Nurse Practitioner Program Curriculum Development: A Competency-based Approach

Competency-based education and assessment is commonplace in many health care disciplines, and is receiving increased attention in nurse practitioner programs. Competency-based education is an outcomes-based approach to the design, implementation, assessment, and evaluation of an education program using an organizing framework of competencies. In this article we describe the factors driving the paradigm shift to competency-based curricular design. We offer a general overview of the basics of a curricular matrix and one process and approach to developing a competency-based curriculum.     

Nurse Practitioner Intervention to improve Postpartum Appointment Keeping in an Outpatient Family Planning Clinic

A nurse practitioner (NP) program to improve postpartum appointment keeping in an outpatient family planning clinic is described and evaluated. The subjects (N = 59) were non-high-risk obstetric patients prescheduled to be seen at 6 weeks postpartum by the NP. Two groups were identified by convenience sampling: Group A (n = 25), the nonintervention group, and Group B (n = 34), the intervention group. Two types of intervention were used: a postpartum telephone call after discharge (n = 11), or a predischarge postpartum visit (n = 23). Results suggest that those in the intervention group were more likely to keep their appointments (p less than .02); only the postpartum visit increased the probability of appointment keeping (p less than .05).     

Nurse Practitioner Student Clinical Placements: A Rural Community Immersion

This article describes a collaboration between a university and a medically underserved area in California’s central valley. Students participate in a community-based clinical immersion to provide care to a medically underserved population. Faculty collaborate with community-based partners to develop and implement clinical experiences. Students are provided opportunities to meet clinical course objectives while developing skills necessary to care for a medically underserved population as part of an interdisciplinary team.     

Simulation-Based Learning in Nurse Practitioner Programs: A Scoping Review

This scoping review aims to identify what is known about simulation-based learning as an instructional tool in nurse practitioner programs. The authors used the 6-step framework by Arksey and O’Malley to conduct the review. Twelve studies fit the inclusion criteria, and 3 themes were identified, including changes in students’ confidence, improved clinical skills, and improved student knowledge. The use of simulation appears to be beneficial for developing clinical skills, cementing knowledge, and helping nurse practitioner students feel more confident in their practice. Randomized controlled trials and longitudinal studies are required to confirm the preliminary results found in this scoping review.     

A review of the Transitional Emergency Nurse Practitioner

Introduction

A retrospective exploratory study was conducted to (i) explore the practice patterns of a Transitional Emergency Nurse Practitioner (TENP) working across two urban Emergency Departments (ED); (ii) identify the demographic characteristics of the TENP patient cohort; and (iii) identify if TENP patients were appropriately and timely managed.

Method

The study was conducted across two hospital sites over two consecutive years for a 3-month period. Data collection occurred during the months of December through to February. TENP patients were identified by hospital electronic medical record and were then grouped into a model that included ‘Fast Track’ or ‘See and Treat’ cohort. The cohorts were then analysed for diagnostic groups, age, sex, length of stay, triage category, and re-presentations.

Results

The TENP worked a total of 600 h (Site 1 252 h; Site 2 348 h) across the study period. The TENP managed a total of 481 patients (262 Site 1; 220 Site 2) during the study period. The majority of patients (412; 84%) were managed in the ‘See and Treat’ cohort (Site 1 246, 94%; Site 2 166, 75%) and 70 patients (16%) were managed in the ‘Fast Track’ cohort (Site 1 16, 4%; Site 2 54, 25%). The median length of stay for TENP managed patients was 143 min, with 96% of patients leaving the ED in less than 8 h. There were no TENP unplanned re-presentations at either site. The TENP managed more male patients across both sites. The majority (75%) of patients the TENP managed had musculoskeletal and/or wound conditions or injuries.

Conclusion

TENP practice across the two Sydney metropolitan ED sites was similar. The model adapted for Tertiary Referral centres was appropriate for smaller urban EDs. The study supports existing evidence of timely and appropriate care being delivered by TENPs across Australian EDs. Given the work practice similarities, the study demonstrates that State and/or National standards and policies could be developed for emergency advanced practice roles.     

Beginning Employment: A Guide for the New Nurse Practitioner

You have successfully passed your national certification boards and are ready to seek employment. Just as the process from graduation to employment was a sequence of events, so is the process of beginning employment. This phase requires information on employment contracting, reimbursement, and coding, as well as insurance and hospital credentialing. The transition into this next phase of your career will depend on you and your future employer's experience with hiring a nurse practitioner. Even if the employer has experience, you will want to oversee that all of the pieces necessary for your success are put into place.     

Wildfire Smoke Exposure: A Guide for the Nurse Practitioner

Wildfires produce enormous quantities of finely sized air pollution. Exposure to wildfire smoke is associated with increased incidence of cardio-respiratory health effects, especially in children, persons with chronic disease, and the elderly. This article discusses exposure to particle air pollution, toxicological mechanisms, timing of clinical presentations, and treatment guidelines for use by the nurse practitioner during smoke events.     

Medical Home and the Nurse Practitioner: A Policy Analysis

As chronic disease and health care costs escalate, nurse practitioners (NPs) are in a pivotal position to participate in the Medicare Medical Home Demonstration Project (2006) that allows for NP-led patient-centered medical home practices to be reimbursed for coordination of chronic care, specifically for those complex patients with multiple chronic conditions. This policy analysis reviews the evidence for three potential patient-centered practice design alternatives, to evaluate the most viable patient-centered medical home practice design alternative for NPs. Strategies are included for NPs to actively participate in this endeavor.     

A Proposal for a Men's Health Nurse Practitioner

The educational preparation of a men's health nurse practitioner (MHNP) is proposed. The MHNP's scope of practice would address the complex health needs of men from a holistic perspective with emphasis on the knowledge and skills necessary for providing comprehensive primary care. Need for the MHNP is discussed, and scope of practice is delineated. Conclusions are drawn regarding the future of the MHNP in the scheme of total health care.     

A Collaboration to Unify Emergency Nurse Practitioner Competencies

Competencies reflect evidence-based behaviors that graduates must demonstrate before graduation and entry to practice. When evidence is inadequate or absent, subject matter expert opinion serves as a reliable and valuable resource. The emergency nurse practitioner specialty represents a focused and discrete area of practice requiring competencies reflective of unique practice. This article discusses the collaborative journey of subject matter experts from the American Academy of Emergency Nurse Practitioners and the Emergency Nurses Association as they merged existing competency documents into 1 nationally recognized set of competencies for emergency nurse practitioners.     

The Shuler Nurse Practitioner Practice Model: A Theoretical Framework for Nurse Practitioner Clinicians, Educators, and Researchers, Part 1

Because nurse practitioners (NPs) have expanded their nursing knowledge and skills into medicine they need a model that reflects this expanded role. This article presents the Shuler Nurse Practitioner Practice Model, which is wellness-oriented and suggests how patient interaction, assessment, intervention, and evaluation should occur.