The role of nurse practitioner in an ambulatory surgery unit

Nurses in advanced practice are expanding the roles they perform. Nurse practitioners (NPs) are the largest group of advanced practice nurses, and they have moved beyond primary care to practice in acute care environments, including perioperative settings. This article provides a brief overview of advanced practice nursing and describes the role of NPs in a hospital-based ambulatory surgery unit (ASU). The ASU NPs provide preoperative care and ensure that patients are ready for surgery, which minimizes OR delays.     

The role and impact of a fracture neck of femur nurse practitioner

The care of patients with a hip fracture is often unsatisfactory. This article gives an insight into the role of the fracture neck of femur nurse practitioner and their impact on the quality of care.     

The clinical nurse specialist and nurse practitioner: core curriculum survey results

The fall 1986 newsletters of the Council of Clinical Nurse Specialists (CCNS) and the Council of Primary Health Care Nurse Practitioners (CPHCNP) featured an editorial examining the similarities and differences between the advanced practice roles of the nurse practitioner and the clinical nurse specialist. The article, entitled "Editorial on Specialization in Advanced Nursing Practice" and written by Patricia Sparacino, MS, RN, chairperson CCNS, and Barbara A. Durand, EdD, RN, FAAN, of the CPHCNP appeared in Momentum, Volume 4, Number 2/1986, and Newsletter, Volume 9, Number 2/1986. This initial exploration into advanced practice roles in nursing elicited a wide variety of responses from affiliates of both councils which, in turn, prompted the executive committees of both groups to convene a joint meeting. In the spring of 1987 the executive committees of the CCNS and the CPHCNP met to review affiliate response to the editioral, further explore concerns, and plan futher action. At that time it was decided to survey all nursing programs in the United States which provide graduate education for one or both of the advanced practice roles. It was hoped that the information gained from such a survey would provide a basis for future determinations. Survey data was compiled and presented to another joint meeting of the executive committees of the CCNS and the CPHCNP on October 3, 1989. This article reports the data, findings, and reactions of the executive committees of the councils in order to obtain feedback from our colleagues.     

The role of the triage nurse practitioner in general medical practice: an analysis of the role

A 2-year pilot study was undertaken in a group general practice to evaluate the nurse practitioner triage role. The study was undertaken in several stages which included a patient satisfaction questionnaire survey, follow-up interviews with 30 patients from the questionnaire survey, and analysis of the nurse practitioner's work at different points over the 2-year study period. This paper describes the work of the nurse practitioner in comparison with that of seven general practitioners in a group general medical practice over a 5-day period in February 1996 and included patients' perceptions of their consultation. In this particular group medical practice, as in others throughout the country, many patients request same day appointments, often for self-limiting conditions, social advice and health education. This study demonstrates that the nurse practitioner can deal with such patients effectively and is undertaking an expanded and extended role in order to provide an holistic service to patients with which they are highly satisfied. It can be concluded that given the right kind of education and training and a supportive framework within the practice, the nurse practitioner undertaking a triage role can provide a highly effective service to patients and is a valuable member of the primary health care team.     

The role of computer-assisted simulation in nurse practitioner education

PURPOSE: To develop a better understanding of the role of computer-assisted simulations (CAS) in nurse practitioner (NP) education by observing 4 pairs of students complete a CAS case. DATA SOURCES: Qualitative observational study of 8 students performing in a computer laboratory and a series of post-observation interviews. Observations were recorded, refined, coded, and quantified based on the theoretical framework of ecological psychology. CONCLUSIONS: Each pair of students established their own "personalities" for the completion of the task. Misinterpretation of information was common and the absence of a live patient interaction affected the reasoning process of the students. The students demonstrated the ability to develop a perspective on the case based on previous nursing experience. Students generally obtained adequate data on which to base differential/final diagnoses. Observations provided information regarding strengths and weaknesses of students and methods used to solve scenarios. IMPLICATIONS FOR PRACTICE: All students agreed that the CAS scenarios were realistic, useful learning experiences, and that the knowledge gained would be transferable to real clinical situations. Such experiences provide useful experience with terminology, sequencing of the examination, and decision-making.     

Barriers to practice and impact on care: an analysis of the psychiatric mental health nurse practitioner role

This paper is a retrospective review of the literature analyzing the role of the psychiatric mental health nurse practitioner in the community. Presented here is an appraisal of national and state mental health initiatives. Professional nursing regulations are reviewed, focusing on New York State advanced practice nursing. Barriers to practice are assessed with discussion on how barriers, such as statutory collaboration, impede access to treatment in the community for mentally ill psychiatric patients. The current New York State legislative agenda is featured. Clinical vignettes from a nurse practitioner's private community practice are presented to introduce and conclude how clinical practice barriers impede autonomous practice.     

The impact of an Emergency Department ambulance offload nurse role: A retrospective comparative study

ObjectiveThis study aimed to evaluate the impact of an Emergency Department Ambulance Offload Nurse (EDAOLN) role on patient and health services outcomes in one Queensland Emergency Department (ED).MethodsA retrospective study of all ED presentations (n = 21,454) made to a tertiary hospital ED in Queensland, Australia, during July 9, 2012 – November 2, 2012; 39 days before (T1), during (T2) and after (T3) the introduction of the trial of an EDAOLN role. The primary outcome of interest was time to be seen by a clinician.ResultsDemographic and clinical profiles of ED presentations made during each of the time periods were relatively similar. Time to be seen improved marginally during the trial period of the EDAOLN (T1: 34 min vs. T2: 31 min, p = 0.002). The proportion of hospital admissions and those who did not wait differed between T1 and T2 (lower during T2 vs. T3). Most outcomes were not sustained when the role was removed (i.e. T2 vs. T3), and most returned close to baseline (i.e. T1 vs. T3).ConclusionsAs part of a health services framework designed to improve timely access to emergency care, an EDAOLN may be one of several options to consider.     

Implementation of a nurse practitioner role in an acute care setting

During the implementation, the authors strived to clearly identify a person to focus on patient outcomes. Thus, they limited the ARNP's involvement in central functions and direct management of the staff. The overall implementation of the demonstration project has benefited patients, staff, and the health care team. The continuity provided allows the patient and family to interact with a consistent person. The ARNP functions as the key to directing patient care in a holistic manner while facilitating staff development. The demonstration project has given the authors an opportunity to evaluate the management structure and redefine roles to achieve those outcomes in the management arena.     

The nurse practitioner role in evidence-based medication strategies.

Nurse Practitioners at Brigham and Women's Hospital Weiner Center for Preoperative Evaluation use evidence-based medication strategies in their assessment of high risk elective surgical patients. Our objective is to identify those patients who meet the criteria for perioperative beta blockade and for deep vein thrombosis prophylaxis. Nurse practitioners were provided with education and training in using established guidelines in identifying those patients at risk. The nurse practitioner communicates with the appropriate member of the health care team (anesthesiologist, primary care physicians, surgeons, and anticoagulation service) and provides patient education. This process improves the utilization of these guidelines with improved patient outcomes.