Increasing Patient Participation in Colorectal Cancer Screening in Primary Care: An Evidence-Based Improvement Initiative
Colorectal cancer (CRC), although preventable, can be lethal. An evidence-based interprofessional improvement initiative established CRC risk categorization in patients aged 45 to 75 years using national screening guidelines. A system-wide policy was created, and the guidelines were used across 3 primary care settings during every health encounter for 12 weeks to improve compliance, screening, and referrals for CRC. The numbers of Cologuard and fecal immunochemical tests returned by patients increased statistically after implementation (P  = 0.001). (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - July 25, 2023 Category: Nursing Authors: Irene Amoako-Attah, Jayne Jennings Dunlap, Rosalie O. Mainous Tags: Brief Report Source Type: research

New Weapons in the Battle Against Type 2 Diabetes in Veterans: Shared Medical Appointments and Conversation Maps
This quality improvement pilot study explored the effect of using Conversation Maps (CMs) during shared medical appointments (SMA) on diabetes knowledge, self-efficacy, self-management, and patient satisfaction in a convenience sample of older veterans with diabetes (N  = 24). Participants attended 4 weekly 2-hour SMAs in which CMs were used. Veterans completed surveys at program start/end. Patient satisfaction was measured at week 4. Before and after survey scores affirmatively differed for diabetes knowledge, self-efficacy, and self-management; patients reporte d high satisfaction. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - July 25, 2023 Category: Nursing Authors: John Gerrity Wade, Janet S. Selway Tags: Brief Report Source Type: research

The New Fat Kid on the Block: Lipoprotein (a)
This report aims to raise awareness about the significance of elevated Lp(a) levels in contributing to atherosclerotic cardiovascular disease and major adverse cardiovascular events and to assist nurse practitioners in using evidence-based approaches to lower its levels. We synthesized recommendations for managing elevated Lp(a) concentrations using the Canadian, United States, and European study guidelines. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - July 19, 2023 Category: Nursing Authors: Mohamed Toufic El Hussein, Sasha Lewis Tags: Featured Article Source Type: research

Fever and Fatigue
Febrile neutropenia is an oncologic emergency that is seen in patients receiving chemotherapy. It is more commonly noted in hematologic malignancies, although it can be observed in solid tumor cancers. Management involves prompt infectious workup, determination of high or low risk using the Multinational Association for Supportive Care in Cancer risk index score, and initiation of empiric antimicrobials in the inpatient or outpatient setting. Close monitoring for organ dysfunction and worsening clinical status is essential. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - July 13, 2023 Category: Nursing Authors: Nicole Kuhnly, Leon L. Chen Tags: Case Challenge Source Type: research

Low-Dose Combination Pills for Management of Hypertension
Hypertension (HTN) is the most common modifiable chronic disease that significantly increases cardiovascular morbidity and mortality.1 Antihypertensive treatment reduces incidence of coronary heart disease and stroke and prolongs life.1 Improving blood pressure (BP) control is a key strategy to decrease the burden of cardiovascular disease. Despite availability of very effective BP-lowering therapy, HTN remains uncontrolled in nearly 50% of American adults.2 In the majority of patients, a single-agent drug therapy is not sufficient for adequate reduction of BP, and more than half of patients need at least 2 antihypertensiv...
Source: The Journal for Nurse Practitioners - July 13, 2023 Category: Nursing Authors: Irina Benenson Tags: Prescription Pad Source Type: research

A Contemporary Review of Community and Transitional Heart Failure Programs
For patients with heart failure (HF), the transition period from hospital to home remains a critical period of vulnerability. Transitional and community-based interventions aimed at reducing hospitalizations and death were explored to inform models of care in the Australian health care system. A search query was derived using key-terms such as “HF,” “transitional care,” and “discharge” on the PubMed and Ovid databases. We identified 5 key interventions from the final 30 studied, including telemonitoring, nurse-led home visits, patient education, pharmacist intervention, and telehealth. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - July 12, 2023 Category: Nursing Authors: Saad Fahd, Mandeep Singh Kalsi, Gautam Vaddadi, Naveen Sharma Tags: Review Article Source Type: research

Depressive Episodes in a Patient With Bipolar Disorder
This article highlights the importance of differentiating between unipolar and bipolar depression and the utilization of appropriate psychopharmacotherapy for bipolar depression. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - July 10, 2023 Category: Nursing Authors: Andrew Makowski, Holly Gray, Julie Perry Tags: Case Report Source Type: research

An Atypical Presentation of a Uterine Fibroid
Uterine fibroids are a common diagnosis in primary care, but uterine fibroids can present with atypical symptoms. This case report describes a 47-year-old female, G6P6006, who presented to family medicine for follow-up of persistent left-sided flank pain, dysuria, and urinary frequency for 1.5 months that led to the diagnosis and treatment of a subserosal uterine fibroid. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - July 8, 2023 Category: Nursing Authors: Hannah Hineman, Hayden Middleton, Elizabeth Stewart Tags: Case Report Source Type: research

HPV Infection Oncogenesis and Prevention in Canada —What Nurse Practitioners Need to Know
This article presents an evidence-based understanding of the advantages of the HPV vaccination. Although the information presented in this report may be relevant to other countries, the focus was on the experience of HPV in Canada. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - July 8, 2023 Category: Nursing Authors: Mohamed Toufic El Hussein, Nicole Canonizado Tags: Featured Article Source Type: research

Incorporating an Evidence-Based Bundle to Standardize the Heart Failure Discharge Process
This project aimed to improve adherence to postdischarge follow-up among all-cause heart failure (HF) veterans by implementing the evidence-based Focused Discharge Handoff Tool (FDHT). (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - July 8, 2023 Category: Nursing Authors: LaQuadria S. Robinson, Jolly Thomas, Manju Cibi, Randy Moore Tags: Brief Report Source Type: research

Navigating Alcohol Use Disorder in Adults: A Case Report
This case study presents the diagnosis and treatment of a male patient with an alcohol use disorder (AUD). Although medications are helpful in AUD, nurse practitioners must be cognizant when combining them with other approaches, such as therapy. Some clinicians prefer to control AUD use before treating other issues, under the theory that alcohol can obscure and aggravate underlying physical and psychiatric conditions. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - July 8, 2023 Category: Nursing Authors: Christina Threet, Rhigel Tan, Reimund Serafica Tags: Case Report Source Type: research

Dysmenorrhea in Adolescents
Dysmenorrhea is present is 60% to 90% of menstruating teens. The wide disparity in the presentation is indicative of underreporting, cultural aspects, stigma, and normalization of menstrual discomforts. Although the symptoms of dysmenorrhea are common, they often mask more serious pathology. Early recognition, adequate treatment, socialization, and open dialogue surrounding menstruation are necessary to intercept late diagnosis of critical conditions. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - July 7, 2023 Category: Nursing Authors: Gay L. Goss Tags: Feature Article Source Type: research

Sodium –Glucose Cotransporter-2 Inhibitors: An Old Medication With New Indication in Heart Failure With Preserved Ejection Fraction
This report h ighlights a new indication for SGLT2 inhibitors in managing HF with preserved ejection fraction and the proposed mechanisms of action. Data from randomized controlled trials demonstrated that SGLT2 inhibitors reduce mortality, decrease hospitalization, and enhance functional status in patients with HF with preserved ejection fraction. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - July 7, 2023 Category: Nursing Authors: Mohamed Toufic El Hussein, Cassandra Reeves Tags: Featured Article Source Type: research

A Case of Nitroimidazole-Resistant Trichomonas vaginalis in a 30-Year-Old Female With an Intrauterine Device
Resistant Trichomonas vaginalis (T.  vaginalis) presents a unique challenge to health care providers given that information on novel treatments is often limited to scientific case studies. Additionally, nonstandard/nonformulary treatments are often not routinely endorsed by traditional prescription coverage and can be a costly out-of -pocket treatment plan. It is important for clinicians to have knowledge of appropriate alternative treatment options when initial treatments have failed and resistance is suspected or confirmed. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - July 6, 2023 Category: Nursing Authors: Allison M. Jedson, Christopher S. Nasin Tags: Case Report Source Type: research

A Retrospective Study on Toenail Onychomycosis: Efficacy of Combination Therapy and Correlating Factors to Washout Time
Onychomycosis in the toenail is a common fungal infection. Moderate to severe onychomycosis, especially, may persist chronically with a considerable recurrence rate that can be a challenge for management. Oral antifungal therapy is the current gold standard to treat for moderate to severe toenail onychomycosis. However, there are alternative combination modalities including topical agents and/or procedural modalities that are emerging because of potential adverse effects of oral antifungals and to prevent recurrence. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - July 5, 2023 Category: Nursing Authors: Alice S. Park, Mary L. Thomas, Esther O. Park, Jayson K. Choi Tags: Original Research Source Type: research