scholarly journals Clinical practice characteristics of gerontological nurse practitioners: A national study

Author(s):  
Laurie Kennedy-Malone ◽  
Judith Penny ◽  
Mary Elizabeth Fleming
Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 261
Author(s):  
Priya Patel ◽  
Andrew Houck ◽  
Daniel Fuentes

Variability in neonatal clinical practice is well recognized. Respiratory management involves interdisciplinary care and often is protocol driven. The most recent published guidelines for management of respiratory distress syndrome and surfactant administration were published in 2014 and may not reflect current clinical practice in the United States. The goal of this project was to better understand variability in surfactant administration through conduct of health care provider (HCP) interviews. Questions focused on known practice variations included: use of premedication, decisions to treat, technique of surfactant administration and use of guidelines. Data were analyzed for trends and results were communicated with participants. A total of 54 HCPs participated from June to September 2020. In almost all settings, neonatologists or nurse practitioners intubated the infant and respiratory therapists administered surfactant. The INSURE (INtubation-SURrfactant-Extubation) technique was practiced by 83% of participants. Premedication prior to intubation was used by 76% of HCPs. An FiO2 ≥ 30% was the most common threshold for surfactant administration (48%). In conclusion, clinical practice variations exist in respiratory management and surfactant administration and do not seem to be specific to NICU level or institution type. It is unknown what effects the variability in clinical practice might have on clinical outcomes.


2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Kylie Fitzgerald ◽  
Brett Vaughan ◽  
Michael Fleischmann ◽  
Shane Pritchard ◽  
Jane Mulcahy ◽  
...  

AbstractObjectivesAdvice, reassurance and education are recommended as first line treatments for musculoskeletal pain conditions such as low back pain. Osteopaths are registered primary contact allied health professionals in the Australian healthcare system who primarily manage acute and chronic musculoskeletal pain conditions. This study aimed to investigate the proportion of Australian osteopaths who do and do not utilise advice, reassurance and education (pain counselling) in their clinical practice, and determine the characteristics associated with the frequency of using pain counselling in clinical practice.MethodsA secondary analysis of practice characteristics from a nationally representative sample of Australian osteopaths was undertaken. Participants completed a 27-item practice characteristics questionnaire between July-December 2016. Bivariate analyses were used to identify significant variables for inclusion in a backward multiple logistic regression model. Adjusted odds ratios (OR) were calculated for significant variables.ResultsResponses were received from 991 Australian osteopaths, representing 49% of the profession. Of these 264 (26.64%) indicated often utilising pain counselling, and 727 (73.36%) reported not often utilising pain counselling. Those who utilised pain counselling were more than twice as likely to report research evidence had a high impact on their clinical practice (OR 2.11), and nearly twice as likely to discuss physical activity with their patients (OR 1.84).ConclusionsPain counselling is under-utilised by nearly three quarters of the Australian osteopathic profession as a management strategy. Future studies are required to explore the reasons why most in the profession comprised in this sample are infrequently utilising this guideline recommendation. Given the frequency of chronic musculoskeletal pain conditions presenting to Australian osteopaths, strategies appear to be needed to advance the profession via professional development in accessing and using evidence-based care for pain conditions.


2019 ◽  
Vol 26 (2) ◽  
pp. 911-924
Author(s):  
Mark J Rapoport ◽  
Carla Zucchero Sarracini ◽  
Benoit M Mulsant ◽  
Dallas P Seitz ◽  
Frank Molnar ◽  
...  

Clinicians face challenges in deciding which older patients with dementia to report to transportation administrators. This study used a qualitative thematic analysis to understand the utility and limitations of implementing a computer-based Driving in Dementia Decision Tool in clinical practice. Thirteen physicians and eight nurse practitioners participated in an interview to discuss their experience using the tool. While many participants felt the tool provided a useful ‘virtual second opinion’, specialist physicians felt that the tool did not add value to their clinical practice. Barriers to using the Driving in Dementia Decision Tool included lack of integration with electronic medical records and inability to capture certain contextual nuances. Opinions varied about the impact of the tool on the relationship of clinicians with patients and their families. The Driving in Dementia Decision Tool was judged most useful by nurse practitioners and least useful by specialist physicians. This work highlights the importance of tailoring knowledge translation interventions to particular practices.


2019 ◽  
Vol 186 (2-3) ◽  
pp. 386-390
Author(s):  
V Dufek ◽  
H Zackova ◽  
L Kotik ◽  
I Horakova

Abstract About 26 000 patients are treated per year with radiotherapy for non-malignant diseases in the Czech Republic. Approximately 75% of them are treated on X-ray therapy units and most of these patients undergo radiotherapy of heel spurs. The evaluation of radiation exposure of these patients was based on measured organ doses and on data from clinical practice. Collective effective doses for particular diagnoses were calculated in order to compare doses resulting from different diagnoses treated on X-ray therapy units. The collective effective dose from radiotherapy of heel spurs in the Czech Republic in 2013 was evaluated to 77 manSv. It represents 25.6% of the total collective effective dose for all diagnoses of radiotherapy for non-malignant diseases treated on X-ray therapy units.


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