Improving Transition Readiness in Young Adults With Sickle Cell Disease
Transition of young adults with sickle cell disease is essential. This project examined the effectiveness of an educational intervention at a pediatric hematology practice to improve transition readiness in young adults with sickle cell disease. Interventions used were 2 Stepping Up videos and 5 questions from “Incorporating Health Care Transition Services Into Preventive Care for Adolescents and Young Adult.” Data was collected and results were analyzed preintervention, immediately postintervention, and at return office visit. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - October 24, 2020 Category: Nursing Authors: Andrea D. Johnson, Eula Pines, Sherry Seibenhener, Shunda Wilburn Tags: Brief Report Source Type: research

Achieving Health Equity: Examining Telehealth in Response to a Pandemic
This article examines the use of telehealth during the pandemic as a case for demonstrating the necessity for advanced practice nurses to engage in broad policy initiatives to address social determinants of health care. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - October 24, 2020 Category: Nursing Authors: Shelly Smith, Sarah Raskin Tags: Health Policy Source Type: research

Disrupting the System: An Innovative Model of Comprehensive Care
Despite health care reform, our nation continues to struggle containing health care costs while meeting the needs of persons with behavioral health disorders and comorbid chronic care conditions. The purpose of this article is to propose that dually certified primary care and psychiatric mental health nurse practitioners may be the disruptive innovation that becomes the solution for improving the coordination and care for high-need patients while containing costs. The concepts of disruptive innovation, integrated care, and whole person care are discussed followed by an introduction to the innovative primary care and psychi...
Source: The Journal for Nurse Practitioners - October 23, 2020 Category: Nursing Authors: Virginia M. Conley, Teresa Judge-Ellis Tags: Feature Article Source Type: research

Broken Hearts in Disguise: Atypical Symptoms in Women
Heart disease is the leading cause of death for women, but it is often difficult to diagnose in them. Diagnosing heart disease in women is challenging for many reasons, including atypical symptom presentation. Atypical symptoms found in women include unusual fatigue; sleep disturbance; shortness of breath; and discomfort in the chest, back, thorax, jaws, teeth, or arm. Primary care providers should remain alert to female patients with atypical chest pain and uncharacteristic symptoms of coronary concern. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - October 23, 2020 Category: Nursing Authors: Christina Bricker, Andrea Efre Tags: Quality Care for Women ’s Health Source Type: research

Telehealth Benefits and Barriers
Telehealth includes health care services provided using audio and video technology. Telehealth was originally developed to provide basic care to rural and underserved patients. Higher rates of use of telehealth are now standard in many practices since the coronavirus disease 2019 pandemic. Increasing emphases on patient satisfaction, providing efficient and quality care, and minimizing costs have also led to higher telehealth implementation. Patients and providers have enjoyed the benefits of telehealth, but widespread adoption has been hindered by regulatory, legal, and reimbursement barriers. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - October 21, 2020 Category: Nursing Authors: Shilpa N. Gajarawala, Jessica N. Pelkowski Tags: Health Policy Source Type: research

LactFacts and MyDirectives Mobile Apps
Editor's Note: The Journal for Nurse Practitioners would like to thank Patricia Krauskopf for 3 years of superior service as the department editor and contributor for Mobile Apps for NPs. We wish her well in her retirement. This will be the last Mobile Apps for NPs column in the journal. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - October 19, 2020 Category: Nursing Authors: Patricia Biller Krauskopf Tags: Mobile Apps for NPs Source Type: research

Atopic Dermatitis With a Focus on Moderate to Severe Disease
Atopic dermatitis (AD) affects nearly 10% of children and 7% of adults in the United States. Initial treatments for all patients with AD include vigilant skin hygiene and moisturizers. Other treatments, depending on disease severity, include topical corticosteroids, calcineurin inhibitors, or phototherapy as maintenance therapy to lengthen the time to relapse. Systemic immunosuppressants are recommended when these regimens are inadequate but are associated with poor side effect profiles. Recent discoveries are leading to more effective and safer immunomodulatory therapies. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - October 19, 2020 Category: Nursing Authors: Lakshi M. Aldredge Tags: Feature Article Source Type: research

An Overview of Drug Interactions With Grapefruit Juice
Studies show grapefruit juice contains antioxidant and antiseptic properties, among other health benefits, including bone growth promotion and weight loss.1 Grapefruit juice also carries the American Heart Association ’s healthy “heart-check” food mark and contains compounds that may reduce atherosclerotic plaque formation and inhibit cancer cell proliferation.1 Although generally considered healthy, grapefruit juice can interact with many classes of medications. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - October 9, 2020 Category: Nursing Authors: Julie Mei, Jason Babby Tags: Prescription Pad Source Type: research

Cocci Are in the Air
The San Joaquin Valley in Central California is a semiarid region that is known to be highly endemic for coccidioidomycosis infections in high-risk groups. Coccidioidomycosis, also known as valley fever, is caused by the fungal spore Coccidioides, which can be found in the soil in arid and semiarid regions in the Southwest United States and parts of Central and South America. When soil is disturbed through excavation, agricultural activities, or with any other soil movement, these activities can release the fungal spores into air; people who are in close proximity can potentially inhale them. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - October 9, 2020 Category: Nursing Authors: Michelle Bergen Tags: Case Challenge Source Type: research

Self-Leadership for Nurse Practitioners in Complex Times
The caregiver archetype is common among nurse practitioners (NPs). The desire to care for and meaningfully impact others can also have a shadow side, leaving NPs feeling 1 or more of the 3 key dimensions of burnout: a lack of professional effectiveness, emotional exhaustion, and/or detachment from their patients. The current health care climate is highly complex and in constant churn with widespread complaints of administrative burden on providers, whereas national surveys report pervasive dissatisfaction among patients and providers alike. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - October 9, 2020 Category: Nursing Authors: Eileen T. O'Grady Tags: Feature Article Source Type: research

Implementation of a nurse practitioner led drive through COVID-19 testing site
Efficient strategies for testing large numbers of patients must be developed to limit the spread of COVID-19. We demonstrate that our drive-through model is an efficient method of testing large numbers of patients during a pandemic. In the drive-through, cost per patient and PPE use were significantly less than three brick and mortar clinics providing testing. We provide an example of effective nurse practitioner leadership in a drive-through testing site and demonstrate that NPs are ideally suited to provide leadership given their adaptability, ability to function in a variety of settings and extensive experience with car...
Source: The Journal for Nurse Practitioners - October 9, 2020 Category: Nursing Authors: Kathryn S. Dippel, Emily K. Kelly Tags: Featured Article Source Type: research

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

Regular Health Screenings and Immunizations Are Essential, Despite COVID-19
We have been plagued with handling COVID-19 cases for most of the year, and during this time, preventive health care and early screenings took a back seat due to fears of transmission of the virus. As a consequence, some patients have had complications of diseases that could have been prevented with early screening and detection. With a better understanding about proper infection prevention measures, it ’s time to refocus ourselves on providing routine screenings and immunizations for adults and children of all ages. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - October 1, 2020 Category: Nursing Authors: Sophia L. Thomas Tags: From the AANP President 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 - October 1, 2020 Category: Nursing Tags: AANP Forum Source Type: research

Treating Child and Adolescent Attention-Deficit/Hyperactivity Disorder and Behavioral Disorders in Primary Care
Attention-deficit/hyperactivity disorder (ADHD) and behavioral disorders are 2 of the most common mental health diagnoses in child and adolescent patients. Many patients seeking treatment for these disorders will initially present to a primary care provider (PCP). PCPs need to be able to identify ADHD or behavioral disorders with a thorough history, possibly aided by a screening tool. Pharmacologic interventions are considered first-line treatment for ADHD, but behavioral interventions and school modifications can enhance care. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 28, 2020 Category: Nursing Authors: Matthew Schroer, Brittany Haskell, Rose Vick Tags: Featured Article Source Type: research

Psychiatric Nurse Practitioners as Leaders in Behavioral Health Integration
With up to 70% of primary care visits prompted by psychosocial concerns, busy primary care clinics are increasingly addressing complex behavioral health (BH) needs. Substantial evidence demonstrates that the integration of BH into primary care improves access and outcomes, yet clinics face significant challenges in real-world implementation. This collaborative care integration project used psychiatric mental health nurse practitioner faculty as integration and BH specialists at an urban primary care clinic serving a diverse and largely indigent population. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 28, 2020 Category: Nursing Authors: Kara Birch, Amanda Ling, Beth Phoenix Tags: Brief Report Source Type: research

Perinatal Anxiety and Depression During Covid-19
The novel coronavirus disease 2019 (COVID-19) outbreak places perinatal women at higher risk of developing anxiety and depression. Uncertainty, fear, and confusion in medical, social, economic, occupational and political aspects of life in the US add to existing stressors that perinatal women experience. To optimize the quality of perinatal care during the pandemic, appropriate mental health interventions must be implemented to prevent and alleviate perinatal anxiety and depression and improve maternal and infant outcomes. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 28, 2020 Category: Nursing Authors: Helen Chen, Nancy Selix, Marcianna Nosek Tags: Featured Article Source Type: research

Stakeholder Perspectives on Improving an Advance Practice Provider Emergency Department Critical Care Step-Down Unit
In response to concerns about the continued care and safety of critically ill and injured patients, our academic, urban, tertiary care, level I trauma center adult emergency department (ED) created an advanced practice provider (APP)-staffed critical care step-down unit (CCSU). We conducted semistructured interviews of ED physicians, APPs, and nursing staff about the value added by the CCSU as well as suggestions for its improvement. The results from the interviews showed staff were highly complimentary of the CCSU and recommended expansion of its hours and APP staffing, but indicated areas of improvement. (Source: The Jou...
Source: The Journal for Nurse Practitioners - September 24, 2020 Category: Nursing Authors: Lisa Murphy, Gino Paolucci, Laura Pittenger, Morayo Akande, Roland C. Merchant Tags: Brief Report Source Type: research

Using Trauma-Informed Care to Address Sexual Assault and Intimate Partner Violence in Primary Care
This article will offer guidance on screening for and responding to sexual assault and intimate partner violence using trauma-informed principles with the goal of promoting health and healing for survivors. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 24, 2020 Category: Nursing Authors: Julia Palmieri, Julie L. Valentine Tags: Featured Article Source Type: research

A Rare Case of Upper Extremity Swelling and Pain
Ms. L is an active 39-year-old female with past medical history including Raynaud ’s disease and migraines. She presents to her primary care provider with several days of pain and swelling in her right upper extremity from the shoulder to forearm. The pain is not localized, and she denies any preceding trauma or injury. She describes her arm pain as achy, mild to moderate, and continuous. Ms. L also reports some color change to her right arm, but none in her hand. She is athletic and is an avid runner. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 24, 2020 Category: Nursing Authors: Christina Cantey Tags: Case Challenge Source Type: research

Anxiety in Adolescents
Anxiety is a highly prevalent mental disorder in today ’s adolescent population. It can sometimes lead to severe physical and mental impairment. Several adolescent population-specific factors make this age group particularly vulnerable to the development of anxiety. Providers and the medical team must be diligent in recognizing subtle signs of adolesc ent anxiety and implement prompt treatment of this disorder. Untreated anxiety can have detrimental consequences later in life. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 17, 2020 Category: Nursing Authors: Iliana Garcia, Jean O ’Neil Tags: Featured Article Source Type: research

Screening for Adverse Childhood Experiences: Literature Review and Practice Implications
Adverse childhood experiences (ACEs) are linked with negatively impacting child and adult health outcomes. Clinicians are integral in identifying childhood adversities and offering supportive measures to minimize negative effects. This systematic literature review included 13 ACE studies that examined the acceptability, feasibility, and implementation of ACE screenings from the perspectives of clinicians and patients. The findings of this review can assist clinicians in considering the appropriateness of ACE screenings for their patients and the ethical and practical issues that must be addressed for effective screening im...
Source: The Journal for Nurse Practitioners - September 16, 2020 Category: Nursing Authors: Christina Rariden, Lee SmithBattle, Jee Hye Yoo, Nancy Cibulka, Deborah Loman Tags: Review Article Source Type: research

Avoidant Restrictive Food Intake Disorder —More Than Just Picky Eating: A Case Discussion and Literature Review
This review of the literature was conducted to define avoidant restrictive food intake disorder (ARFID) and provide the current evidence-based treatment modalities and implications for Nurse Practitioners. A specific case is used to illustrate the daily struggles of a pediatric patient with ARFID that include bullying, self-doubt, and anxiety related to eating. There is a need for increased awareness of the disorder to increase identification of the disorder, enhance the research on treatment modalities for the disorder, and most importantly, to increase the quality of life for those with the disorder and their family memb...
Source: The Journal for Nurse Practitioners - September 16, 2020 Category: Nursing Authors: Emily Davis, Elizabeth L. Stone Tags: Featured Article Source Type: research

The Diagnosis and Management of Anxiety in Adolescents With Comorbid ADHD
Among adolescents suffering from attention-deficit/hyperactivity disorder (ADHD), comorbid anxiety disorders are common, and symptoms need to be recognized early to minimize the potential impact on their quality of life. Anxiety disorders are recognized by using validated screening tools such as the Screen for Child Anxiety Related Emotional Disorders and the Spence Children ’s Anxiety Scale. Clinicians should first optimize ADHD therapy to ensure anxiety is not related to uncontrolled ADHD. This population benefits greatest from family-based cognitive behavioral therapy; however, best results are seen with the addit...
Source: The Journal for Nurse Practitioners - September 15, 2020 Category: Nursing Authors: Kelsey Friesen, Ashley Markowsky Tags: Featured Article Source Type: research

A Little Extra Tender Loving Care to Weather the Perfect Storm
As nurse practitioners (NPs), on a daily basis, we counsel patients experiencing stress. Regardless of the chief complaint, there always seems to be some component of the diagnosis that either has a context of stress or itself induces stress. Our patients interpret and define stress in different ways. What may cause stress for one person may not for another. We know that it ’s the patient’s perception of stress that matters. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 15, 2020 Category: Nursing Authors: Leslie Neal-Boylan Tags: Editorial Source Type: research

Treating Child and Adolescent Depression and Anxiety in Primary Care
Depression and anxiety are prevalent mental health illnesses often diagnosed during the child and adolescent years. Patients presenting with depression and/or anxiety symptoms typically initially present to a primary care provider (PCP). PCPs need to be able to identify symptoms, which can be aided by a screening tool. First-line treatment is psychotherapy followed by a selective serotonin reuptake inhibitor (SSRI) for those diagnosed with depression or anxiety. PCPs should refer child and adolescent patients to a psychiatric specialist who have 8 weeks of no symptom improvement, severe symptoms, suicidal thoughts, self-ha...
Source: The Journal for Nurse Practitioners - September 15, 2020 Category: Nursing Authors: Marci Zsamboky, Brittany Haskell, Rose Vick, Matt Schroer Tags: Featured Article Source Type: research

A Newly Approved Cholesterol Drug Joins the Lipid-Lowering Arsenal: Bempedoic Acid
Elevated low-density lipoprotein cholesterol (LDL-C) leads to atherosclerosis. Cholesterol-lowering agents are the mainstay in cardiovascular treatment. Statin therapy is the first-line treatment, followed by ezetimibe if further LDL-C reduction is needed. A proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor may be considered as an add-on in patients with established atherosclerotic cardiovascular disease if additional LDL-C reduction is warranted. Bempedoic acid is a once-daily oral medication newly approved by the United States Food and Drug Administration. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 15, 2020 Category: Nursing Authors: Joseph Furer, Olga Popova, Roda Plakogiannis Tags: Featured Article Source Type: research

Cannabidiol Products: Review of the Regulatory and Clinical Considerations
Use of cannabidiol (CBD) products has become widespread due to the proposed medical benefits without the “high” of marijuana, with recent polling indicating that 1 in 7 Americans report using a CBD product. However, health care professionals have apprehension about whether these treatments are legal, safe, and effective. In this review, we provide a summary of the scientific evidence on CBD oil so that a nurse practitioner can guide patients to the safest and most beneficial products within today’s regulatory environment. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 14, 2020 Category: Nursing Authors: Emily M. Hawes, Cameron R. Lee, Dana E. Brackney, Tucker G. Ensley, Julie Kidd, Cristen Page Tags: Featured Article Source Type: research

Unilateral Shoulder Pain: No History of Trauma
The diagnosis of musculoskeletal pathology is not always straightforward. This case challenge is designed to allow practitioners to familiarize themselves with the history of the presenting complaints and apply both imaging and examination techniques as diagnostic measures. Clinical diagnostic techniques are discussed, as well as pertinent treatment options. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 11, 2020 Category: Nursing Authors: Stephen McGhee, Juan M. Gonzalez, Johis Ortega Tags: Case Challenge Source Type: research

Facial Swelling —Where to Next?
This case study describes a 24-year-old woman who presents to her primary care provider with marked unilateral facial swelling that has been present for 6 months. Facial swelling is a frequently observed symptom associated with various odontogenic and nonodontogenic conditions. Appropriate diagnosis and referral are critical when patients seek care for a suspected oral pathology. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 11, 2020 Category: Nursing Authors: Katharine Ciarrocca, Sajitha Kalathingal, Brittany Klein Tags: Case Challenge Source Type: research

The Effect of Health Education on Knowledge and Self-Care Among Arabic Schoolgirls With Primary Dysmenorrhea in Malaysia
The purpose of this study was to evaluate the effect of health education on knowledge and self-care among Arabic schoolgirls with primary dysmenorrhea. A quasi-experimental intervention with a non-equivalent pre-test and post-test control group design. The KoPD and ADSCS questionnaires were used. A health education program regarding primary dysmenorrhea was provided after the pre-test for the experimental group. The post-test was conducted after two months for both groups. Results revealed a significant increase in the experimental group related knowledge and self-care. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 11, 2020 Category: Nursing Authors: Latifa Yahya Al Ajeel, Mei Chan Chong, Li Yoong Tang, Li Ping Wong, Abdulaziz Mansoor Al Raimi Tags: Original Research Source Type: research

Two Different Primary Care Approaches for Caring for People With Dementia and Their Families
This study explored an established primary care –based dementia pathway in New Zealand (NZ) and nurse practitioner dementia diagnosis and care in 1 small United States state that has adopted a value-based delivery model. Central to the NZ model was the education of primary care providers, clear delineation of specialists’ support and referral pathways, and routine and predictable family carer respite. The US respondents reported that the essential resources necessary to support the diagnosis and management of dementia were lacking. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 9, 2020 Category: Nursing Authors: Mary Val Palumbo, Betty Rambur Tags: Original Research Source Type: research

Desquamative Inflammatory Vaginitis: A Closer Look
Desquamative inflammatory vaginitis (DIV) is an uncommon form of vaginitis first described in 1965. Although etiology of this chronic vaginitis is unknown, it is believed to be immune mediated. DIV is a diagnosis of exclusion, characterized by inflammation and a purulent, odorless discharge. The incidence and prevalence are unclear, but perimenopausal, white women seem to be the most affected. DIV has been reported to be present in 0.8% to 4.3% of women with vulvovaginal symptoms. Signs and symptoms are nonspecific. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 8, 2020 Category: Nursing Authors: Christy D. Martin, Aimee Chism Holland Tags: Featured Article Source Type: research

Diagnostic Reasoning and Diagnostic Errors
I have always enjoyed the diagnostic reasoning process, and I feel I learned from a master. My first collaborating physician was a pediatrician who taught me how to overcome being “stuck” if the signs and symptoms in a patient’s presentation did not align with my protocol book. He taught me that the patient would lead me to the answer(s), but it was my job to keep asking questions until they did. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 7, 2020 Category: Nursing Authors: Julee B. Waldrop Tags: Editorial Source Type: research

Are We Asking? Nurse Practitioners ’ Interpersonal Violence Screening Practices
This cross-sectional study examined nurse practitioners ’ (NPs’) intimate partner and sexual violence screening behaviors and identified associated factors. A survey invitation was mailed to 1000 primary care NPs, and the final sample included 170 NPs. The mean rate of violence screening was 18.9%. Of NPs who responded, 56% reported screening “almo st none” of the female patients for violence during the past 3 months. Main concerns included time required to screen (32.3%) and disruption to clinic operations (18.3%). (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 6, 2020 Category: Nursing Authors: Melissa A. Sutherland, M. Katherine Hutchinson, Heidi Collins Fantasia, Bing Si, Lan Jiang Tags: Original Research Source Type: research

Measuring the Effects of Childhood Trauma in HIV Primary Care
This quality improvement pilot screened 60 people living with HIV for childhood trauma using the Adverse Childhood Experience (ACE) questionnaire. Antiretroviral adherence and substance use were compared between 2 ACE scoring groups 0 to 3 and 4 to 10, because scoring 4 and higher reflects complex trauma. Higher ACE scores correlated with increased substance use and suboptimal antiretroviral adherence. This project supports the need for childhood trauma screening and implementation of a trauma-informed approach to care. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 6, 2020 Category: Nursing Authors: Aeryn E. Peck, Crystal Chapman Lambert, Gina C. Dobbs Tags: Brief Report Source Type: research

Coccydynia: Diagnostic and Management Guidance
Coccydynia refers to pain in the region of the tailbone. Most cases are related to mild injury, trauma, and childbirth. The primary care provider will come across this complaint in a small portion of patients presenting with “low back pain.” There are no comprehensive guidelines for treatment of coccydynia. A thorough evaluation in the office with physical examination and imaging are essential. Specialty referrals should be considered for complex or concerning cases or with intractable pain. Injections, surgery, and neurostimulation are rare but acceptable options for certain patients (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 6, 2020 Category: Nursing Authors: Lynn Gufeld, Josephina A. Vossen, David Urquia Tags: Featured Article Source Type: research

Do We Know How to Sacrifice?
We become acquainted with the sacrifices of our parents through their stories, and each generation seems to redefine the concept. My parents were born between 1901 and 1925, the “Greatest Generation”.1 They had survived the Great Depression and the Nazi occupation of their country, the Netherlands, in large part by inestimable sacrifice. During the famine that spanned the harsh winter of 1944–1945, my mother and her sister walked with an empty baby carriage some 90 ki lometers to a farm where they filled the carriage up with food for their family and then walked home again. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 6, 2020 Category: Nursing Authors: Donald Gardenier, Robert Metzger, Susan Apold Tags: Point/Counterpoint Source Type: research

Postpartum Anxiety
During the perinatal and postpartum period, women are vulnerable to mental health disorders. Primary care providers are skilled at screening, diagnosing, and treating the mother for postpartum depression. However, perinatal and postpartum anxiety demonstrates a greater prevalence rate and appears to be under-recognized and under-treated, despite its increased prevalence. With frequent patient encounters during pregnancy and in the postpartum period, nurse practitioners have the opportunity to recognize and treat postpartum anxiety and, as a result, improve patient outcomes for the mother and infant. (Source: The Journal fo...
Source: The Journal for Nurse Practitioners - September 6, 2020 Category: Nursing Authors: Michelle P. Zappas, Kathleen Becker, Benita Walton-Moss Tags: Featured Article Source Type: research

Social Herd Immunity
One year ago, I was preparing to welcome the beginning of 2020 with an extended visit with children and grandchildren. I greeted the new year with much anticipation as it would include my retirement from full-time teaching. My newfound freedom would be spent mostly in travel with my husband either to places on my personal “bucket list” or in more family time. Little did I imagine that soon, my contact with not only my family but students, friends, and colleagues would be limited to electronic communication on the telephone or via audio video Internet connection. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 4, 2020 Category: Nursing Authors: Denise Link Tags: Quality Care for Women ’s Health Source Type: research

Connect, Engage: Televisits for Children With Asthma During COVID-19 and After
Despite the many barriers to receiving care, children with asthma must have access to regular care and frequent follow-up visits. The usual barriers to the provision of asthma care have been made even more complicated by the current coronavirus disease 2019 pandemic. To minimize the disruption of care due to the necessary constraints dictated by coronavirus disease 2019, the televisit provides a practical solution that can assess the child ’s current level of symptom control, reinforce asthma education, and determine treatment options. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 3, 2020 Category: Nursing Authors: Constance L. Wall-Haas Tags: Feature Article Source Type: research

Connect, Engage: Televists for Children With Asthma During COVID-19
Despite the many barriers to receiving care, children with asthma must have access to regular care and frequent follow-up visits. The usual barriers to the provision of asthma care have been made even more complicated by the current COVID-19 pandemic. To minimize the disruption of care due to the necessary constraints dictated by COVID-19, the televisit provides a practical solution that can assess the child ’s current level of symptom control, reinforce asthma education, and determine treatment options. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 3, 2020 Category: Nursing Authors: Constance L. Wall-Haas Tags: Featured Article Source Type: research

Implementation of Cluster-Based Management Strategies for Patients With Chronic Kidney Disease
Chronic kidney disease is a critical public health problem and health economic burden. This research adopted the clustering analysis method, which was used to divide 259 patients into 3 subgroups of patients, based on the situational leadership management. The goal was to discover the needs for patient management and a self-management support strategy applied to clinical care. At the same time, the aim was to constantly improve the ability of self-management for patients with chronic kidney disease to improve their physical and mental health, to realize the diversification of slow disease management, and customization of c...
Source: The Journal for Nurse Practitioners - September 2, 2020 Category: Nursing Authors: Yu Shi, Hongmei Peng, Yan Chen, Junna Deng, Wang Li, Jing He, Jiachuan Xiong Tags: Featured Article Source Type: research

Reconsidering Benzodiazepines and Z-Drug Prescriptions: Responsible Prescribing and Deprescribing
Benzodiazepines and sedative-hypnotic (Z-drugs), collectively termed hypnotic drugs, bind to γ-aminobutyric acid receptors, the primary inhibitory neurotransmitters in the brain. Hypnotic drugs are among the most prescribed medications worldwide, with primary care providers leading this prescribing trend, primarily for the management of insomnia and anxiety. There is no evidence to support the use of long-term hypnotics, and evidence regarding the risks associated with long-term use of hypnotics is growing. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 2, 2020 Category: Nursing Authors: Nancy McGee, J ’Laine Proctor, Ann Marie Hart, Mary Burman Tags: Featured Article Source Type: research

Eastern Equine Encephalitis Virus: A Current and Future Danger
Eastern equine encephalitis virus (EEEV) is a rare arbovirus that is transmitted to humans by mosquitos. In the United States, approximately 8 cases of EEEV are reported each year, with a recent outlier of 38 reported cases in 2019. This update is a review of the current data and recommendations for diagnosis, treatment, and prevention of EEEV to help the nurse practitioner prepare for ongoing and potential increases in cases. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 2, 2020 Category: Nursing Authors: Louis E. D ’Onofrio Tags: Featured Article Source Type: research

Understanding Cannabis
Over the past decade, cannabis has gained popularity as a treatment for many conditions. Patients with various complaints ranging from chronic pain to insomnia to posttraumatic stress disorder are using cannabis with or without medical oversight. The effects of cannabis can vary widely depending on the strain that is consumed, the ratio of delta-9-tetrahydrocannabinol to cannabidiol, and the plant ’s terpene profile. Considering the wide range of possible effects on the mind and the body, it is important for clinicians to have a basic understanding of medicinal cannabis, including the neurotransmitters and the endoca...
Source: The Journal for Nurse Practitioners - September 1, 2020 Category: Nursing Authors: Debra A. Hunt, Joanne Keefe, Tammy Whitehead, Amber Littlefield Tags: Feature Article Source Type: research

Well-being Content in Nurse Practitioner Curricula: Facilitators and Barriers
The challenges and stressors of primary care require nurse practitioners to balance patient demands with their own health and well-being. Academic institutions have a responsibility to promote health and well-being among all students, with the goal of their continuing these activities after graduation. Results of this project describe the current state of well-being content integration in the curriculum of a hybrid family nurse practitioner program and identify potential barriers and facilitators of curriculum refinement. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - September 1, 2020 Category: Nursing Authors: Josephine Fava Hochuli, Mary A. Dolansky, Kathleen Becker, Latina M. Brooks, Mary Terhaar Tags: By Faculty for Faculty Source Type: research

September 2020 Continuing Education Credit Application
(Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - August 29, 2020 Category: Nursing Tags: CE Test and Application 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 - August 29, 2020 Category: Nursing Tags: AANP Forum Source Type: research

Offering CE Opportunities in light of COVID-19
As the professional home for nurse practitioners (NPs) of all specialties, the American Association of Nurse Practitioners ® (AANP) strives to provide high-quality continuing education (CE). This year, just as our members have had to adjust due to COVID-19, AANP has had to change the way we connect to deliver educational opportunities. With the cancellation of our national and fall conferences, we looked beyond the nor m to develop online ways to keep members up to date. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - August 29, 2020 Category: Nursing Authors: Sophia L. Thomas Tags: From the AANP President Source Type: research