scholarly journals A survey of personnel and services offered in 32 outpatient US clozapine clinics

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Robert O. Cotes ◽  
Donna Rolin ◽  
Jonathan M. Meyer ◽  
Alexander S. Young ◽  
Amy N. Cohen ◽  
...  
Keyword(s):  
Nurse Practitioners ◽  
Case Managers ◽  
Psychiatric Nurse ◽  
Systematic Description ◽  
Center Of Excellence ◽  
The Us

Abstract Background Clozapine clinics can facilitate greater access to clozapine, but there is a paucity of data on their structure in the US. Methods A 23-item survey was administered to participants recruited from the SMI Adviser Clozapine Center of Excellence listserv to understand characteristics of clozapine clinics. Results Clozapine clinics (N = 32) had a median caseload of 45 (IQR = 21–88) patients and utilized a median of 5 (IQR = 4–6) interdisciplinary roles. The most common roles included psychiatrists (100%), pharmacists (65.6%), nurses (65.6%), psychiatric nurse practitioners (53.1%), and case managers (53.1%). The majority of clinics outreached to patients who were overdue for labs (78.1%) and had access to on-site phlebotomy (62.5%). Less than half had on call services (46.9%). Conclusions In this first systematic description of clozapine clinics in the US, there was variation in the size, staffing, and services offered. These findings may serve as a window into configurations of clozapine teams.

Care Work on the Front Lines

2020 ◽  
Vol 119 (820) ◽  
pp. 326-328
Author(s):  
Mary F. E. Ebeling
Keyword(s):  
Nurse Practitioners ◽  
Outpatient Care ◽  
Care Facility ◽  
Safety Net ◽  
Ethnographic Study ◽  
Care Work ◽  
Medical Professionals ◽  
Essential Work ◽  
Social Safety Net ◽  
The Us

An ethnographic study of the work of nurse practitioners at an outpatient care facility shows how these medical professionals must endlessly multitask to fill gaps in the US social safety net. In the context of the COVID-19 pandemic, a new focus on the essential work of nurses and the lack of resources with which they often contend is especially timely.

Small talk as work talk: Enacting the patient-centered approach in nurse-practitioner-patient visits

2018 ◽  
Vol 14 (2) ◽  
pp. 97-107 ◽  
Author(s):  
Staci Defibaugh
Keyword(s):  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Medical Visit ◽  
Patient Centered ◽  
Small Talk ◽  
Medical Visits ◽  
Relational Work ◽  
The Us ◽  
The Individual ◽  
Patient Relationships

Small talk in medical visits has received ample attention; however, small talk that occurs at the close of a medical visit has not been explored. Small talk, with its focus on relational work, is an important aspect of medical care, particularly so considering the current focus in the US on the patient-centered approach and the desire to construct positive provider– patient relationships, which have been shown to contribute to higher patient satisfaction and better health outcomes. Therefore, even small talk that is unrelated to the transactional aspect of the medical visit in fact serves an important function. In this article, I analyze small talk exchanges between nurse practitioners (NPs) and their patients which occur after the transactional work of the visit is completed. I focus on two exchanges which highlight different interactional goals. I argue that these examples illustrate a willingness on the part of all participants to extend the visit solely for the purpose of constructing positive provider–patient relationships. Furthermore, because exchanges occur after the ‘work’ of the visit has been completed, they have the potential to construct positive relationships that extend beyond the individual visit.

QUO VADIS?

PEDIATRICS ◽  
1989 ◽  
Vol 84 (4) ◽  
pp. A100-A100
Author(s):  
Student
Keyword(s):  
Medical Care ◽  
Case Managers ◽  
Administrative Costs ◽  
Physician Autonomy ◽  
Medical Care Costs ◽  
The Us ◽  
Private And Public ◽  
Quo Vadis ◽  
Professional Review ◽  
The Impact

There are growing concerns, among physicians and others in the US, about the impact of [present] policies on medical care costs, on the commercialisation of medicine, and on physician autonomy. As a result of the new market-oriented policies, physicians in the US are now the most litigated-against, second-guessed, and paperwork-laden physicians in western industrialised democracies. Physicians' day-to-day clinical decisionmaking—commonly referred to as clinical freedom—is increasingly subject to review and appoval by "case managers" working for employers, insurance carriers, and government financed and regulated professional review organisations. Malpractice suits and administrative costs are multiplying. The growing adversarial relationship with private and public payers and loss of physican autonomy are closely related to the growing view that medical care should be treated like any other private business.

The role of the psychiatric nurse practitioner in disaster response

2009 ◽  
Vol 7 (4) ◽  
pp. 39
Author(s):  
Brenda Marshall, EdD, MSN, PMHNP-BC
Keyword(s):  
Life Cycle ◽  
Registered Nurses ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Disaster Response ◽  
Healthcare Providers ◽  
Psychiatric Nurse ◽  
Florence Nightingale

Nurses have responded to, and prepared for disasters from the time of Florence Nightingale and Harriet Werley. Nurses are the largest group of professional healthcare providers in America with more than 2.4 million registered nurses, a quarter of a million of whom are Nurse Practitioners capable of diagnosing, prescribing, and treating patients. Psychiatric Nurse Practitioners are in a position to understand the unique cultural nuances and needs of a community in all phases of the disaster life cycle.

Community Psychiatric Nurse Teams: Cost-effectiveness of Intensive Support Versus Generic Care

1994 ◽  
Vol 165 (2) ◽  
pp. 218-221 ◽  
Author(s):  
Paul McCrone ◽  
Jennifer Beecham ◽  
Martin Knapp
Keyword(s):  
Economic Evaluation ◽  
Cost Effectiveness ◽  
Community Support ◽  
Case Managers ◽  
Psychiatric Nurse ◽  
Short Term ◽  
Community Psychiatric ◽  
Support Team ◽  
The Difference ◽  
And Control

Background.Part of the community psychiatric nurse (CPN) service was reorganised into a community support team (CST), with staff acting as case managers. An economic evaluation ran parallel to the comparison with generic CPN care.Method.Eighty-two clients were randomly allocated to experimental and control groups. Costs were comprehensively measured over a pre-referral period (three months), and then at 6, 12, and 18 months.Results.The economic evaluation found a cost difference between the groups. Generic group costs averaged £89 per patient per week more than CST group costs. The difference was only significant for the first six months. Changes in the burden of cost across agencies were observed.Conclusions.Although CPN inputs and costs were higher for the CST group, there was a significant short-term reduction in total cost. Beyond the short term, the CST did not confer cost or cost-effectiveness advantages.

scholarly journals Physician assistants in geriatric medical care

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Andrzej Kozikowski ◽  
Trenton Honda ◽  
Freddi Segal-Gidan ◽  
Roderick S. Hooker
Keyword(s):  
Medical Care ◽  
Nurse Practitioners ◽  
Geriatric Medicine ◽  
Physician Assistants ◽  
National Commission ◽  
Chi Square ◽  
Extended Care ◽  
The Us ◽  
Rehabilitation Facilities

Abstract Background The US population is maturing. As of 2020, over 52 million (16%) people are age 65 or older. With a citizenry that is increasingly “gray,” the nation is short of medical providers who specialize in geriatric medical care. For example, the number of geriatrician physicians per 10,000 adults 65 years and older has decreased since 2000, with approximately 5300 in 2018. Nurse practitioners in geriatric medical care numbered 598 in 2018. Considering that the projected needs by 2030 will be over 30,000, the trajectory of geriatricians is becoming increasingly inadequate for the aging population. Physician assistants (PA) are another class of providers that are filling this geriatric medical care role, although little has been published. To address this role of PAs a study was undertaken. Methods The National Commission on Certification of Physician Assistants databank provided the number and characteristics of PAs in geriatric medicine and compared them to all other certified PAs. Analyses included descriptive statistics, Chi-Square, and Wilcoxon Rank Sum tests for comparisons between PAs practicing in geriatric medical care vs. all other PA specialties. Where a comparison between PAs in geriatrics and other specialties was made, a P value of .05 or less was considered statistically significant. Results As of 2018, there were 794 certified PAs, or 0.8% of the certified PA workforce, in geriatric medical care. This cadre has grown significantly since 2013, both in total number (increasing over 373%) and as a percentage of the PA workforce. The median age of certified PAs in geriatrics is 45 years, and 79% are female. Almost half (46%) of PAs in geriatric medicine work in extended care facilities or nursing homes, which differs from PAs in non-geriatric care. Another 8% work in government facilities and 8% in rehabilitation facilities. In 2018, the mean annual income for this PA group was $106,680. Conclusions As the American population continues to age, the relative growth of PAs in geriatric medicine makes them a natural part of the solution to the projected physician geriatrician deficit. The role of PAs in geriatric medical care remains to be explored.

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