A continuing education program for nurse practitioners in ambulatory care

Continuing education should be an integral part of all health care providers' practice. This article discusses the recognition of this need by a group of nurse practitioners in an acute ambulatory care center. The process undertaken in developing the program of continuing education is described. The program outline can serve as a model for other NPs in similar settings.     

Achieving excellence in practice: a model for continuing education for nurse practitioners

PURPOSE: To provide a continuing education (CE) model that will meet varied needs of nurse practitioners by incorporating the variable of years of experience in practice setting. DATA SOURCES: An empirical study conducted over a period of approximately 10 months, from Fall 2002 to Spring 2003 in one of the southeastern states. CONCLUSIONS: A model has been developed to plan and deliver CE education programs based on the changing CE needs of NPs as they gain experience and expertise. IMPLICATIONS FOR PRACTICE: Results of this study may be used to guide providers to develop and offer CE programs based on the CE needs of NPs related to length of time in clinical practice, general issues of practice, and specialty practice area needs.     

Culture Care Theory: a proposed practice theory guide for nurse practitioners in primary care settings

Leininger's Theory of Culture Care Diversity and Universality is presented as a foundational basis for the educational preparation, primary care contextual practice, and outcomes-focused research endeavours of advanced practice nursing. Discussion emphasises the value of care and caring as the essence of advanced practice nursing through the use of three modes of care, use of the Sunrise and other enablers, and the ethnonursing method. Education, research, practice, and key concepts of the theory are connected as essential components toward the provision of culturally congruent care to meet the healthcare needs of diverse individuals, families, groups, and communities by family nurse practitioners.     

Methodology for a six-state survey of primary care nurse practitioners

BackgroundPrimary care practices employing nurse practitioners (NPs) can play an important role in improving access to high quality health care services. However, most studies on the NP role in health care use administrative data, which have many limitations.PurposeIn this paper, we report the methods of the largest survey of primary care NPs to date.MethodsTo overcome the limitations of administrative data, we fielded a cross-sectional, mixed-mode (mail/online) survey of primary care NPs in six states to collect data directly from NPs on their clinical roles and practice environments.FindingsWhile we were able to collect data from over 1,200 NPs, we encountered several challenges with our sampling frame, including provider turnover and challenges with identification of NP specialty.DiscussionIn future surveys, researchers can employ strategies to avoid the issues we encountered with the sampling frame and enhance large scale survey data collection from NPs.     

Developing ambulatory care clinics: nurse practitioners as primary providers

While hospitals evaluate ambulatory clinics as a revenue-generating service alternative, nursing executives develop new areas for nursing practice in nurse-managed clinics. The authors describe the five-year growth of a nurse-managed ambulatory clinic providing primary health care to those aged 55 and older. The discussion explains nurse practitioner leadership and practice, and accountability between professions. The concept and structure of services and marketing strategies are elated to the people served. Financial feasibility, cost containment, and other factors demonstrate the clinic's contribution to its sponsoring hospital.     

The role of nurse practitioners in primary care groups

The author of this article is a newly elected member of the Hammersmith primary care group. She describes how she developed the role, learned new responsibilities and discovered opportunities to improve her work with patients.     

Integration of spirituality into health care practice by nurse practitioners

Although conceptualizations of mind, body, and spirit are ancient, spiritual aspects have not been readily integrated into health care. Western medicine's mechanistic model, with its "fix-broken-parts" paradigm, focuses on the physical body, with occasional consideration given to emotional and mental aspects. One's view of self in relation to a Supreme Being, and one's existence and purpose for life is central to health at all levels, e.g., spiritual, physical, emotional, and cognitive. The purpose of this article is to describe the role that nurse practitioners can and should take with patients and their families in integrating spirituality into health care practice.     

Shifting patterns of practice: nurse practitioners in a managed care environment

The purpose of this qualitative study was to uncover patterns across nurse practitioner (NP) experiences that contribute to understanding their perceptions of managed care, how it affects daily practice, and how NPs respond to a changing managed care workplace. In-depth interviews were conducted with 14 NPs representing primary care, specialty, and independent practices. Over an 18-month period, data collection and analysis occurred simultaneously using standard methods of purposive sampling, constant comparison, memoing, and member checks. This study illuminates the tension NPs experience between a business and a professional ethic and the strategies they use to reconcile this difference with core nursing values. Type of setting, workplace dynamics, and length of time in practice contributed to variation in NP perspectives.