Journal of the American Academy of Nurse Practitioners

Purpose: To examine the Consensus Model for APRN Regulation as a proposed solution to simplify and unify regulation of advanced nursing practice with respect to licensure, certification, accreditation, and educational standards. Data sources: Policy statements and reports issued by national organizations of nursing professionals and discussion within the scholarly literature provided an overview of regulatory differences among the 50 U.S. states, their impacts on advanced practice registered nurse (APRN) practice, and discussion of the Consensus Model as a potential solution...

PURPOSE: To study the effectiveness of multidisciplinary nurse practitioner coordinated team (NPCT) group visits in medically underserved Appalachia on the health, knowledge, and self-efficacy of patients with type 2 diabetes (DM). The study also identified perceived barriers to participating in the diabetes programs. DATA SOURCES: A researcher-developed tool was used to assess demographic data, clinical data, and barriers to care. The participants completed the Diabetes Knowledge Tests and the Diabetes Empowerment Scales...

PURPOSE: To determine the prevalence of postpartum depression (PPD) among Hispanic immigrant women seeking healthcare services at a community health clinic. DATA SOURCES: Of the 116 Hispanic immigrant women recruited, 96 comprised the final sample. Using the Beck PDSS-Spanish version, participants were screened for symptoms of PPD. CONCLUSIONS: The prevalence of significant symptoms of PPD was 54.2% for the entire sample. Nearly 66% of women who screened positive for symptoms of PPD scored above the listed cutoff score for suicidal thoughts...

PURPOSE: To perform a literature review of barriers to and facilitators of parents' decisions to have their children vaccinated. Both differences and similarities between the civilian sector and the military health system (MHS) were explored. DATA SOURCES: Articles and documents were identified from the following databases: CINAHL, PubMed, Defense Technical Information Center (DTIC), ISI, and Google Scholar. Reference lists from articles were reviewed. CONCLUSIONS: Common themes identified in the civilian sector and the MHS included an electronic registry, care access issues, provider characteristics, and child illness...

PURPOSE: Evidence-based practice (EBP) involves integrating research evidence with clinical expertise to answer clinical practice inquiries. The purpose of part 3 of this EBP series is to provide an introductory overview of the critical appraisal process, relevant clinical measurements, and critical thinking skills that can enhance nurse practitioners' (NPs') confidence in the clinical decision-making process. DATA SOURCES: Scientific literature review, gray literature, PubMed and other online literature databases and resources, and online EBP websites...

PURPOSE: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality for adults in the United States. One risk factor for CVD is metabolic syndrome, which encompasses obesity, hypertension, insulin resistance, proinflammatory state, and prothrombotic state. A lesser-understood risk factor is obstructive sleep apnea hypopnea syndrome (OSAHS). This article explores the physiological consequences of the interaction between OSAHS and metabolic syndrome on the cardiovascular system...

National survey data on the practice of nurse practitioners (NPs) provides valuable information on role components, practice patterns, and specialty practice descriptions. The American Academy of Nurse Practitioners (AANP) has been conducting NP surveys since 1988. The most recent AANP Sample Survey was conducted in 2009-2010 with responses from over 13,000 NPs, 962 of who were acute care NPs (ACNPs). This article reports on the findings of the 2009-2010 AANP National NP Sample Survey related to ACNP practice...

PURPOSE: To provide nurse practitioners (NPs) with a review of the 2012 Standards of Care for the management of hospitalized patients who are hyperglycemic. DATA SOURCES: The 2012 American Diabetes Association's (ADA) Standards of Care for the treatment of inpatient hyperglycemia and selected evidence-based articles. CONCLUSIONS: Because hyperglycemia occurs at alarming rates in the inpatient setting when hyperglycemia is not controlled, there is a great impact on acute and even chronic conditions...

PURPOSE: We examined the feasibility of using cell phones to monitor medication adherence among homeless participants and collected data for research purposes. DATA SOURCES: Ten homeless individuals with a co-occurring substance use and psychiatric disorders who were receiving psychopharmacologic treatment participated in the study. All psychopharmacologic treatment was provided by a psychiatric mental health nurse practitioner. Cell phones were provided to participants with unlimited phone service for 45 days...

PURPOSE: To identify predictors of older adults' use of exercise and/or acetaminophen, and avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs) to treat their osteoarthritis pain. DATA SOURCES: Data were analyzed from 457 adults aged 60 and older with moderate or greater osteoarthritis pain intensity who responded to the Brief Pain Inventory between 2006 and 2007. The following predictors were entered into a logistic regression to predict use of exercise and/or acetaminophen and nonuse of NSAIDs: age, gender, ethnicity, race, education, arthritis treatment by a practitioner, pain treatment by a practitioner, pain intensity, functional interference from the pain, and percent of pain relief from current treatments...

PURPOSE: The purpose of this descriptive correlational study was to describe the coping behaviors used by Army wives during deployment separation, the perceived effectiveness of the coping behaviors used, and the correlation between the two variables. DATA SOURCES: A secondary analysis was conducted to examine coping use and perceived effectiveness, measured by the Jalowiec Coping Scale (JCS), in a sample of 102 Army wives surveyed during deployment separation. CONCLUSIONS: The most used coping subscales from the JCS were the optimistic and supportant and the most effective were the supportant and confrontive...

PURPOSE: To define what can be considered to be nursing practice, time that can be calculated as the practice of nursing as well as what is considered to be advanced nursing practice and how all this can be related to the current endorsement process for nurse practitioner (NP) in Australia. DATA SOURCES: Current codes and guidelines cited by the Nurse and Midwifery Board of Australia related to nursing practice and NPs, cited competency standards from the Australian Midwifery Accreditation Council, as well as published material of peak nursing bodies from within Australia as well as internationally were used...

PURPOSE: The purpose of this four-part evidence-based practice (EBP) series is to enhance the nurse practitioner's (NP's) EBP skills by reviewing the process of developing a clinical question, searching for the best evidence, and critically appraising and applying the findings. Part two of the series focuses on how to search the published scientific literature for the most relevant studies that will answer a specific clinical question of importance to the NP. DATA SOURCES: Scientific literature review, gray searching, PubMed and other online literature databases and resources, and online EBP websites...

PURPOSE: Consults promote additional perspectives and help with complex patient management. As the population ages and healthcare demands increase, providers are consulting palliative care (PC). Nurse practitioners (NPs) should understand when to consult PC. DATA SOURCES: Information was obtained from an extensive search of the scientific literature to include Pallimed (https://www.pallimed.org/) and the author's clinical experience. CONCLUSIONS: Based on the 2009 Clinical Practice Guidelines for Quality PC developed from the Hospice and PC Coalition, PC should be consulted at diagnosis...

PURPOSE: To discuss the role of the nurse practitioner in medical management of adult patients with cystic fibrosis (CF). DATA SOURCES: A systematic literature review was done by searching online databases: CINAHYL, OVID, and Medline. The Cystic Fibrosis Foundation (CFF) guidelines were reviewed. Tables were compiled for recommended screening and treatment for adult CF patients. CONCLUSIONS: Comorbidities occur among adult CF patients and include: CF-related diabetes (CFRD), fertility issues, CF liver disease (CFLD), and CF bone disease...

PURPOSE: The purpose of this web-based, quantitative, descriptive, correlational study was to identify frequency of use and success of strategies to alleviate sleep problems, to determine whether there is any relationship between use and success (perceived effectiveness) of strategies, on the one hand, and adults' gender, age, income, or education, on the other. DATA SOURCES: Data were collected from a web-based survey that examined strategy use and success to alleviate insomnia...

PURPOSE: The purpose of this study was to ascertain the knowledge level of nurse practitioner (NP) students about emergency contraception (EC), and to explore attitudes about EC that may intersect with willingness to prescribe EC. DATA SOURCES: Four hundred and sixty-seven NP students completed a 30-item web-based survey using Vovici survey software. CONCLUSIONS: Students who reported formal content on EC in their program of study showed significantly better mean knowledge scores (t= 5...

PURPOSE: To describe the lived experience of women diagnosed with ovarian cancer using individual interviews. DATA SOURCES: Eleven women who had been diagnosed with ovarian cancer within the past five years were interviewed with open-ended guiding questions. The narrative responses were analyzed for constitutive patterns and relational themes according to Diekelmann and Allen's hermeneutic phenomenological process. CONCLUSIONS: This phenomenological study gave voice to the women's experience with ovarian cancer...

PURPOSE: To examine recent evidence concerning the health benefits and cost effectiveness of replacing a single dose of adult tetanus/diphtheria vaccine with a single dose of tetanus/diphtheria/pertussis (TDaP). METHODS: A review of the literature was conducted utilizing the databases CINAHL and Medline with the keywords pertussis, adult immunization, vaccination, TDaP, DTaP, and healthcare workers. CONCLUSIONS: Recent outbreaks of pertussis have shown that preventing such outbreaks through immunization of adults with a single TDaP vaccine is a cost-effective measure...

PURPOSE: Evidence-based practice (EBP) continues to gain momentum within health care. The purpose of this four-part EBP series is to provide an introductory overview of the EBP process, emphasizing EBP steps one through three, in order to assist nurse practitioners (NPs) in building EBP skills that can be integrated into clinical practice. The relevance of EBP to the NP's clinical practice, an introduction to the EBP process steps, and clinical inquiry process begin the series. DATA SOURCES: Scientific literature review, gray literature, and online evidence-based practice databases and resources...