Medical Management of Neurosurgical Patients

2019 ◽  
Keyword(s):  
Nurse Practitioners ◽  
Medical Management ◽  
Physician Assistants ◽  
Medical Decision ◽  
Critical Areas ◽  
Neurosurgical Patient ◽  
Neurosurgical Patients ◽  
Close Cooperation ◽  
Practical Tool ◽  
Preoperative Risk Stratification

Modern management of neurosurgical patients requires close cooperation between neurosurgeons and other specialists. The latter include internists, nurse practitioners, and physician assistants. This textbook aims to provide for these professionals a guide to the challenges associated with the medical management of these patients. It gives an overview of neurosurgical operations and procedures, seizure management, and preoperative risk stratification. It further discusses the intricacies of the management of fever, infection, electrolytes, bleeding disorders, and endocrine problems in the context of central nervous system injury. A particular emphasis is placed on the management of pressure injuries, pain management, and physical and occupational therapy, which are critical areas in the care of the neurosurgical patient. Finally, it reviews the types of contributions that palliative care can make to the care of the neurosurgical patient. The book’s objective is to provide a practical tool, and, where appropriate, its chapters include algorithms and tables to increase the efficiency of medical decision-making when caring for these patients.

Common Neurosurgical Procedures

2019 ◽  
pp. 1-15
Author(s):  
Kevin Hines ◽  
Stavropoula Tjoumakaris ◽  
Pascal M. Jabbour ◽  
Robert H. Rosenwasser ◽  
M. Reid Gooch
Keyword(s):  
Cervical Spine ◽  
Lumbar Spine ◽  
Adverse Events ◽  
Medical Management ◽  
Neurosurgical Procedures ◽  
Ventriculoperitoneal Shunting ◽  
Neurosurgical Patient ◽  
Neurosurgical Patients

Medical management of the neurosurgical patient can be complicated. These patients may suffer from a difficult neurosurgical pathology while still living with challenging comorbidities. As a result, this population often requires cooperation between multiple teams including neurosurgeons, neurologists, neurointensivists, and hospitalists. In this chapter, the authors review common neurosurgical procedures that the neurohospitalist encounters, including ventriculoperitoneal shunting, craniotomy and craniectomy, cervical spine decompression with or without fusion, lumbar spine decompression and/or fusion, and cerebral angiograms. The authors aim to highlight the methodology, indications, and issues of perioperative medical management. Understanding these procedures is vital to minimizing adverse events and providing the best possible care for neurosurgical patients.

Bartlett's Medical Management of HIV Infection

2019 ◽  
Author(s):  
John G. Bartlett ◽  
Robert R. Redfield ◽  
Paul A. Pham
Keyword(s):  
Hiv Infection ◽  
Nurse Practitioners ◽  
Medical Management ◽  
Clinical Care ◽  
Hiv Infections ◽  
Physician Assistants ◽  
People Living With Hiv ◽  
Hiv Research ◽  
Reference Format ◽  
Living With Hiv

With more than 30 million people living with HIV, nearly 2 million new HIV infections, and 1 million deaths in 2017 globally, the HIV epidemic continues to exert a considerable deleterious impact on the health of individuals, communities, and the economic growth of nations. However, remarkable advances have also been achieved: improvements in our scientific understanding of the biology of HIV, how it causes disease, and its prevention and treatment, coupled with unprecedented multi-sectoral global efforts, have resulted in rendering HIV infection essentially a manageable chronic disease. The 17th edition of Bartlett’s Medical Management of HIV Infection offers the best-available clinical guidance for treatment of patients with HIV, all in a portable, quick-reference format. Edited by preeminent and pioneering authorities in HIV research and clinical care, it has earned its status as the definitive work for physicians, physician assistants, nurse practitioners, pharmacists, and anyone working in the care of persons with HIV.

scholarly journals Barriers to identifying and obtaining CME: a national survey of physicians, nurse practitioners and physician assistants

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maureen O’Brien Pott ◽  
Anissa S. Blanshan ◽  
Kelly M. Huneke ◽  
Barbara L. Baasch Thomas ◽  
David A. Cook
Keyword(s):  
Travel Time ◽  
Nurse Practitioners ◽  
Professional Associations ◽  
Physician Assistants ◽  
Age Group ◽  
Sources Of Information ◽  
Online Search ◽  
The Past ◽  
Online Tools ◽  
Source Of Information

Abstract Background CPD educators and CME providers would benefit from further insight regarding barriers and supports in obtaining CME, including sources of information about CME. To address this gap, we sought to explore challenges that clinicians encounter as they seek CME, and time and monetary support allotted for CME. Methods In August 2018, we surveyed licensed US clinicians (physicians, nurse practitioners, and physician assistants), sampling 100 respondents each of family medicine physicians, internal medicine and hospitalist physicians, medicine specialist physicians, nurse practitioners, and physician assistants (1895 invited, 500 [26.3%] responded). The Internet-based questionnaire addressed barriers to obtaining CME, sources of CME information, and time and monetary support for CME. Results The most often-selected barriers were expense (338/500 [68%]) and travel time (N = 286 [57%]). The source of information about CME activities most commonly selected was online search (N = 348 [70%]). Direct email, professional associations, direct mail, and journals were also each selected by > 50% of respondents. Most respondents reported receiving 1–6 days (N = 301 [60%]) and $1000–$5000 (n = 263 [53%]) per year to use in CME activities. Most (> 70%) also reported no change in time or monetary support over the past 24 months. We found few significant differences in responses across clinician type or age group. In open-ended responses, respondents suggested eight ways to enhance CME: optimize location, reduce cost, publicize effectively, offer more courses and content, allow flexibility, ensure accessibility, make content clinically relevant, and encourage application. Conclusions Clinicians report that expense and travel time are the biggest barriers to CME. Time and money support is limited, and not increasing. Online search and email are the most frequently-used sources of information about CME. Those who organize and market CME should explore options that reduce barriers of time and money, and creatively use online tools to publicize new offerings.

Comparison of nurse practitioners/physician assistants to gastroenterologists in performing flexible sigmoidoscopy

1998 ◽  
Vol 114 ◽  
pp. A698-A699 ◽  
Author(s):  
MB Wallace ◽  
KY Ho ◽  
Y Trnka ◽  
C Henderson ◽  
JA Kemp ◽  
...  
Keyword(s):  
Nurse Practitioners ◽  
Flexible Sigmoidoscopy ◽  
Physician Assistants

The Use of Nurse Practitioners and Physician Assistants in Washington and Oregon Emergency Departments

2010 ◽  
Vol 32 (4) ◽  
pp. 338-345 ◽  
Author(s):  
Patricia D. Abbott ◽  
Karen G. Schepp ◽  
Brenda K. Zierler ◽  
Deborah Ward
Keyword(s):  
Nurse Practitioners ◽  
Emergency Departments ◽  
Physician Assistants

Quality of HIV Care Provided by Nurse Practitioners, Physician Assistants, and Physicians

2005 ◽  
Vol 143 (10) ◽  
pp. 729 ◽  
Author(s):  
Ira B. Wilson ◽  
Bruce E. Landon ◽  
Lisa R. Hirschhorn ◽  
Keith McInnes ◽  
Lin Ding ◽  
...  
Keyword(s):  
Nurse Practitioners ◽  
Physician Assistants ◽  
Hiv Care

scholarly journals US-based cross-sectional survey of clinicians’ knowledge and attitudes about shared decision-making across healthcare professions and specialties

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022730 ◽  
Author(s):  
Rachel C Forcino ◽  
Renata West Yen ◽  
Maya Aboumrad ◽  
Paul J Barr ◽  
Danielle Schubbe ◽  
...  
Keyword(s):  
Decision Making ◽  
Family Medicine ◽  
Shared Decision Making ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Shared Decision ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Knowledge And Attitudes ◽  
Positive Attitudes

ObjectiveIn this study, we aim to compare shared decision-making (SDM) knowledge and attitudes between US-based physician assistants (PAs), nurse practitioners (NPs) and physicians across surgical and family medicine specialties.SettingWe administered a cross-sectional, web-based survey between 20 September 2017 and 1 November 2017.Participants272 US-based NPs, PA and physicians completed the survey. 250 physicians were sent a generic email invitation to participate, of whom 100 completed the survey. 3300 NPs and PAs were invited, among whom 172 completed the survey. Individuals who met the following exclusion criteria were excluded from participation: (1) lack of English proficiency; (2) area of practice other than family medicine or surgery; (3) licensure other than physician, PA or NP; (4) practicing in a country other than the US.ResultsWe found few substantial differences in SDM knowledge and attitudes across clinician types, revealing positive attitudes across the sample paired with low to moderate knowledge. Family medicine professionals (PAs) were most knowledgeable on several items. Very few respondents (3%; 95% CI 1.5% to 6.2%) favoured a paternalistic approach to decision-making.ConclusionsRecent policy-level promotion of SDM may have influenced positive clinician attitudes towards SDM. Positive attitudes despite limited knowledge warrant SDM training across occupations and specialties, while encouraging all clinicians to promote SDM. Given positive attitudes and similar knowledge across clinician types, we recommend that SDM is not confined to the patient-physician dyad but instead advocated among other health professionals.

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