Collaborative Practice Agreements Between Nurse Practitioners and Pharmacists

As nurse practitioners (NPs) gain autonomous prescribing status in more states, their ability to work interprofessionally with pharmacists through collaborative practice agreements will increase. Interprofessional care provided by pharmacists and NPs can improve care, and so it is important to consider ways to make this care more efficient, such as through collaborative practice agreements. We focus on collaborative practice agreements between NPs and pharmacists in community settings or ambulatory care settings. Not all states authorize collaborative practice agreements between NPs and pharmacists, which limits the ability for both professionals to work to the full scope of their license.     

Adult-Gerontology Nurse Practitioners: A Discussion of Scope and Expertise

Adult-gerontology primary care nurse practitioners (NPs) deliver longitudinal primary care in outpatient settings from adolescence to older adulthood, and adult-gerontology acute care NPs provide care to critically ill adults and older adults. Family NP programs vastly outnumber adult-gerontology NP programs nationwide, despite a rapidly aging population. This report discusses the differences in education and scope of practice of adult-gerontology primary care NPs, adult-gerontology acute care NPs, and family NPs and highlights the crucial and unique assets adult-gerontology NPs bring to any health care system or practice. Differences in competencies, certification examinations, and practice settings are discussed in depth.     

Educating Nurse Practitioners About Climate Change,Health, and Climate Justice

Climate change poses unprecedented threats to health, leading to higher rates of heat stress; cardiopulmonary illness; food-, water-, and vector-borne diseases; adverse pregnancy outcomes; poor mental health; and premature death. These impacts are inequitably distributed, with vulnerable populations bearing the greatest burdens. Nurse practitioners must be prepared to care for people affected by climate change and to advocate for policies to mitigate its harm. To date, efforts to integrate climate change and health concepts into health professions education are lacking. This article describes one nursing school’s experience incorporating these concepts into nurse practitioner curricula.     

COVID-19 on New Primary Care Nurse Practitioners: A Qualitative Exploration

New nurse practitioners (NPs) struggle with the transition to practice and feelings of uncertainty concerning roles and responsibilities. COVID-19 has added a new layer of stress. This pilot study used a qualitative case study design featuring semistructured interviews of 10 newly graduated primary care NPs. Data analysis revealed 2 main themes: (1) emotional burden, and (2) coping and support. Emerging themes highlight the resiliency of NPs, who cope and seek support when faced with emotional burdens. This study informs educators and employers on the needs of new NPs during a global pandemic in order to better support the future workforce.     

Integrating Climate Change in the Curriculum: Using Instructional Design Methods to Create an Educational Innovation for Nurse Practitioners in a Doctor of Nursing Practice Program

An applied epidemiology course for doctor of nursing practice students was revised to include a module on the impact of climate change on population health. The Analyze, Design, Develop, Implement, and Evaluate (ADDIE) model of instructional design is a gold standard framework for creating course content and guided the module development. A nurse content expert discussed the environmental impacts of climate change on health using literature, actual clinical scenarios, and the application of epidemiologic data. Topics included safeguarding workers and vulnerable populations within the context of the coronavirus disease 2019 pandemic. Students posted reflections on their understanding of module content in response to structured prompts electronically in the learning management system for review by the faculty. Faculty evaluation of responses identified the need to further develop and integrate environmental epidemiology and climate change content more fully within the doctor of nursing practice curriculum.     

Hospital Regulation of Pediatric-Focused Nurse Practitioners: A Multistate Survey

The growing need for pediatric-focused providers remains unmatched by patient demands in acute care settings. Additional organizational restrictions above and beyond state scope of practice laws further limit the ability of nurse practitioners (NPs) to practice to the fullest extent of their training and education. Knowledge of scope of practice is essential for NPs, physicians, and hospital leadership to efficiently use NPs, decrease turnover, and promote access to care. This original research sought to describe hospital-level practice regulation and credentialing patterns across the southeastern United States and inform effective use of NPs at the organizational level.     

Nurse Practitioner Transition to Practice: Development of a Residency Program

Nurse practitioner residency programs assist new graduates to transition to practice. This article describes the development of a primary care nurse practitioner residency program at a large academic medical center in the mid-Atlantic region. Organizational factors related to program development and support as well as fiscal and human resource considerations are presented. Curricular considerations inclusive of both clinical and didactic content are presented in conjunction with a curricular outline. Finally, recommendations for nurse practitioner residency program development and expansion within academic and nonacademic medical centers are provided.     

Highlighting the Lived Experience of Nurse Practitioners in Independent Practice

Nurse practitioner (NP)-owned practice has emerged as a growing phenomenon for NPs in states with full-practice authority. The purpose of the study was to explore the lived experience of NPs in independent practice. This qualitative study explored NPs in independent practice using a purposive sample of 17 NPs. Data analysis using van Manen’s hermeneutic phenomenological approach was concurrent with data collection and allowed composition, confirmation, and evaluation of themes as they emerged. Four core themes were identified: Questioning, Self-Directing, Positioning, and Achieving Fulfillment.     

Nurse Practitioner Post-Graduate Residency Program: Best Practice

This review aims to better understand the novice nurse practitioner (NP) transition to practice, while providing content from organizations focused on quality transitional programs. A major problem is the shortage of NPs in primary care. This is related to high turnover due to the difficult transition from expert RN to novice NP. To better understand this transition, Duchscher’s Transition Shock Theory was examined and used to support the importance of residency programs. This review provides support for the use of NP residencies to positively impact the transition to practice for the novice NP. The Community Health Center Inc. NP Residency Program promotes quality NP residencies and is used as an exemplar. The article also addresses the concern with residency variability and the cost associated with these programs.     

HIV Clinician Workforce Shortage: Nurse Practitioners Filling the Gap

The development of highly effective antiretroviral treatment has significantly decreased the disease burden and increased the life expectancy of people living with HIV. As people with HIV live longer, they will require ongoing HIV specialty and primary care, which will increase the demand for specialty-trained nurse practitioners and other health care workers. This report describes the emerging HIV provider shortage and offers models to expand nurse practitioner training in HIV primary care as an approach to addressing the HIV provider shortage.     

Dual-Track Education for Nurse Practitioners: Current and Future Directions

Dual-track programs are increasing in number to meet needs of students who wish to earn nurse practitioner (NP) certification with more than 1 population focus. This article describes dual-preparation programs, reports how 1 program is structured and implemented, and examines challenges of such programs. NP programs should create opportunities for NP students to be seamlessly prepared for more than 1 role through dual-track NP programs.     

Nurse Practitioner Role,Independent Practice,and Teamwork in Primary Care

Primary care nurse practitioner (NP) workforce represents a substantial supply of primary care providers able to meet the demand for care. However, many barriers influence NP practice and care. This study conducted a survey of NPs in New York state to better understand NPs' role, independent practice, and teamwork in primary care organizations. Overall, 278 NPs completed the online survey. Forty-two percent of NPs had their own patient panel. The mean score of the Autonomy and Independent Practice scale was higher than that of the Teamwork scale. These scales were positively correlated, suggesting that NP independent practice may improve teamwork.     

The Nurse Practitioner in Saudi Arabia: Potentials and Threats

The provision of the nurse practitioner (NP) began in the mid-1960s and is defined more clearly nowadays in many developed countries, such as the United States, Canada, United Kingdom, and Australia. Their scope of practice is legally well defined in these nations. However, the countries of the Middle East, including Saudi Arabia, face the problem of lack of enough numbers of NPs and even lack well-defined NPs’ roles and duties. Several challenges face the effective adoption of the NP title and roles in Saudi Arabia, where it cannot be identified successfully without a clear recognition, definition, scope, legislation, or a regulatory framework     

Development and psychometric testing of the EverCare Nurse Practitioner Role and Activity Scale (ENPRAS)

PURPOSE: To develop and test an instrument measuring the frequency of the performance of role activities by EverCare nurse practitioners (NPs), who provide primary care to nursing home residents. DATA SOURCES: One hundred thirty-one EverCare Nurse Practitioner Role and Activity Scale (ENPRAS) activities were identified through telephone interviews (n= 11), participant observation (n= 5), and a focus group (n= 4). CONCLUSIONS: Two content validity tests (n= 11; n= 15) (Content Validity Index > or = .78 for all retained items) and internal consistency reliability testing (n= 127; Cronbach's alpha = .78-.96) yielded 99 activities arranged in six role subscales-Collaborator, Clinician, Care Manager/Coordinator, Counselor, Communicator/Cheerleader, and Coach/Educator. IMPLICATIONS FOR PRACTICE: The ENPRAS can be used to measure similarities and differences in NP practice activities performed by EverCare NPs working at different EverCare program sites and to compare practice activities performed by EverCare NPs and other NPs. The EverCare program is sponsored by United Health Care, which leads the field in collaborative NP/MD primary care in nursing homes. Future studies should be directed toward testing the generalizability of the ENPRAS with NPs working in other collaborative models, as well as NPs in noncollaborative models of care delivery in the long-term care setting.     

Improving Oral Health: Integrating Oral Health Content in Advanced Practice Registered Nurse Education

This article describes the development, implementation, and evaluation of a community-based, interprofessional education experience designed to improve oral health and collaborative practice knowledge, skills, and attitudes of advanced practice registered nurse students. As part of an online advanced physical assessment course, students completed Smiles for Life (Society of Teachers of Family Medicine Group on Oral Health, Leawood, KS) online modules and a 4-hour observational experience with a dental provider in their community. After completing the assignments, students had increased knowledge and skills and improved attitudes about oral health and collaborative practice. These learning strategies are suitable for on-campus and distance programs. Additionally, these resources are useful to practicing nurse practitioners for improving their oral health knowledge.     

Navigating Population Foci and Implications for Nurse Practitioner Scope of Practice

Nurse practitioner (NP) scope of practice is broadly defined by national nursing policies. The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education is the hallmark policy that establishes principles outlining the scope of practice for all APRNs. NPs must be familiar with The Consensus Model and with how professional organizations define the scope of practice for each of the 6 NP population foci. This knowledge is essential to support NPs practicing within their defined scope of practice.     

Primary Care Practice Environment and Burnout Among Nurse Practitioners

Poor practice environments contribute to burnout, but favorable environments containing support, resources, autonomy, and optimal relations with colleagues may prevent burnout. Compared with all nurse practitioners (NPs), 69% of these NPs provide primary care to patients, yet whether the practice environment is associated with NP burnout is unknown. A study to examine environmental factors related to NP burnout was conducted. Overall, 396 NPs completed the survey, and 25.3% were burnt-out. Higher scores on the professional visibility, NP-physician relations, NP-administration relations, independent practice, and support subscales were associated with 51%, 51%, 58%, and 56% lower risk of NP burnout, respectively.