carrying out an in-depth school-based asthma program within their communities. Furthermore, nurse practitioners can focus advocacy efforts toward policy development to close legislative and practice gaps that may inhibit the success of a comprehensive asthma program in schools. (...
Source: The Journal for Nurse Practitioners - April 10, 2020 Category: Nursing Authors: Ashleigh F. Bowman, Donna J. Copeland, Kristina S. Miller Tags: Featured Article Source Type: research

Postgraduate Inpatient Training in the time COVID
Late February is always an exciting time for me as the Co-Director of the inpatient medicine Advanced Practice Fellowship (APF) at the University of Colorado Hospital. Six nurse practitioners and physician assistants were getting ready for their first day as fellows on March 1. Our leadership team was putting the final touches on our month-long boot camp while badges were printed and white coats were embroidered. Then on February 26, the first case of COVID-19 without a clear exposure was diagnosed in the United States; community spread was here, and the world within the hospital seemed to geologically shift overnight. (So...
Source: The Journal for Nurse Practitioners - April 10, 2020 Category: Nursing Authors: Brian Wolfe Tags: In My Opinion Source Type: research

Compassion Needed for All
COVID-19 has impacted everyone on the planet in some way. Some more severely than others, of course. By the time you read this, we may be experiencing continued social distancing and shelter in place. Or all our collective efforts might be making a difference, and we are together for the AANP annual conference or maybe somewhere in between – a virtual conference. Only time will tell. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 10, 2020 Category: Nursing Authors: Julee Waldrop Tags: Editorial Source Type: research

Cardiovascular Health in Patients With Rheumatoid Arthritis
The recognition that patients with rheumatoid arthritis are at a heightened risk of cardiovascular disease (CVD) events and mortality spans more than 2 decades, yet there continues to be debate as to who should screen this population for CVD risk. There are several challenges to regular screening of this population: limited time, the assumption that this problem is being addressed by the rheumatologist, and lack of awareness by primary care providers (PCP) of increased CVD risk. A collaborative approach between PCPs and rheumatologists is necessary to address the increased CVD risk and to treat these risk factors aggressiv...
Source: The Journal for Nurse Practitioners - April 9, 2020 Category: Nursing Authors: Patricia McMahon, Avis Ware Tags: Featured Article Source Type: research

Combating Compassion Fatigue With Mindfulness Practice in Military Nurse Practitioners
Like their civilian counterparts, military clinicians are at risk for compassion fatigue. Studies have shown a relationship between mindfulness interventions and reduction of compassion fatigue and its components of burnout and secondary traumatic stress. A pilot feasibility study using a mindfulness-based stress reduction program via a mobile application was completed with a group of nurse practitioners in the military. Seventy-five percent of the participants showed improvement in burnout and stress levels and 100% improvement in mindfulness attention. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 8, 2020 Category: Nursing Authors: Natasha Ideta Best, Carol F. Durham, Cheryl Woods-Giscombe, Julee Waldrop Tags: Brief Report Source Type: research

Clinical Care for the Aging LGBT Population
US Census estimates indicate that there are currently 1.75 to 4 million Americans who identify as lesbian, gay, bisexual, and transgender (LGBT), which will double by 2030. Life expectancy for the aging LGBT population is lower than that of the same age cohort due to health care disparities. Most nurse practitioners (NPs) and certified nurse midwives (CNMs) are not aware of needs of this population and clinical modifications required to improve access to care and health outcomes. This lack of information adds to the gap in health care services and deepens disparities. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 6, 2020 Category: Nursing Authors: Nancy W. Selix, Karen Cotler, Lyn Behnke Tags: Featured Article Source Type: research

A Pediatric Nurse Practitioner –Led Moderate Sedation Service: Our 7-Year Experience
The use of moderate sedation in children for the performance of a variety of diagnostic imaging tests and therapeutic interventions outside of the operating room, not directly supervised by an anesthesiologist, has been successful and well-documented in recent years. However, to date, all published reports describe only physicians as the primary provider performing the moderate sedation. In this article, we discuss our development of a nurse practitioner (NP)-led pediatric sedation program and a 7-year review of practice. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 6, 2020 Category: Nursing Authors: Peggy Dorr Tags: Featured Article Source Type: research

Glycogen Storage Disease Type l: Don ’t Miss the Signs
Glycogen storage diseases (GSDs) are a group of genetic disorders that occur in approximately 1 in 100,000 individuals depending on the subtype. Patients with GSD type I lack glucose-6 phosphate, 1 of the enzymes needed to convert glycogen to glucose during times of fasting. GSD type I is the most severe form because of the risk of life-threatening hypoglycemic episodes. Patients with GSDs require a team of professionals who specialize in metabolic disorders to monitor and manage their disease because of its complex nature. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 6, 2020 Category: Nursing Authors: Carla Q. Anderson, Elizabeth Wechter, Lee Anne Siegmund Tags: Featured Article Source Type: research

Necrotizing Fasciitis in the Adult Patient: Implications for Nurse Practitioners
Necrotizing fasciitis is a life-threatening skin and soft tissue infection associated with high morbidity and mortality in adult patients. Nurse practitioners in both outpatient and inpatient settings should be vigilant for the hallmark signs and symptoms, such as pain out of proportion to the wound appearance and gray or “dishwasher”-colored discharge from the wound. Prompt recognition of these signs and symptoms, rapid surgical debridement, and early initiation of broad-spectrum antimicrobial management are necessary for optimizing patient outcomes and reducing hospital length of stay, cost, morbidity, and mo...
Source: The Journal for Nurse Practitioners - April 3, 2020 Category: Nursing Authors: Lillian H. Guevel, Megan M. Shifrin Tags: Featured Article Source Type: research

MISSION Syncope and Seizure First Aide Mobile Apps
In this issue the Multilevel Implementation Strategy for Syncope OptImalCare thrOugh eNgagement (MISSION) Syncope app will be reviewed for clinicians, and the Seizure First Aide app will be reviewed for patients and health care consumers using the NPMEDAPP criteria (https://doi.org/10.1016/j.nurpra.2015.10.005). The MISSION Syncope app can be accessed at https://apps.apple.com/us/app/mission-syncope/id1488750770 for Apple users and at https://play.google.com/store/apps/details?id=org.mission_is.syncope for Android users. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 3, 2020 Category: Nursing Authors: Patricia Biller Krauskopf Tags: Mobile Apps for NPs Source Type: research

Sleep Quality, Fatigue, and Quality of Life in Individuals With Heart Failure
Heart failure is a chronic condition that negatively impacts sleep, fatigue, and quality of life. The purpose of this study was to explore sleep, fatigue, and quality of life among patients with heart failure. There were significant differences between the study variables, and these were moderately correlated. Together, sleep quality and fatigue predicted 40% of the variance in the physical and mental components of quality of life. The findings of this study support the use of sleep and fatigue assessments in patients with heart failure. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 3, 2020 Category: Nursing Authors: Jihane Hajj, Hansie Mathelier, Brian Drachman, Krzysztof Laudanski Tags: Featured Article Source Type: research

AANP Forum
By MaryAnne Sapio, VP, AANP Federal Government Affairs (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 1, 2020 Category: Nursing Tags: AANP Forum Source Type: research

The Unprecedented COVID-19 Crisis
Earlier this spring, the powerful new coronavirus, called COVID-19, swept through our country like nothing we have seen since the Spanish Flu pandemic in 1918. The numbers of those infected with the COVID-19 virus soared on a steep trajectory over a relatively short period of time, and the health care community mobilized itself to care for those who needed testing and treatment. We quickly learned to adjust our traditional methods for providing care, including the utilization of drive-through services and expanding telehealth care. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - April 1, 2020 Category: Nursing Authors: Sophia L. Thomas Tags: From the AANP President Source Type: research