Journal of the American Association of Nurse Practitioners
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J Am Assoc Nurse Pract · Mar 2013
ReviewOrganizational climate in primary care settings: implications for nurse practitioner practice.
The purpose of this review is to investigate literature related to organizational climate, define organizational climate, and identify its domains for nurse practitioner (NP) practice in primary care settings. ⋯ NPs should be encouraged to assess organizational climate in their workplace and choose organizations that promote autonomy, collegiality between NPs and physicians, and encourage professional visibility. Organizational and NP awareness of qualities that foster NP practice will be a first step for developing strategies to creating an optimal organizational climate for NPs to deliver high-quality care. More research is needed to develop a comprehensive conceptual framework for organizational climate and develop new instruments to accurately measure organizational climate and link it to NP and patient outcomes.
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J Am Assoc Nurse Pract · Mar 2013
ACNP intensivist: a new ICU care delivery model and its supporting educational programs.
The purposes of this article are to describe a physician (MD)/acute care nurse practitioner (ACNP) intensivist model for delivery of critical care services in a tertiary academic medical center and to describe an innovative nurse practitioner educational program developed to support the model. In an effort to address the current shortage of intensivists, Vanderbilt Medical Center has developed and refined a multidisciplinary intensivist MD/ACNP teams to provide expanded critical care services. ⋯ As the concept of the MD/ACNP intensivist team has developed, Vanderbilt University School of Nursing ACNP Program has expanded its curriculum to provide graduates with the knowledge, skills, and experiences to safely manage unstable critically ill patients. Multidisciplinary critical care teams of MD intensivists who work in collaboration with ACNP intensivists address the current shortfall of intensivists and represent a cost-effective means for expanding ICU coverage and increasing ICU bed availability while maintaining Leap Frog ICU staffing compliance.
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To provide primary care providers with knowledge of unique challenges faced by military families. By understanding how military families cope with military lifestyle and deployment, providers can be more effective in their care of these patients and offer assistance in optimizing their health. ⋯ Healthcare providers should routinely inquire about a patient's possible military affiliation. Military spouses need to be assessed for current stress levels and coping behaviors used in order to provide the most appropriate recommendations and referrals. As healthcare providers, understanding the unique demands of the military lifestyle is necessary to provide effective quality care with optimal health outcomes in this population.
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J Am Assoc Nurse Pract · Feb 2013
My military: a navy nurse practitioner's perspective on military culture and joining forces for veteran health.
This article responds to the need for improved integration of veteran health considerations across the broader community. A focus of the Joining Forces initiative is to foster partnerships between veterans and their communities through enhanced education, knowledge, and commitment of resources and support. ⋯ Nurse practitioners (NPs) are ideal providers of care for veteran and military family healthcare needs. NP practice incorporates cultural sensitivity, prevention strategies, and wellness-focused care while delivering and facilitating optimal patient, family, and community outcomes. The NP will be of critical community value in joining forces for veteran health.
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J Am Assoc Nurse Pract · Jan 2013
Evidence-based practice for the busy nurse practitioner: part four: putting it all together.
Understanding the critical appraisal process allows nurse practitioners (NPs) to determine a study's reliability, validity, and applicability to their client(s)/families, and to their clinical practice setting. The purpose of this final part of this four-part evidence-based practice (EBP) series is designed to utilize a clinical scenario that will walk the NP through EBP steps 1 through 3 while providing an example of how to critically appraise a randomized control trial. ⋯ It is hoped that this four-part series enhanced NPs' understanding of the EBP processes of developing a clinical inquiry, searching for the best evidence, critically appraising the evidence, and integrating EBP into clinical practice.