The Right Tools for the Job
My Dad was a carpenter. I credit him for my love of tools and enthusiasm for home do-it-yourself projects. Over the years I have built a workbench for our garage, rewired our doorbell, and installed new hardware on our front door. When my husband gave me an electric screwdriver for our first wedding anniversary, my father-in-law sternly advised him this was no way to stay married. The screwdriver was on my wish list … and it wouldn’t be the last time I’d surprise my father-in-law. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 30, 2020 Category: Nursing Authors: Gale Adcock Tags: Under the Dome Source Type: research

Endocrine Therapy for Breast Cancer
Endocrine therapy is the primary treatment for the most common types of breast cancer. Endocrine agents work by inhibiting the tumor-stimulating effects of estrogen in hormone-sensitive tumors. A new class of targeted drugs synergize with endocrine agents to improve survival for patients with metastatic disease. Endocrine therapy is continued for years, and long-term survival is common, although toxicities often occur due to the alteration of the physiologic effects of estrogen. It is important, therefore, that primary care providers remain knowledgeable about patient needs during and after treatment. (Source: The Journal ...
Source: The Journal for Nurse Practitioners - November 29, 2020 Category: Nursing Authors: Jeanne F. Noe, Margaret A. Bush Tags: Featured Article Source Type: research

Chlorthalidone or Hydrochlorothiazide for Treatment of Hypertension
Thiazide diuretics chlorthalidone (CLTD) and hydrochlorothiazide (HCTZ) have been a mainstay of the therapy of primary hypertension (HTN).1 As a class of medications, thiazide diuretics inhibit sodium-chloride cotransporters at the distal tubule of the nephron, which reabsorbs approximately 10% of the filtered sodium load.2 The initial hypotensive effect of thiazides is attributable to a decrease in sodium and water reabsorption and a reduction in intravascular volume. However, the early fall in blood pressure (BP) becomes partially reversed by hypovolemia-triggered activation of the renin-angiotensin-aldosterone response ...
Source: The Journal for Nurse Practitioners - November 29, 2020 Category: Nursing Authors: Irina Benenson Tags: Prescription Pad Source Type: research

Veteran Suicide
Current statistics emphasize the national concerns with rising veteran suicides. Advanced practice registered nurses (APRNs) treat veterans in many settings, and establishing a therapeutic relationship may allow the veteran to express symptoms that lead to feelings of hopelessness, guilt, shame, and remorse. A key component is the role of the APRN in identifying those at risk, prevention, and treatment for veterans expressing symptoms that might lead to suicide. Exploring evidence-based therapeutic approaches for the treatment of posttraumatic stress disorder and other mental disorders is critical for APRNs treating vetera...
Source: The Journal for Nurse Practitioners - November 29, 2020 Category: Nursing Authors: Dawn Goldstein Tags: Brief Report Source Type: research

Acute Pericarditis: Best Practices for Nurse Practitioners
Acute pericarditis (AP) is inflammation of the outermost layer of the heart due to infectious or noninfectious etiologies that result in increased pericardial vascular permeability, cardiac motion restriction, and augmented electrophysiology. It is a clinical diagnosis based on the presence of at least 2 of 4 clinical manifestations: pleuritic chest pain, pericardial friction rub, widespread ST elevation or PR depression, and new or worsening pericardial effusion. Nurse practitioners in primary and acute care settings need to recognize the hallmark finding of new global ST elevation or PR depression on electrocardiogram, a...
Source: The Journal for Nurse Practitioners - November 29, 2020 Category: Nursing Authors: Roathipoun Po, Courtney J. Cook Tags: Featured Article Source Type: research

Understanding Cannabis: Clinical Considerations
The use of cannabis for medicinal purposes and recreational use across all age groups continues to increase across the United States. Cannabis is reported to be the most commonly used illicit drug in the United States. In recent years, more states have legalized cannabis for both medicinal and recreational use. With the growing public acceptance and prevalence of cannabis use, advanced practice nurses will encounter more patients seeking guidance on the use of cannabis for a variety of conditions. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 29, 2020 Category: Nursing Authors: Debra A. Hunt, Joanne Keefe, Tammy Whitehead Tags: Featured Article Source Type: research

Development of Interprofessional Collaborative Podcasts to Introduce Electrocardiographic Fundamentals
Learning interpretation of the 12-lead electrocardiogram is a critical component of health care curricula. Collaborative, multidisciplinary instruction provides an approach to teaching complex skills such as electrocardiographic (ECG) interpretation. Faculty from advanced practice nursing, pharmacy, emergency medicine, and cardiology collaborated to produce a 5-module podcast series on the fundamentals of 12-lead ECG interpretation for use with health care students. Students from multiple health care professional education programs at different universities worked together to learn ECG interpretation. (Source: The Journal ...
Source: The Journal for Nurse Practitioners - November 29, 2020 Category: Nursing Authors: Kumhee Ro, Joshua Villarreal Tags: By Faculty for Faculty Source Type: research

Lessons Learned From 2020: Don ’t Get Complacent
The dawning of 2020 brought a fresh perspective and vision for the new year and decade. The American Association of Nurse Practitioners outlined important actions for the future practice of nurse practitioners (NPs) in its 2020 State Policy Priorities.1 Current progress was highlighted as the adoption of full-practice authority laws for NPs in states across the country, increased visibility, and broadening acceptance from insurance companies for treatment during the previous decade.2 Across the country, NPs continue to make strides toward greater recognition and ability to practice to their fullest scope; however, individu...
Source: The Journal for Nurse Practitioners - November 28, 2020 Category: Nursing Authors: Kamala D. Via Tags: In My Opinion Source Type: research

Telehealth billing for nurse practitioners during COVID-19: Policy updates
Telehealth is a growing valuable strategy to assist patients accessing needed care when unable to get to a healthcare setting for one of several reasons. During the COVID-19 pandemic of 2020, many healthcare practices were forced to implement telehealth services to meet both patient and practice needs. In 2020, several temporary waivers, exceptions, and telehealth policy changes emerged across the nation. Many telehealth policies are state or federal specific. This manuscript provides a general overview of essential telehealth policies and legislative updates along with resources and websites to guide and support nurse pra...
Source: The Journal for Nurse Practitioners - November 25, 2020 Category: Nursing Authors: Elizabeth F. Snyder, Lisa Kerns Tags: CE Article Source Type: research

Data Point: Race in the Pandemic ’s Homelessness Hotels
Nurse practitioners working for the San Francisco Department of Public Health during the pandemic provided medical care to people experiencing homelessness during the pandemic. In San Francisco, more than 2,000 people experiencing homelessness were moved into shelter-in-place hotels during the pandemic. The shelter-in-place hotels offer a unique microcosm of our society, highlighting drivers of inequality such as race, class, and sex. Elements of White privilege were observed among people experiencing homelessness who were moved into shelter-in-place hotels. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 24, 2020 Category: Nursing Authors: P. Suzanne Portnoy Tags: In My Opinion Source Type: research

When You Hear Hoof Beats, Look for the Zebras: Atypical Presentation of Illness in the Older Adult
Nurse practitioners in acute, primary, and long-term care manage the complex needs of the geriatric population. Symptom presentation is fundamental to building the differential diagnosis. However, older adults often present atypically, for example, with only functional changes, rather than with typical symptoms. In order to identify potentially life-threatening illness in this group, it is necessary to have an understanding of symptom& exam alterations and the physiological age changes that underly them. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 21, 2020 Category: Nursing Authors: Cassandra Vonnes, Rosalie El-Rady Tags: Clinical Practice Source Type: research

Implementation of a Human Trafficking Screening Protocol
In the United States, young females are at greatest risk for sex trafficking and often seek health services for unplanned pregnancies, sexually transmitted infections, and traumatic injuries. Unfortunately, health care providers often fail to identify human trafficking victims. This project implemented a screening protocol including a flowchart and standardized human trafficking screening tool, provided human trafficking education, and distributed human trafficking resources for women at a crisis pregnancy center. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 21, 2020 Category: Nursing Authors: Jessica McDow, Jean Dowling Dols Tags: Brief Report Source Type: research

An Assessment of Distress Levels of Patients Undergoing Lung Cancer Treatment and Surveillance During the COVID-19 Pandemic
According to the Centers for Disease Control and Prevention, COVID-19 has affected more than 5,119,711 patients with more than 163,651 confirmed deaths reported. The mass media coverage and widespread eruption of illnesses have been associated with adverse mental health outcomes.1 Cancer patients represent an already-compromised population with elevated levels of anxiety and distress; the introduction of the COVID-19 pandemic places this vulnerable group at an even higher risk for mental health consequences. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 21, 2020 Category: Nursing Authors: Denise Albano, Melissa Feraca, Barbara Nemesure Tags: Brief Report Source Type: research

Factors for Assisting Adolescents with Autism Develop Health Self-Management
Although nurses provide much of the health care for adolescents with special health needs, the nursing literature has focused limited attention on these adolescents ’ health transitions, particularly in adolescents with autism spectrum disorder (ASD). As many as 95% of individuals with ASD have co-occurring health conditions. Despite their need to develop health self-management skills as they transition to adulthood, only 14% of adolescents with ASD receive h ealth transition planning. One barrier to such planning is a limited understanding of concepts and relationships within health care transitions. (Source: The Jo...
Source: The Journal for Nurse Practitioners - November 20, 2020 Category: Nursing Authors: Jamie L. Rock, Heather Becker Tags: Featured Article Source Type: research

Vaccination in the Adult with HIV
This article gives an overview of specific vaccines  indicated for adults when they are first diagnosed with HIV: pneumococcal, hepatitis A, hepatitis B, and meningococcal (Table 1). (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 20, 2020 Category: Nursing Authors: Jacqueline Thomas Tags: Prescription Pad Source Type: research

A COVID-19 Deterioration Report: The Nurse Practitioner ’s Perspective
The first patient diagnosed with COVID-19 was admitted to our community hospital in northern New Jersey on March 9, 2020. By April 1st , the vast majority of our total inpatient census was critically ill with the Coronavirus and, certainly, we began experiencing the severe impact of the pandemic that has been described as nightmarish (Lauerman, J., Griffin, R., 2020). A small non-teaching hospital within a large, five (5) hospital system, our capacity for caring for the massive influx of critically ill patients was quickly challenged and demanded much clinical, operational and supply chain flexibility. (Source: The Journal...
Source: The Journal for Nurse Practitioners - November 20, 2020 Category: Nursing Authors: Catherine Stevens, Mary Ann T. Donohue-Ryan Tags: Brief Report Source Type: research

Veteran Suicide Risk Reduction: A Recommendation for Practice
On August 3, 2016, the United States Department of Veterans Affairs Office of Suicide Prevention published the most comprehensive analysis of Veteran suicide in the nation ’s history. After adjusting for differences in age and sex, the risk for suicide was 21% higher in the Veteran population than their civilian peers. Substantial decreases in suicide rates have been achieved after targeted dissemination of the Columbia Suicide Severity Rating Scale, an evidence-bas ed tool that is effective not only as a predictor of suicide risk but also is preventative when appropriately used at every point of care. (Source: The J...
Source: The Journal for Nurse Practitioners - November 17, 2020 Category: Nursing Authors: Joshua Faucett Tags: Feature Article Source Type: research

From Awareness to Action: Assessing for Human Trafficking in Primary Care
Human trafficking (HT) is a global phenomenon that affects all people, particularly women and children, with captivity having a significant negative health impact on victims, including a shortened life expectancy. Assessment for HT is often overlooked in the primary care setting, yet nurse practitioners are in a position to lead the campaign for early identification, assessment, and referral of trafficked persons. Educating providers and offering an assessment tool that is convenient to use and easy to incorporate into the electronic health record have the potential to impact the lives of those at risk. (Source: The Journa...
Source: The Journal for Nurse Practitioners - November 17, 2020 Category: Nursing Authors: Crystal Stevens, Shirley Dinkel Tags: Brief Report Source Type: research

Obesity Management in Primary Care During and Beyond the COVID-19 Pandemic
With 6.1 million US cases as of early September 2020, the coronavirus disease 2019 (COVID-19) pandemic is presenting unprecedented challenges to primary care. As a complex multifactorial chronic disease, obesity is a significant risk for severe COVID-19 complications associated with high morbidity and mortality. Sustainable lifestyle changes and weight loss can be effective to address obesity and its complications. With COVID-19 expected to persist for the foreseeable future, treatment and prevention of obesity is more imperative than ever. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 14, 2020 Category: Nursing Authors: Wudeneh M. Mulugeta Tags: Featured Article Source Type: research

Using a Patient Portal to Expand Warfarin Self-Management
This article describes a quality improvement (QI) project on the expansion of self-management of warfarin to include patients whose international normalized ratios (INRs) are drawn by the laboratory and those patients who were only INR self-testing. Patients used portals to check or report their INR results and to report their warfarin dosing. The project was a success with all patients, exceeding the national benchmark of 68% for time in therapeutic range and nearly 100% use of patient portal for self-management of warfarin. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 11, 2020 Category: Nursing Authors: Amanda Cabral, Kathleen R. Bonaventura, Kerry A. Milner Tags: Featured Article Source Type: research

Hereditary Hemochromatosis: New Guidelines and Implications for Primary Care
Hereditary hemochromatosis (HH) is an autosomal recessive mutation that results in iron overload. Undetected, it can cause irreversible organ damage to the pituitary and thyroid glands, heart, liver, pancreas, testis, skin, and joints. This irreversible damage can lead to gonadotropin insufficiency, hypothyroidism, heart disease, cirrhosis, hepatocellular carcinoma, diabetes, hypogonadism, bronzing of the skin, pseudogout, and arthropathy. This case study describes a patient who presented to a primary care office for a routine examination with nonspecific complaints and was found to have elevated aminotransferases. (Source...
Source: The Journal for Nurse Practitioners - November 11, 2020 Category: Nursing Authors: Alicia Ribar, Laura Herbert, Patricia Keane Tags: Featured Article Source Type: research

The Effects of Telephone-Based Telenursing on Glycated Hemoglobin Among Older Adults With Type 2 Diabetes Mellitus: A Randomized Controlled Trial
Telenursing is the delivery of nursing care through information technology, such as telephone, computer, and Internet. This randomized controlled trial aimed to assess the effects of telephone-based telenursing on glycated hemoglobin (HbA1C) in older adult with type 2 diabetes in Iran. A 3-month telephone-based telenursing program using the Health Ministry Diabetes Mellitus Educational Material demonstrated that telephone-based telenursing is an effective strategy for diabetes type 2 management in older adults with type 2 diabetes mellitus. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 10, 2020 Category: Nursing Authors: Mohammad Esmaeilpour-BandBoni, Faeze Gholami-Shilsar, Korosh Khanaki Tags: Original Research Source Type: research

BMI and Pediatric Hypertension Categories
This study sought to understand the relationship between pediatric blood pressure measurements and body mass index (BMI) percentiles. The Pedia BP data repository was analyzed to assess prevalence of pediatric hypertension and differences in blood pressure categories based on BMI percentile. Half the sample (n  = 600) had elevated blood pressure or hypertension. BMI percentile was only associated with elevation in blood pressure between the elevated blood pressure and stage 1 hypertension category. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 9, 2020 Category: Nursing Authors: Hope Bussenius, Lauren Head Zauche Tags: Original Research Source Type: research

Identifying Veterans in Your Practice: What Clinicians Need to Know
Clinicians in ambulatory care are likely seeing veterans regularly without knowing it. In fact, most practices are not screening for military service, and most veterans do not divulge their military service without being asked. Veterans experience unique stressors during their service, placing them at risk for long-term health issues, including emotional health and psychiatric problems. Incorporating screening for military service into the health history for all patients and including military health history questions for those who screen positive is important. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 8, 2020 Category: Nursing Authors: Cynthia S. Selleck, Teena M. McGuinness, John P. McGuinness, Glenda J. Stanley, Rebecca S. Miltner Tags: Featured Article Source Type: research

Private Summers
Malaun (not her real name) was an administrative associate where I was a faculty member. As with many in her position, she was the source of all knowledge for policy, where to find a university form, and so on. She also shared colloquialisms. One day, while I was talking with her about a presentation about menopause, she said “Oh, you mean ‘private summers’?” I had never heard that term used to describe the "hot flashes" that occur during menopause. When I experienced the symptoms of the perimenopausal transition, although my private summers were not so private, I thought of Malaun and smi...
Source: The Journal for Nurse Practitioners - November 7, 2020 Category: Nursing Authors: Denise Link Tags: Quality Care for Women ’s Health Source Type: research

Adult Patients With Peritonsillar Abscess: What Nurse Practitioners in Primary Care Need to Know
This article describes the most common characteristics of the patient who presents to outpatient providers with unilateral throat pain consistent with a diagnosis of PTA. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 5, 2020 Category: Nursing Authors: Nicole L. Tiefel, Mark Lorenz, T. Robin Bartlett Tags: Featured Article Source Type: research

Nurse Practitioner COVID-19 Experience in Skilled Nursing Facilities
This article reflects on the experience of Nurse Practitioners (NP) caring for older adults with COVID-19 in skilled nursing facilities in Northern California. The personal impact of COVID on NPs is as varied as the symptoms of the patients. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 5, 2020 Category: Nursing Authors: Rebecca A. Spear, Amy L. Schmuecker, Susan M. DeGutes Tags: In My Opinion Source Type: research

Nurses ’ and Physicians’ Perspectives on Text-Based Postpartum Blood Pressure Monitoring
This study was conducted to understand perspectives of nurses and physicians who have used text-based postpartum BP monitoring. Nurses and physicians who implemented text-based postpartum BP monitoring programs participated in a survey focused on perceived quality and an interview focused on perceived program advantages, disadvantages, and implementation considerations. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 4, 2020 Category: Nursing Authors: Samuel Demers, Jennie M. Wagner Tags: Brief Report Source Type: research

Depression in Primary Care
Depression is a heterogeneous disorder with a wide range of presentations. Most patients with depression are seen in primary care, where it is often unrecognized; thus, screening for depression is important. Medical conditions can mimic depression and vice versa. For mild cases of depression, symptom monitoring and nonpharmacologic strategies are generally recommended initially, whereas psychotherapy and antidepressant drugs are first-line treatment for moderate to severe cases. Patients with depression often experience relapse, recurrence, or both, and multiple options are available. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 2, 2020 Category: Nursing Authors: Luann Richardson, Anand Brahmbhatt Tags: Featured Article Source Type: research

Student Connectivity in Online Programs: Role of the Nurse Faculty
This article describes the results of a previously validated survey exploring experienced and desired connectivity among online master of science nurse practitioner students. Students reported experiencing more connectivity than initially desired. There was significant (P ≤ .05) variability by age, time in the program, and hours working. Students reported the highest connectivity with instructors. The results imply that nursing faculty/instructors must develop high-quality online learning communities that include strong teaching methods as well as social presence. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 2, 2020 Category: Nursing Authors: Shawnda Schroeder, Maridee Shogren, Katherine Terras Tags: By Faculty for Faculty Source Type: research

Australian College of Nurse Practitioners and COVID-19
The ACNP has been actively involved in the response to COVID-19 in Australia. We are providing ongoing support to our members to enable them to care for their patients, and themselves during the pandemic. We have expanded our website considerably and provide up to date resources and information for our members, and also have included a section on self-care. Our regular social media posts are focussed on issues our members are experiencing, and our work to provide solutions. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 1, 2020 Category: Nursing Tags: From the Australian College of Nurse Practitioners 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 - November 1, 2020 Category: Nursing Tags: AANP Forum Source Type: research

COVID-19 – Insights and Impacts
As 2020 quickly comes to a close, I reflect on what a whirlwind this year has been. Although COVID-19 remains a focus, especially as we head into flu season, positive strides are being made to develop vaccines. We ’ve also witnessed advances throughout the year in testing, treatment and mitigation efforts. I am so proud of the work my NP colleagues have done to positively impact this crisis. That being said, I also grieve with the families and friends of those colleagues and health care workers from around the world who have lost their battles in the fight against this invisible enemy. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 1, 2020 Category: Nursing Authors: Sophia L. Thomas Tags: From the AANP President Source Type: research

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

Publisher Notice
We are excited to announce that JNP: The Journal for Nurse Practitioners is moving to an all-online format in 2021, which means this issue is the last to appear in both print and online. We will no longer publish a print edition. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 1, 2020 Category: Nursing Source Type: research

Military Sexual Trauma: An Update for Nurse Practitioners
Military sexual trauma (MST) is a pervasive and insidious problem among military personnel. MST is defined as sexual harassment or sexual assault that occurs during ones ’ time in military service. Due to the physical, mental, and psychosocial consequences of MST, all nurse practitioners (NPs) must be able to effectively identify survivors of MST, recognize and address health consequences of MST, and provide appropriate interventions and referrals for MST survivor s. The purpose of this report is to provide an overview so that NPs are equipped to effectively care for MST survivors in both Veterans Health Administrati...
Source: The Journal for Nurse Practitioners - October 31, 2020 Category: Nursing Authors: Brayden N. Kameg, Dina Fradkin Tags: Featured Article Source Type: research

Bone Density in Pregnancy and Lactation
Osteopenia and osteoporosis are rare complications that can affect patients who are pregnant or lactating. Primary care providers should be aware of risk factors contributing to this pathophysiological process to provide guidance to patients, including recommendations for supplementation. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - October 31, 2020 Category: Nursing Authors: Ruth Madden Foreman, Susan Mihaljevic Tags: Featured Article Source Type: research

Plantar Fasciitis: Low-Cost Treatment Interventions in Primary Care
Plantar fasciitis, the most common diagnosis of chronic heel pain, is at an epidemic proportion. The condition affects 1 in 6 Americans regardless of age or activity level, resulting in over 1 million outpatient visits annually. Plantar fasciitis is a common presentation in primary care and is frequently diagnosed and managed by nurse practitioners. Treatment options include a myriad of interventions ranging from conservative, noninvasive therapies to invasive, surgical modalities. For those affected, the majority will have symptom resolution in 12 to 18 months with conservative treatments. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - October 26, 2020 Category: Nursing Authors: Glynnis J. Haley, Sallie Coke Tags: Feature Article Source Type: research

Does Setting Matter When Treating Behavioral Health?
The complex and inefficient systems by which health care is delivered in the United States are a study in disparities. Two of the most perennial of these disparities are the difference in the delivery of behavioral versus nonbehavioral care and the one that divides the care that is delivered in rural settings from that found in suburban and urban settings. How do we deliver behavioral health in urban versus rural settings, and what are the key differences? With practice innovations, some born of the coronavirus disease 2019 (COVID-19) pandemic and others intended to optimize resources, it seems we can look forward to conti...
Source: The Journal for Nurse Practitioners - October 26, 2020 Category: Nursing Authors: Donald Gardenier, Lili Cargill, Gary Carlisle Tags: Point Counterpoint Source Type: research

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

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 coronavirus disease 2019 (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 personal protective equipment use were significantly less than in 3 brick-and-mortar clinics providing testing. We provide an example of effective nurse practitioner leadership in a drive-through testing site and demonstrate that nurse practitioners are ideally suited to provide leadership given their adaptability, ability to...
Source: The Journal for Nurse Practitioners - October 9, 2020 Category: Nursing Authors: Kathryn Schultz Dippel, Emily Katherine Kelly Tags: Featured 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