Healthcare Providers Face Numerous Challenges in Treating Patients with Psoriasis: Results from a Mixed-Methods Study

2021 ◽  
pp. 247553032110628
Author(s):  
Suzanne Murray ◽  
Jeffrey Crowley ◽  
Melinda J. Gooderham ◽  
Alan Kivitz ◽  
Vinod Chandran ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Nurse Practitioners ◽  
Paradigm Shift ◽  
Primary Care Physicians ◽  
Healthcare Providers ◽  
Continuing Professional Development ◽  
Physician Assistants ◽  
Care Providers ◽  
Starting Point ◽  
Practice Gaps

Background The paradigm shift toward biologic medications in psoriasis care requires healthcare providers (HCPs) to become acquainted with mechanisms of action and safety profiles of these new treatments to confidently use them in practice. A better understanding of this paradigm shift is necessary to provide adequate education for HCPs in psoriasis care. Objectives This study assessed clinical practice gaps and challenges experienced by HCPs caring for patients with psoriasis. Methods A mixed-methods approach was used to identify practice gaps and clinical challenges of dermatologists, rheumatologists, primary care physicians, physician assistants, and nurse practitioners with various levels of clinical experience in academic and community-based settings. Qualitative and quantitative data were collected sequentially. Interviews were transcribed and thematically analyzed. Results A total of 380 psoriasis care providers in Canada and the US participated in this study. Analysis revealed challenges in establishing an accurate diagnosis of psoriasis (including screening for sub-type and distinguishing psoriasis from other skin conditions), selecting treatment (particularly regarding recently approved treatments), monitoring side effects, and collaborating with other HCPs involved in psoriasis care. Conclusion These findings highlight educational needs of HCPs involved in psoriasis care that could have repercussions on accurate and timely diagnosis of the condition, treatment initiation, side effect monitoring, and continuity of care. Findings provide a starting point for clinicians to reflect on their practice and for the improvement of continuing professional development interventions that would bridge these gaps.

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 The impact on patient flow after the integration of nurse practitioners and physician assistants in 6 Ontario emergency departments

CJEM ◽  
2009 ◽  
Vol 11 (05) ◽  
pp. 455-461 ◽  
Author(s):  
James Ducharme ◽  
Robert J. Alder ◽  
Cindy Pelletier ◽  
Don Murray ◽  
Joshua Tepper
Keyword(s):  
Health Care ◽  
Nurse Practitioners ◽  
Emergency Departments ◽  
Patient Flow ◽  
Physician Assistants ◽  
Wait Times ◽  
Care Providers ◽  
Lengths Of Stay ◽  
Left Without Being Seen ◽  
The Impact

ABSTRACT Objective: We sought to assess the impact of the integration of the new roles of primary health care nurse practitioners (NPs) and physician assistants (PAs) on patient flow, wait times and proportions of patients who left without being seen in 6 Ontario emergency departments (EDs). Methods: We performed a retrospective review of health records data on patient arrival time, time of initial assessment by a physician, time of discharge from the ED and discharge status. Results: Whether a PA or NP was directly involved in the care of patients or indirectly involved by being on duty, the wait times, lengths of stay and proportion of patients who left without being seen were significantly reduced. When a PA or NP were directly involved in patients' care, patients were 1.6 (95% confidence interval [CI] 1.3–2.1, p < 0.05) and 2.1 (95% CI 1.6–2.8, p < 0.05) times more likely to be seen within the wait time benchmarks, respectively. Lengths of stay were 30.3% (95% CI 21.6%–39.0%, p < 0.01) and 48.8% (95% CI 35.0%–62.7%, p < 0.01) lower when PAs and NPs, respectively, were involved. When PAs and NPs were not on duty, the proportion of patients who left without being seen were 44% (95% CI 31%–63%, p < 0.01) and 71% (95% CI 53%–96%, p < 0.05), respectively. Conclusion: The addition of PAs or NPs to the ED team can improve patient flow in medium-sized community hospital EDs. Given the ongoing shortage of physicians, use of alternative health care providers should be considered. These results require validation, as their generalizability to other locations or types of EDs is not known.

Heightened malpractice risk for hospitalist physicians in the USA: what to know and what to do

2019 ◽  
Vol 95 (1128) ◽  
pp. 531-533
Author(s):  
Zachary R Paterick ◽  
Timothy Edward Paterick
Keyword(s):  
Nurse Practitioners ◽  
Quality Care ◽  
Healthcare Providers ◽  
Hospital Medicine ◽  
Physician Assistants ◽  
Medical Providers ◽  
Professional Liability ◽  
Optimal Patient Care ◽  
The Usa ◽  
Unique Relationship

Hospitalists, nurse practitioners, physician assistants and institutions are all at risk for the potential professional liability issues. The unique relationship between healthcare providers and their sponsoring institution generates complex and evolving legal issues for all participants. The law has played a great role integrating quality care and patient safety with physicians, while providing an avenue for relief when a medical error occurs. The intersection of law and medicine, while allowing for optimal patient care, exposes participating medical providers and the sponsoring institutions to specific professional liability issues. This article addresses the heightened medical practice risk that hospitalist physicians’ encounter in today’s practice of hospital medicine.

scholarly journals National mixed methods evaluation of the effects of removing legal barriers to full practice authority of Dutch nurse practitioners and physician assistants

BMJ Open ◽  
2018 ◽  
Vol 8 (6) ◽  
pp. e019962 ◽  
Author(s):  
Daisy P De Bruijn-Geraets ◽  
Yvonne J L van Eijk-Hustings ◽  
Monique C M Bessems-Beks ◽  
Brigitte A B Essers ◽  
Carmen D Dirksen ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Mixed Methods Evaluation ◽  
Legal Barriers

Knowledge gaps and practice patterns of clinicians treating patients with opioid use disorder

2019 ◽  
Vol 15 (6) ◽  
pp. 455-468 ◽  
Author(s):  
Maziar Rasulnia, PhD ◽  
Billy Stephen Burton, MS ◽  
Dhiren Patel, PharmD
Keyword(s):  
Nurse Practitioners ◽  
Primary Care Physicians ◽  
Practice Patterns ◽  
Physician Assistants ◽  
Opioid Use Disorder ◽  
Audit And Feedback ◽  
Primary Study ◽  
Opioid Use ◽  
Knowledge Gaps ◽  
Survey Tool

Objective: The goal of the study was to assess knowledge gaps and practice patterns of US-based addiction specialists, primary care physicians (PCPs), nurse practitioners (NPs), and physician assistants (PAs) who treat patients with opioid use disorder (OUD).Design: As part of a prospective study, the authors developed a survey tool consisting of case-vignettes and questions designed to reveal practice patterns and highlight gaps in clinician knowledge.Setting: The primary study setting included clinicians practicing in outpatient care.Participants: The surveys were distributed via email between August and September 2017 to a national sample of addiction specialists, PCPs, and NPs/Pas that see at least one patient per week and at least 1 percent of their patient population had to be diagnosed with OUD.Results: The knowledge assessment results varied among the clinicians surveyed. Addiction specialists saw more patients with OUD than PCPs, NPs, or PAs. They also demonstrated a higher level of understanding and knowledge of the various domains assessed.Conclusions: There are multiple educational intervention strategies that can support the clinicians; including reducing restrictions to access treatment for OUD, care coordination programs for patients to improve early access to treatment and education, and frequent chart audit and feedback programs to support clinician decision making and education.

Survey of opioid tapering practices of pediatric healthcare providers: A national perspective

2017 ◽  
Vol 13 (1) ◽  
pp. 59 ◽  
Author(s):  
Deborah Fisher, PhD, RN, PPCNP-BC ◽  
Suzanne W. Ameringer, PhD, RN
Keyword(s):  
Nurse Practitioners ◽  
Online Survey ◽  
Medical Center ◽  
Pediatric Population ◽  
Healthcare Providers ◽  
Physician Assistants ◽  
Pediatric Pain ◽  
Wide Range ◽  
Opioid Tapering ◽  
Pediatric Healthcare

Objective: The purpose of this study was to describe the current opioid tapering practice.Design: Cross-sectional, online, survey research.Participants: Pediatric healthcare providers from a national sample of practicing nurse practitioners, physician assistants, and physicians who participate in five different pediatric pain and/or palliative care list serves.Results: One hundred four participants responded to the survey. The respondents were predominantly physicians (n = 58, 62 percent). The majority of respondents worked in an academic children's medical center (n = 50, 52 percent). The average number of years in pediatric practice was 16 (mean = 16.33, range of 0-45 years). Of the 104 respondents, only 22 (27 percent) had a written protocol for opioid tapering. Use of expert consultants such as pharmacists or pediatric pain management teams varied. The majority of respondents (n = 46, 44 percent) seldom or never consult a pharmacist. Only 22 percent (n = 17) almost always or always consult a pediatric pain team. There was a wide range of personal tapering rate preferences. Conclusions: This study provided a baseline assessment of pediatric opioid tapering practices by pediatric healthcare providers. Results revealed a marked variation in practice patterns that may indicate deficits in the assessment and management of opioid withdrawal in children. The need for the development of assessment-based opioid tapering guidelines for the pediatric population is long overdue.

Development of an Instrument to Measure Community Acceptance of Nurse Practictioners and Physician Assistants

1999 ◽  
Vol 7 (1) ◽  
pp. 63-77 ◽  
Author(s):  
Lynn C. Baer ◽  
Kathleen A. Baldwin ◽  
Rebecca J. Sisk ◽  
Parris Watts ◽  
Margaret S. Grinslade ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Rural Communities ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Methodological Approach ◽  
Physician Assistants ◽  
Care Providers ◽  
Oblique Rotation ◽  
Survey Tool ◽  
Community Acceptance

The purpose of this study was to identify the significant dimensions of the concept of community acceptance of nurse practitioners/physician’s assistants and to construct areliable and valid instrument which would reflect these dimensions. The methodological approach included: conceptualization of categories, development of items for each category, development of the tool, administration of the tool, and psychometric analysis of results. Community input through focus-group interviews and post-administration questions provided qualitative data. The survey tool, consisting of items in four conceptualized categories (knowledge, access, competence, and trust), was administered in five rural communities. The responses of 967 residents were analyzed through factor analysis. The criterion, eigenvalue > 1.0, resulted in seven factors. Oblique rotation was applied to the seven factors and marker variables (loadings > .70) facilitated the identification of the underlying dimensions of each factor. Overall, 98% of the items assigned to the original categories were maintained after factor analysis. The identification of these dimensions helped to simplify the description and understanding of community acceptance of nurse practitioners and physicians’ assistants. Community acceptance of these advanced health care providers is a necessary precursor to use of services.

scholarly journals A Hepatitis C Educational Needs Assessment of Canadian Healthcare Providers

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Reza Naghdi ◽  
Karen Seto ◽  
Carolyn Klassen ◽  
Didi Emokpare ◽  
Brian Conway ◽  
...  
Keyword(s):  
Primary Care ◽  
Hepatitis C ◽  
Needs Assessment ◽  
Primary Care Physicians ◽  
Healthcare Providers ◽  
Public Health Problem ◽  
Primary Care Providers ◽  
Educational Needs ◽  
Major Public Health Problem ◽  
Care Providers

Background and Aim. Despite advances in the treatment of chronic hepatitis C infection (CHC), it remains a major public health problem in Canada and globally. The knowledge of healthcare providers (HCPs) is critical to improve the care of CHC in Canada. To assess the current knowledge and educational needs of healthcare providers (HCPs) in the area of CHC management a national online survey was conducted. Method. An interprofessional steering committee designed a 29-question survey distributed through various direct and electronic routes. The survey assessed several domains (e.g., participant and practice demographics, access to resources, knowledge of new treatments, and educational preferences). Results. A total of 163 HCPs responded to the survey. All hepatologists and 8% of primary care providers (PCPs) reported involvement in treatment of CHC. Physicians most frequently screened patients who had abnormal liver enzymes, while nurses tended to screen based on lifestyle factors. More than 70% of PCPs were not aware of new medications and their mechanisms. Conclusion. Overall, the needs assessment demonstrated that there was a need for further education, particularly for primary care physicians, to maximize the role that they can play in screening, testing, and treatment of hepatitis C in Canada.

Evaluation of an Inter-Professional Educational Intervention to Improve the Use of Arthritis Best Practices in Primary Care

2011 ◽  
Vol 38 (5) ◽  
pp. 931-937 ◽  
Author(s):  
SYDNEY C. LINEKER ◽  
MARY J. BELL ◽  
ELIZABETH M. BADLEY
Keyword(s):  
Primary Care ◽  
Best Practices ◽  
Nurse Practitioners ◽  
Professional Education ◽  
Best Practice ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
Care Providers ◽  
Rehabilitation Professionals ◽  
Knee Oa

Objective.To describe the evaluation of a community-based continuing health education program designed to improve the management of rheumatoid arthritis (RA) and osteoarthritis (OA), and to examine the results by discipline.Methods.The Getting a Grip on Arthritis©program was based on clinical practice guidelines adapted for the primary care environment (best practices). The program consisted of an accredited inter-professional workshop and 6 months of activities to reinforce the learning. Analyses compared best practice scores derived from responses to 3 standardized case scenarios (early and late RA; moderate knee OA) at baseline and 6 months post-workshop using the ACREU Primary Care Survey.Results.In total, 553 primary care providers (nurses/licensed practical nurses 30.9%, rehabilitation professionals 22.5%, physicians 22.5%, nurse practitioners 10.9%, other healthcare providers/non-clinical staff/students 13.1%) attended one of 27 workshops across Canada; 275 (49.7%) completed followup surveys. Best practice scores varied by discipline at baseline (p < 0.05) and improved for all 3 case scenarios, with nurse practitioners and rehabilitation therapists improving the most (p ≤ 0.05).Conclusion.Results suggest that inter-professional education may be an effective method for dissemination of guidelines and has potential to improve the delivery of arthritis care, particularly when nurse practitioners and rehabilitation therapists are involved in the care of patients.

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