scholarly journals Geriatric Knowledge Gaps of Community-Based Providers: A National Study of Asked Questions

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 827-827
Author(s):  
Lee Lindquist ◽  
Aylin Madore ◽  
Stephanie Miller ◽  
Alice Kerr ◽  
Sara Bradley
Keyword(s):  
Older Adults ◽  
Nurse Practitioners ◽  
Clinical Care ◽  
Physician Assistants ◽  
Primary Care Providers ◽  
National Study ◽  
Adult Health ◽  
Care Providers ◽  
Community Based ◽  
Asymptomatic Patients

Abstract Primary care providers (PCP) - internists, family practitioners, nurse practitioners, physician assistants - play an integral role in the care of older adults, although many receive limited geriatrics education. We sought to examine what questions community-based PCPs had about geriatrics and clinical care of older adults. As part of large clinical continuing medical education (CME) conferences across 12 states (FL,GA,CA,IL,NY,MA,DC, PA,AZ,TX,TN,WA), PCPs attended a live in-person 60-minute geriatrics-focused lecture and entered questions into a mobile application. Questions were then qualitatively analyzed using constant-comparison and tie-break methodology. At all sites, 103 questions were asked with 158 upticks (PCPs could check off that they had similar question) with a range of 3-18 questions per lecture. PCPs asked questions on the following common themes: 1.) Medication-related (e.g. discontinuing medicines in asymptomatic patients, optimizing pain relief), 2.) Dementia (e.g. prevention, nutraceuticals, agitation) 3.) Medicare Coding 4.) Falls 5.) Weight loss, and 6.) Insomnia. There were a number of questions referencing incorrect practices (e.g. prescribing inappropriate medications such as benzodiazepines for sleep, placement of gastric tubes in late-stage dementia, antibiotics to treat asymptomatic bacteria). In conclusion, community-based PCPs nationally experience gaps in geriatric knowledge and several utilize practices that could jeopardize older adult health. While attending CME-based lectures is one means of overcoming these gaps, some PCPs may not find time or realize geriatrics as an educational need. PCPs need to be better supported with opportunities to ask geriatric care-related questions in order to improve the care of older adults.

Students’ lack of knowledge regarding healthcare providers’ duties, and their preferences for information when selecting new providers

2015 ◽  
Vol 3 (1) ◽  
pp. 113 ◽  
Author(s):  
Evan Perrault
Keyword(s):  
College Students ◽  
Nurse Practitioners ◽  
Personal Information ◽  
Healthcare Providers ◽  
Physician Assistants ◽  
Primary Care Providers ◽  
Health Centers ◽  
Care Providers ◽  
Web Based ◽  
Midwestern Usa

Rationale, aims and objectives: When USA college students need medical care, their first destinations are usually campus health centers. Normally, staffed by a variety of care providers (e.g., nurse practitioners, physician assistants, physicians), students may be confused about who they may need to see and possibly hesitant to receive care. The present study sought to determine students’ knowledge about primary care providers and the qualities they would like to know about them prior to consultations. The goal of this paper is to improve the information campus health centers in terms of their ability to provide students health solutions when and where they need them. Methods: 534 USA college students from a large Midwestern USA university completed a web-based survey about their knowledge, attitudes and information preferences regarding their various care providers. They also viewed 3 experimentally manipulated biographies of providers and chose the provider they would want to visit. Results: The majority of students did not know the differences between physicians, physician assistants and nurse practitioners and the types of care that they could provide. About 9% stated they would not seek care and 16% would delay seeking care if unable to see a physician immediately. The most important pieces of information desired were providers’ philosophies of care, certifications, areas of specialization and length of time practising medicine. As students perceived greater similarities due to more personal information provided in the biographies, they viewed, uncertainty was reduced leading to higher levels of anticipated patient satisfaction and quality of care. Conclusions: USA college students need greater levels of education regarding the care that can be received from a variety of healthcare professionals. Information provided should also include more personal information about the providers to help reduce students’ uncertainty and to enable students to access services that are person-centered in their nature.

scholarly journals Cost Outcomes of Physical Therapist Providers Compared to Primary Care Providers in the Treatment of Musculoskeletal Patients in a Military Treatment Facility: A Retrospective Chart Review”

2021 ◽  
Author(s):  
Troy McGill ◽  
Debra Stern ◽  
Morey Kolber ◽  
John McGee
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Physical Therapist ◽  
Physician Assistants ◽  
Primary Care Providers ◽  
Cost Of Care ◽  
Direct Access ◽  
Care Providers ◽  
Care Managers ◽  
Significant Difference

Purpose: The purpose of this study was to compare the cost of physical therapist (PT) management of patients with musculoskeletal (MSK) disorders to management by traditional primary care managers (PCMs); medical doctors (MDs), doctors of osteopathic medicine (DOs), advanced registered nurse practitioners (ARNPs), and physician assistants (PAs). Methods: This is a retrospective study of electronic medical records using an exploratory, non-experimental, cross-sectional, and quantitative design method. The records of patients with MSK disorders were assessed at an Air Force military medical clinic for 18 months from January 2016 through June 2017. Results: PT management of MSK patients resulted in a significantly lower rate of imaging studies, NSAIDS, and cost of care when compared to MDs, DOs, PAs, or ARNPs. Patients with MSK disorders managed by PTs had no significant difference in return-to-work rate when compared to MDs, DOs, PAs, or ARNPs. Conclusions:The military model of physical therapy direct access care has been shown to be cost effective when compared to care provided by traditional primary care managers.

Pain Care Essentials

2019 ◽  
Keyword(s):  
Clinical Practice ◽  
Nurse Practitioners ◽  
Clinical Skills ◽  
Core Competencies ◽  
Physician Assistants ◽  
Primary Care Providers ◽  
Care Providers ◽  
Multiple Choice Questions ◽  
Full Spectrum ◽  
Pain Care

Pain Care Essentials targets the needs of primary care providers and entry-level healthcare professionals to understand pain. Based on the successful approach of examining four basic questions, this textbook addresses: What is pain? How is pain assessed? How is pain managed? and How does clinical context impact pain experience and management? Weaving together advances in science and clinical practice, this text covers the full spectrum from basic pain signaling mechanisms, psychology, and epidemiology, to clinical skills, treatment choices, and impacts on children, older adults, and those with substance use disorders, at a depth attuned to the foundations of clinical practice. Based on a learner-centered teaching philosophy; we believe that a deeper understanding of patient-centered pain care, including socioemotional development, enhances the clinical experience for patients, caregivers, and healthcare providers; leading to better outcomes, higher levels of patient satisfaction, and less provider burnout. Each chapter includes learning objectives, a clinical case, multiple choice questions, and selected references. Figures, tables, and textboxes enhance reader engagement. The goal is to deliver essential pain content that can be incorporated into an integrated curriculum preparing students for formative and summative assessments of core competencies in pain, as well as meeting the needs of the more experienced general reader seeking a quick update. Prepared by an interprofessional authorship team for an audience that includes physicians, nurse practitioners, physician assistants, pharmacists, and students of all healthcare professions, this work fills an important gap by focusing on pain as encountered by the broadest spectrum of healthcare practitioners.

Electronic consultation system demonstrates educational benefit for primary care providers

2017 ◽  
Vol 24 (7) ◽  
pp. 465-472 ◽  
Author(s):  
Jonas Kwok ◽  
J Nwando Olayiwola ◽  
Margae Knox ◽  
Elizabeth J Murphy ◽  
Delphine S Tuot
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Primary Care Providers ◽  
Referral System ◽  
Years Of Experience ◽  
Care Providers ◽  
Educational Value ◽  
Electronic Consultation ◽  
Consultation And Referral

Background Electronic consultation systems allow primary care providers to receive timely speciality expertise via iterative electronic communication. The use of such systems is expanding across the USA with well-documented high levels of user satisfaction. We characterise the educational impact for primary care providers of a long-standing integrated electronic consultation and referral system. Methods Primary care providers’ perceptions of the educational value inherent to electronic consultation system communication and the impact on their ability to manage common speciality clinical conditions and questions were examined by electronic survey using five-point Likert scales. Differences in primary care providers’ perceptions were examined overall and by primary care providers’ speciality, provider type and years of experience. Results Among 221 primary care provider participants (35% response rate), 83.9% agreed or strongly agreed that the integrated electronic consultation and referral system provided educational value. There were no significant differences in educational value reported by provider type (attending physician, mid-level provider, or trainee physician), primary care providers’ speciality, or years of experience. Perceived benefit of the electronic consultation and referral system in clinical management appeared stronger for laboratory-based conditions (i.e. subclinical hypothyroidism) than more diffuse conditions (i.e. abdominal pain). Nurse practitioners/physician assistants and trainee physicians were more likely to report improved abilities to manage specific clinical conditions when using the electronic consultation and/or referral system than were attending physicians, as were primary care providers with ≤10 years experience, versus those with >20 years of experience. Conclusions Primary care providers report overwhelmingly positive perceptions of the educational value of an integrated electronic consultation and referral system. Nurse practitioners, physician assistants, trainee physicians and less-experienced primary care providers report the greatest clinical educational benefit, particularly for conditions involving lab-based diagnosis and management.

scholarly journals Understanding providers’ attitudes and key concerns toward incorporating CVD risk prediction into clinical practice: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Linda Takamine ◽  
Jane Forman ◽  
Laura J. Damschroder ◽  
Bradley Youles ◽  
Jeremy Sussman
Keyword(s):  
Clinical Practice ◽  
Risk Prediction ◽  
Nurse Practitioners ◽  
Clinical Decision Making ◽  
Physician Assistants ◽  
Primary Care Providers ◽  
Primary Concern ◽  
Full Time ◽  
Care Providers ◽  
Cvd Prevention

Abstract Background Although risk prediction has become an integral part of clinical practice guidelines for cardiovascular disease (CVD) prevention, multiple studies have shown that patients’ risk still plays almost no role in clinical decision-making. Because little is known about why this is so, we sought to understand providers’ views on the opportunities, barriers, and facilitators of incorporating risk prediction to guide their use of cardiovascular preventive medicines. Methods We conducted semi-structured interviews with primary care providers (n = 33) at VA facilities in the Midwest. Facilities were chosen using a maximum variation approach according to their geography, size, proportion of MD to non-MD providers, and percentage of full-time providers. Providers included MD/DO physicians, physician assistants, nurse practitioners, and clinical pharmacists. Providers were asked about their reaction to a hypothetical situation in which the VA would introduce a risk prediction-based approach to CVD treatment. We conducted matrix and content analysis to identify providers’ reactions to risk prediction, reasons for their reaction, and exemplar quotes. Results Most providers were classified as Enthusiastic (n = 14) or Cautious Adopters (n = 15), with only a few Non-Adopters (n = 4). Providers described four key concerns toward adopting risk prediction. Their primary concern was that risk prediction is not always compatible with a “whole patient” approach to patient care. Other concerns included questions about the validity of the proposed risk prediction model, potential workflow burdens, and whether risk prediction adds value to existing clinical practice. Enthusiastic, Cautious, and Non-Adopters all expressed both doubts about and support for risk prediction categorizable in the above four key areas of concern. Conclusions Providers were generally supportive of adopting risk prediction into CVD prevention, but many had misgivings, which included concerns about impact on workflow, validity of predictive models, the value of making this change, and possible negative effects on providers’ ability to address the whole patient. These concerns have likely contributed to the slow introduction of risk prediction into clinical practice. These concerns will need to be addressed for risk prediction, and other approaches relying on “big data” including machine learning and artificial intelligence, to have a meaningful role in clinical practice.

scholarly journals HOW TO PREPARE PHYSICIAN ASSISTANTS FOR THE CARE OF OLDER ADULTS? PARTNER WITH GERONTOLOGY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S298-S298
Author(s):  
Jacqueline Eaton ◽  
Trenton Honda
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Adult Population ◽  
Physician Assistants ◽  
Primary Care Providers ◽  
Student Interest ◽  
Care Providers ◽  
University Of Utah ◽  
Program Of Study ◽  
The University

Abstract Approximately 80% of older adults have chronic illness which requires complex care. Primary care providers require special training to improve the care they provide older adults. As primary care shortages increase, and the older adult population swells, physician assistants (PA) will increasingly be relied upon to provide care and advocacy for older adults. The purpose of this presentation is to describe the development of a dual degree program that facilitates enhanced gerontological training for students pursuing a Masters of PA Studies degree. The Gerontology Interdisciplinary Program and the PA Program at the University of Utah collaborated to assess program objectives, competencies, and coursework, while identifying student interest in this dual MS venture. Students were interested in increasing their skills to meet the growing need for geriatric care while also saving time and money. In addition, it was important that the combined program of study did not overburden students and accommodated participants off-site. Faculty and administrative buy-in was sought from within departments and colleges. Revisions to the proposed program of study included altering course offerings, changing program start dates, and removing course overlap. A 30-month dual MS was developed that incorporates 87 PA Program credits, 25 Gerontology Credits, and 6 credits shared through practicum, geriatric content, and evidence based practice. Students who graduate will complete a Gerontology focused Masters Project that combines their work from the two programs. This dual MS program prepares students to be competitive in the job market, while also targeting an area of need in primary care.

scholarly journals Primary Care Providers’ Perceptions and Experiences of Family-Centered Care for Older Adults: A Qualitative Study of Community-Based Diabetes Management in China

2021 ◽  
Author(s):  
Jing Liao ◽  
Jiong Tu
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Health Professionals ◽  
Diabetes Management ◽  
Primary Care Providers ◽  
Family Centered Care ◽  
Care Providers ◽  
Community Based ◽  
Centered Care ◽  
Family Centered

Abstract Background: Family-centered care, as a contemporary model of health service delivery, involves a mutually beneficial partnership between healthcare providers, patients and their families. Although evidence on the positive effects of family-centered care on older adults and their families is accumulating, less is known about the providers’ beliefs, attitudes and practices related to family-centeredness, especially regarding community-based primary healthcare services for the rapidly-ageing Chinese population. Methods: This study investigated Chinese primary care providers’ perceptions and experiences of family-centered care for older adults, using community-based diabetes management services as an example. Ten focus-group interviews involving 48 community health professionals were conducted. Major themes were identified using thematic analysis. Results: The interviews revealed that the providers acknowledged the importance of the family in older patients’ diabetes management, while their current scope of practice with the patients’ families was limited and informal. The barriers to implementing family-centered care were attributed to structural and environmental obstacles associated with the patients’ families and the community healthcare context and culture. To engage patients’ families more effectively, the providers suggested that family-centered values endorsed by their healthcare organizations and reinforced by policies, a trained interdisciplinary team of health professionals and community social workers, and also that the utilization of technology would be beneficial. Conclusions: Our study extends the evidence of family-centered care for older adults in Chinese community-based healthcare settings, contributing to the design of a tailored healthcare delivery model embodying ageing in place.

scholarly journals Primary care providers’ perceptions and experiences of family-centered care for older adults: a qualitative study of community-based diabetes management in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiong Tu ◽  
Jing Liao
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Health Professionals ◽  
Diabetes Management ◽  
Primary Care Providers ◽  
Family Centered Care ◽  
Care Providers ◽  
Community Based ◽  
Centered Care ◽  
Family Centered

Abstract Background Family-centered care, as a contemporary model of health service delivery, involves a mutually beneficial partnership between healthcare providers, patients and their families. Although evidence on the positive effects of family-centered care on older adults and their families is accumulating, less is known about the providers’ beliefs, attitudes and practices related to family-centeredness, especially regarding community-based primary healthcare services for the rapidly-ageing Chinese population. Methods This study investigated Chinese primary care providers’ perceptions and experiences of family-centered care for older adults, using community-based diabetes management services as an example. Ten focus-group interviews involving 48 community health professionals were conducted. Major themes were identified using thematic analysis. Results The interviews revealed that the providers acknowledged the importance of the family in older patients’ diabetes management, while their current scope of practice with the patients’ families was limited and informal. The barriers to implementing family-centered care were attributed to structural and environmental obstacles associated with the patients’ families and the community healthcare context and culture. To engage patients’ families more effectively, the providers suggested that family-centered values endorsed by their healthcare organizations and reinforced by policies, a trained interdisciplinary team of health professionals and community social workers, and also that the utilization of technology would be beneficial. Conclusions Our study extends the evidence of family-centered care for older adults in Chinese community-based healthcare settings, contributing to the design of a tailored healthcare delivery model embodying ageing in place.

Urinary tract infections (UTIs); a leaflet for older adults, and carers: the development of a UTI leaflet for older adults and their carers

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X696833 ◽  
Author(s):  
Leah Ffion Jones ◽  
Emily Cooper ◽  
Cliodna McNulty
Keyword(s):  
Older Adults ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Care Home ◽  
Asymptomatic Bacteriuria ◽  
Theoretical Domains Framework ◽  
Antibiotic Use ◽  
Primary Care Providers ◽  
Care Providers ◽  
Tract Infections

BackgroundEscherichia coli bacteraemia rates are rising with highest rates in older adults. Mandatory surveillance identifies previous Urinary Tract Infections (UTI) and catheterisation as risk factors.AimTo help control bacteraemias in older frail patients by developing a patient leaflet around the prevention and self-care of UTIs informed by the Theoretical Domains Framework.MethodFocus groups or interviews were held with care home staff, residents and relatives, GP staff and an out of hours service, public panels and stakeholders. Questions explored diagnosis, management, prevention of UTIs and antibiotic use in older adults. The leaflet was modified iteratively. Discussions were transcribed and analysed using Nvivo.ResultsCarers of older adults reported their important role in identifying when older adults might have a UTI, as they usually flag symptoms to nurses or primary care providers. Information on UTIs needs to be presented so residents can follow; larger text and coloured sections were suggested. Carers were optimistic that the leaflet could impact on the way UTIs are managed. Older adults and relatives liked that it provided new information to them. Staff welcomed that diagnostic guidance for UTIs was being developed in parallel; promoting consistent messages. Participants welcomed and helped to word sections on describing asymptomatic bacteriuria simply, preventing UTIs, causes of confusion and when to contact a doctor or nurseConclusionA final UTI leaflet for older adults has been developed informed by the TDF. See the TARGET website www.RCGP.org.uk/targetantibiotics/

scholarly journals Teaching Family Nurse Practitioner Students to Provide Mental Health Care to Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 10-11
Author(s):  
Victoria Grando ◽  
Roy Grando
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Treatment Plan ◽  
Primary Care Providers ◽  
Neurocognitive Disorders ◽  
Mental Condition ◽  
Care Providers

Abstract In recent years, FNPs have been challenged to deliver mental health services in the primary care setting. Over half of mental health services are provided in primary care, and one-quarter of all primary care patients have a mental disorder. Moreover, 20% of older adults have a mental or neurological disorder often not diagnosed. Nationally, it is estimated that 17% of older adults commit suicide, 15% have a mental condition, 11% have dementia, and 5% have a serious mental condition. There is a paucity of adequately prepared primary care providers trained in geropsychiatric treatment. A didactic course was developed to instruct FNP students in the skills needed to provide mental health treatment in primary care. We discuss mental illness in the context of culture to ensure that treatment is congruent with a patient’s unique cultural background and experiences. This shapes the patients’ beliefs and behaviors that influence the way they view their condition and what they perceive as acceptable solutions. We then go into detail about the common mental conditions that older adults exhibit. Through the case study method, students learn to identify the presenting problem, protocols for analyzing the case, which includes making differential diagnoses and a treatment plan including initial medications, non-medical treatments, and referral. Students are introduced to the DMS-5 to learn the criteria for mental health diagnosis with an emphasis on suicide, depressive disorders, anxiety disorders, bipolar disorders, substance use disorders, and neurocognitive disorders. We have found that students most often misdiagnose neurocognitive disorders.

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