Clinical excellence for nurse practitioners : the international journal of NPACE
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Clin Excell Nurse Pract · Mar 2001
ReviewCreating order out of chaos: models of GNP practice with hospitalized older adults.
It has been well documented that hospitalization of an older adult can trigger a cascade of events that negatively affect quality of life long after hospitalization. Three models of care directed by hospital-based geriatric nurse practitioners (GNPs) are described. The GNPs' roles include primary care provider, consultant, educator, researcher, and/or administrator. ⋯ In a third model, the GNP coordinated care of hospitalized nursing home residents in a "scatter bed" program. Working synergistically with a case management program, the length of stay for this group of patients decreased from a median of 12 days to 9 days in the first year to 6.8 days in the third year. All three models showed that the GNP facilitate change, improve resource utilization, and create innovative strategies to optimize care for hospitalized elders.
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Clin Excell Nurse Pract · Mar 2001
Randomized Controlled Trial Comparative Study Clinical TrialBreast cancer screening education: comparing outcome skills of nurse practitioner students and medical residents.
Nurse practitioner students, along with all primary care trainees, need breast cancer screening education. The purpose of the study was to compare the performances of nurse practitioner students and medical residents before and after receiving training. ⋯ Nurse practitioner students perform well in learning breast cancer screening. More than one method of teaching is effective.
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Diabetic peripheral neuropathy (DPN) is a common complication of both type I and II diabetes mellitus. Although the exact cause remains unknown, peripheral neuropathy can cause significant health concerns and decrease the quality of life for those with this condition. Diagnosis of DPN can be made when signs and/or symptoms of peripheral nerve dysfunction are present. ⋯ Strict glycemic control and daily foot care are of utmost importance in the management and prevention of DPN. Pharmacologic therapies for pain control include tricylic antidepressants, anticonvulsants, analgesics, and capsaicin. DPN remains a frequent and serious complication of diabetes mellitus, and left unmanaged, may lead to debilitating consequences of foot ulcers and amputations.
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Diagnosis of rheumatologic disorders in the elderly is often complicated by the primary care clinician's inability to differentiate among similar manifestations of rheumatologic disorders, the presence of comorbid conditions, and symptoms attributed simply to aging. A major consequence of the aches and pains associated with rheumatologic disorders, including polymyalgia rheumatica (PMR), is the impedance of activities of daily living, potentially leading to a loss of independence. ⋯ Timely detection and appropriate treatment of PMR in the elderly may improve quality of life, as well as deter irreversible problems. Patient education also has an important role.
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Clin Excell Nurse Pract · Sep 2000
Comparative StudyNurse/parent role perceptions in care of neonatal intensive care unit infants: implications for the advanced practice nurse.
This study compared parent and nurse perceptions of the nurse's roles regarding responsibilities toward infants in the neonatal intensive care unit (NICU). It also examined the attitudes of nurses and parents regarding the extent to which parents should participate in the care of their infants in the NICU, as well as the role of the advanced practice nurse (APN). ⋯ Results suggest parents and nurses have different perceptions about role expectations and that nurses perceive themselves to lack comfort and knowledge in providing support to parents. The findings support a role of the APN as fostering a nursing NICU philosophy to facilitate role transition for parents of infants in the NICU.