The effectiveness of nurse practitioner care for patients with mental health conditions in primary care settings: A systematic review

BackgroundThe nurse practitioner (NP) workforce is key to meeting the demand for mental health services in primary care settings.PurposeThe purpose of this study is to synthesize the evidence focused on the effectiveness of NP care for patients with mental health conditions in primary care settings, particularly focused on primary care NPs and psychiatric mental health NPs and patients with anxiety, depression, and substance use disorders.MethodsStudies published since 2014 in the United States studying NP care of patients with anxiety, depression, or substance use disorders in primary care settings were included.FindingsSeventeen studies were included. Four high-quality studies showed that NP evidence-based care and prescribing were comparable to that of physicians. Seven low-quality studies suggest that NP-led collaborative care is associated with reduced symptoms.DiscussionMore high-quality evidence is needed to determine the effectiveness of NP care for patients with mental health conditions in primary care settings.     

医护一体化模式在优质护理服务中的应用研究

目的 探讨医护一体化模式在优质护理服务中的应用效果.方法 2010年3月～2011年2月在我科实行医护一体化优质护理服务模式改革,比较改革前后平均住院日、术前等待日、患者满意度和护理人员工作满意度.结果 术前等待日由5.51 d降至3.75 d(P＜0.01),平均住院日由11.9d降至10.68 d(P＜0.05),患者满意度从85.36％提高到94.01％ (P＜0,01),护理人员工作满意度由3.16％提高到3.90％(P＜0.01).结论 医护一体化优质护理服务模式能缩短平均住院日,缓解“住院难、住院贵”的问题;改善患者就医体验,提高患者满意度;促进护理专业发展,深化护理工作内涵.     

What is the role of the coronary care nurse? A review of the literature.

BACKGROUND: The role of the coronary care nurse has often been described based on anecdotal evidence. However in a research conscious society it is vital that this important role is able to be defined using research findings. This paper explores the literature in order to describe this role in a research context. AIM: To review the literature to establish the contemporary role of the coronary care nurse. METHODS: An electronic search of three healthcare databases to identify all journal articles published between 1990 and 2006. The review was focussed on all primary research or audit articles that discussed the roles of nurses working in coronary care units. RESULTS: Coronary care nurses are responsible for patient assessment and symptom management often using technology to achieve these goals. In addition they are able to develop therapeutic relationships with their patients and are in a prime position to provide vital physical and psychological care in both the critical and palliative stages of illness. CONCLUSION: Whilst no study has investigated the coronary care nursing role in its entirety the themes identified within many of the studies were consistent. Therefore the findings of this review are considered to be an accurate reflection of this role.     

Leadership across boundaries: a qualitative study of the nurse consultant role in English primary care

AIM: To explore the emerging role of nurse consultant in an English primary care setting. BACKGROUND: Nurse consultants have been introduced in England since 1999 as senior, non-managerial nurse leaders. They have generally found it that it takes time to negotiate manageable work-loads. DESIGN: Four qualitative case studies METHODS: Semi-structured interviews with stakeholders within the organization. Data were analysed thematically. FINDINGS: All four nurse consultants might potentially work with a very large number of disciplines, departments and other organizations. As a result, it took time to identify priorities and to make relationships. Thus, although nurse consultants are well-placed to work across boundaries, two had made relatively little progress in doing so. CONCLUSION: Nurse consultants working in primary and community health care settings are well-placed to be boundary-spanners, delivering change across organizations. Negotiating priorities and relationships are time-consuming tasks, and nurse consultants may have to work with a restricted number of partners initially.     

Nurse education--the role of the nurse teacher

Aim. To explore and analyse the role of the nurse teacher. Background. This paper examines the issue of clinical credibility among nurse teachers which has been ongoing for over a decade. The move of nurse education from colleges of nursing to the Higher Education Institutes was seen in 1992. Since then, nurse teachers have been faced with the need to juggle the roles of teaching, administration, research and clinical support for students. Nursing students within these Higher Education Institutes require more than the traditional theoretical classroom teaching. Nurse teachers have a role beyond this in encouraging students to link theory with practice, and practice with theory. Therein lies a challenge for nurse teachers to ensure they remain credible within the clinical setting and continue to provide education and support, which is firmly grounded in both practice and theory. Method. The authors have critically reviewed the evidence related to the role of the nurse teacher in an attempt to identify key concepts and ideas, assumptions, supporting examples and the implications for their role. Conclusion. The role of the nurse teacher, it would appear, is a dynamic one that needs to engage actively the needs of the student. Nurses therefore need to be dynamic in their approach in order to respond to both local and global demands and ensure that students become competent, professional, knowledgeable and caring in their approach. Relevance to clinical practice. This paper demonstrates the complex and ever changing role of the nurse teacher. This paper attempts to help nurse teachers understand the complex nature of their role.     

Advancement of Research on Nurse Practitioners: Setting a research agenda

BackgroundPrimary care delivered by nurse practitioners (NPs) helps to meet the United States’ growing demand for care and improves patient outcomes. Yet, barriers impede NP practice. Knowledge of these barriers is limited, hindering opportunities to eliminate them.PurposeWe convened a 1.5-day conference to develop a research agenda to advance evidence on the primary care NP workforce.MethodsThirty experts gathered in New York City for a conference in 2022. The conference included plenary sessions, small group discussions, and a prioritization process to identify areas for future research and research questions.DiscussionThe research agenda includes top-ranked research questions within five categories: (a) policy regulations and implications for care, quality, and access; (b) systems affecting NP practice; (c) health equity and the NP workforce; (d) NP education and workforce dynamics, and (e) international perspectives.ConclusionThe agenda can advance evidence on the NP workforce to guide policy and practice.     

The primary care nurse practitioner: advocate for self care

PURPOSE: To critically analyze the role of the primary care nurse practitioner (NP) as advocate in promoting health through self care. DATA SOURCES: Selected philosophical and theoretical texts and articles, scientific literature, professional standards, and ethical arguments. CONCLUSIONS: Philosophical reasoning and nursing theory must be used to validate and direct human practice. If self-care and well-being are desirable as an end and are defined as a movement toward self-determination, then the philosophical goal of the NP must be the protection and promotion of self care and autonomy through client advocacy. IMPLICATIONS FOR PRACTICE: The role of the NP must be defined by its philosophy of care rather than by its function. The influence of philosophical reasoning, nursing, and critical social theory impact the ability of the NP to promote self-care through advocacy. Understanding the lived experience is an essential component of advocacy.     

Federally qualified health centers reduce the primary care provider gap in health professional shortage counties

Background

Federally qualified health centers (FQHCs) were designed to provide care in medically underserved areas. Substantial and sustained federal funding has accelerated FQHC growth.

Critical care without walls: The role of the nurse consultant in critical care

BACKGROUND: The nurse consultant role was first described in 1999 and has undergone little evaluation since. Critical care nurse consultant roles have developed against a background of service innovation following a review of adult critical care and have resulted in a variety of job roles and titles. There is some evidence to suggest that these posts are developing differentially and with varied role content. AIMS: To provide a profile of the nurse consultant in critical care. To identify critical care roles in practice. METHOD: A national postal survey of all 72 critical care nurse consultants in post in England by August 2003; response rate 72% (n = 52). RESULTS: The majority (54%) of critical care nurse consultants were aged between 40 and 50 years with a mean of 18.4 years post registration experience. The majority held a higher degree (71%) and at least one additional professional qualification (96%); many (44%) continue to study. Most critical care nurse consultants (69%) reported that a nurse does not manage them operationally. Nurse consultants were taking the lead in developing care outside the traditional boundaries of the Intensive Care Unit (ICU) (mean involvement score, M = 4.25) and with outreach rounds on the wards (M = 3.78). Despite having an overall high involvement (M = 3.37) with the practice and service development function, they had a lower involvement with research activities (M = 2.87). They also had a low involvement with strategic organisations such as the Department of Health (M = 1.63), Strategic Health Authorities (M = 1.54) and Primary Care Trust's (M = 1.49). CONCLUSIONS: The critical care nurse consultants who responded to this survey were clinically experienced and educated to an advanced level. They were leading the care of critically ill patients outside the traditional boundaries of the ICU, but have significantly less involvement within the ICU. Nurse consultants' restricted involvement with strategic organisations may limit the development of the role.     

Connected health care: the future of health care and the role of the pharmacist

The population of the world is ageing. As a result, the incidence of chronic disease is projected to increase, there are predicted shortages in health care workforce and budget restraints; implications for future health care provision are serious. The current model of health care is not equipped to deal with these changes. Connected health care, via the use of health informatics, disease management and home telehealth technologies, has been suggested as an approach to ease the projected strain on future health care. Evidence to date suggests a positive impact of the use of connected health care model; however, the majority of studies have overlooked the involvement of the community pharmacist. As the most common point of contact with primary health services for most of the population, the community pharmacist may be well placed to provide connected health care. The research to date is promising with improvements in outcomes for cardiovascular patients noted; however, further work is required to investigate the potential role the community pharmacist can play in the future of connected health care.