Communication barriers that affect medication adherence in patients with learning disabilities

2021 ◽  
Vol 32 (12) ◽  
pp. 485-490
Author(s):  
Jamara Hignett
Keyword(s):  
Learning Disabilities ◽  
Medication Adherence ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Staff Training ◽  
Communication Barriers ◽  
Communication Techniques ◽  
Communication Difficulties ◽  
Wrong Diagnosis ◽  
Communication Needs

Communication formulates a large part of a consultation and as a practitioner, it is vital to communicate effectively with a patient. Jamara Hignett provides an overview of the communication barriers that affect medication adherence in patients with learning disabilities Having a disability that affects communication can cause particular problems in primary care as inadequate communication can lead to the wrong diagnosis, poor assessments and inadequate health care ( Murphy, 2006 ). All patients are entitled to accessible and appropriate information on prescribed medication to facilitate a deeper understanding of the benefits and harms of treatment ( Grime et al, 2007 ). Reasonable adjustments should be made for learning difficultly patients and this can be in the form of easy reads guides that incorporate larger text, simple information and pictorial explanations. Communication passports are a tool used by people with learning disabilities; these provide both a practical and person-centred approach to passing on key information about people with complex communication difficulties ( Nursing Times, 2018 ). They provide information about the communication needs and health needs of a patient which is useful to assist in bridging the communication gap between nurse practitioner and patient. In a time of technological advancements, a move towards digital passports would be more beneficial with regular updates from the multidisciplinary team. This in turn can be shared across numerous health platforms the patient might come into contact with, allowing the nurse practitioner to better prepare for the patient prior to their consultation. Education on learning disabilities is an area of training that is lacking in general practice; there have been no provisions made to make the training mandatory. Incorporating mandatory yearly staff training will ensure nurse practitioners have the tools and knowledge to adapt communication techniques during a consultation.

Communication barriers that affect medication adherence in patients with learning disabilities

2021 ◽  
Vol 3 (11) ◽  
pp. 447-452
Author(s):  
Jamara Hignett
Keyword(s):  
Learning Disabilities ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Staff Training ◽  
Learning Disabled ◽  
Communication Techniques ◽  
Communication Difficulties ◽  
Wrong Diagnosis ◽  
Disabled Patients ◽  
Communication Needs

Having a disability that affects communication can cause particular problems in primary care as inadequate communication can lead to the wrong diagnosis, poor assessments and inadequate health care ( Murphy, 2006 ). All patients are entitled to accessible and appropriate information on prescribed medication to facilitate a deeper understanding of the benefits and harms of treatment ( Grime et al, 2007 ). Reasonable adjustments should be made for learning difficultly patients and this can be in the form of easy reads guides that incorporate larger text, simple information and pictural explanations. Communication passports are a tool used by learning disabled patients, these provide both a practical and person-centred approach to passing on key information about people with complex communication difficulties ( Nursing Times, 2018 ). They provide information about the communication needs and health needs of a patient which is useful to assist in bridging the communication gap between nurse practitioner and patient. In a time of technological advancements, a move towards digital passports would be more beneficial with regular updates from the multidisciplinary team. This in turn can be shared across numerous health platforms the patient might come into contact with, allowing the nurse practitioner to better prepare for the patient prior to their consultation. Education on learning disabilities is an area of training that is lacking in general practice, there have been no provisions made to make the training mandatory. Incorporating mandatory yearly staff training will ensure nurse practitioners have the tools and knowledge to adapt communication techniques during a consultation.

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.

Nurse Practitioner Challenges to the Orthodox Structure of Health Care Delivery: Regulation and Restraints on Trade

1985 ◽  
Vol 11 (2) ◽  
pp. 195-225
Author(s):  
Karla Kelly
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Delivery ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Allied Health ◽  
Care Delivery ◽  
The United States ◽  
Care Providers ◽  
Allied Health Care

AbstractUntil recently, physicians have been the primary health care providers in the United States. In response to the rising health care costs and public demand of the past decade, allied health care providers have challenged this orthodox structure of health care delivery. Among these allied health care providers are nurse practitioners, who have attempted to expand traditional roles of the registered nurse.This article focuses on the legal issues raised by several major obstacles to the expansion of nurse practitioner services: licensing restrictions, third party reimbursement policies, and denial of access to medical facilities and physician back-up services. The successful judicial challenges to discriminatory practices against other allied health care providers will be explored as a solution to the nurse practitioners’ dilemma.

Nurse Practitioner Students’ Perceptions on Delivering Culturally Congruent Care to Vulnerable Mexican Immigrants: A Qualitative Study

2021 ◽  
pp. 154041532110204
Author(s):  
Linda S. Eanes ◽  
Carolina Huerta ◽  
Lilia Azeneth Fuentes ◽  
Beatriz Bautista
Keyword(s):  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Race And Ethnicity ◽  
Mexican Immigrants ◽  
Group Discussion ◽  
Cultural Beliefs ◽  
Cultural Influences ◽  
Therapeutic Communication ◽  
Culturally Congruent ◽  
Nurse Practitioner Students

Increasingly, nurse practitioners serve as vanguards in providing primary health care to vulnerable Mexican immigrants. The aims of this study were to explore the lived experiences of nurse practitioner students in caring for Mexican immigrant patients and to capture their meaning of cultural influences deemed essential to the delivery of culturally congruent care. An exploratory descriptive design was employed. Purposive sampling was used to select 17 nurse practitioner students who volunteered to complete a semistructured face-to-face audio-taped interview and follow-up focus group discussion. Constant comparison was utilized to analyze data. From this process, four distinct themes emerged: Culturally congruent care extends beyond race and ethnicity, understands the importance of therapeutic communication, accepts complementary and alternative medical modalities, and recognizes the importance of eating patterns, food choices, and perceptions of ideal weight and health. These findings build on our understanding of key evidence–based cultural beliefs and practices that are important in delivering culturally congruent care to this subgroup.

Holistic Nurse Practitioner Care Including Promotion of Shared Decision-Making

2021 ◽  
pp. 089801012110627
Author(s):  
Elizabeth Kinchen
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Medical Condition ◽  
Holistic Care ◽  
Special Focus ◽  
Free Text ◽  
Shared Decision ◽  
Convenience Sample

The purpose of this quantitative, descriptive, exploratory study was to gauge the degree to which nurse practitioners (NPs) incorporate holistic nursing values in their care, with a special focus on shared decision-making (SDM), using the Nurse Practitioner Holistic Caring Instrument (NPHCI), an investigator-developed scale. A single open-ended question inviting free-text comment was also included, soliciting participants’ views on the holistic attributes of their care. A convenience sample of NPs ( n = 573) was recruited from a southeastern U.S. state Board of Nursing's (BON) publicly available list of licensed NPs. Results suggest that NPs do indeed perceive their care to be holistic, and that they routinely incorporate elements of SDM in their care. Highest scores were accorded to listening, taking time to talk to patients, knowledge of physical condition, soliciting patient input in care decisions, considering how other areas of a patient's life may affect their medical condition, and attention to “what matters most” to the patient. Age, gender, level of education, practice specialty, and location were also associated with inclusion of holistic care. Free-text responses revealed that NPs value holistic care and desire to practice holistically, but identify “lack of time” to incorporate or practice holistic care as a barrier.

An Efficient Nurse Practitioner–Led Community-Based Service Model for Delivering Coordinated Care to Persons With Serious Mental Illness at Risk for Homelessness

2017 ◽  
Vol 24 (2) ◽  
pp. 101-108 ◽  
Author(s):  
Jeannemarie Baker ◽  
Jasmine L. Travers ◽  
Penelope Buschman ◽  
Jacqueline A. Merrill
Keyword(s):  
Mental Health ◽  
At Risk ◽  
Mental Illness ◽  
Serious Mental Illness ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Quality Care ◽  
Coordinated Care ◽  
Community Based ◽  
Provide Quality Care

BACKGROUND: Access to mental health care is a struggle for those with serious mental illness (SMI). About 25% of homeless suffer from SMI, compared with 4.2% of the general population. OBJECTIVE: From 2003 to 2012, St. Paul’s Center (SPC) operated a unique model to provide quality care to the homeless and those at risk for homelessness, incarceration, and unnecessary hospitalization because of SMI. Data were available for analysis for the years 2008 to 2010. DESIGN: The SPC was developed, managed, and staffed by board-certified psychiatric/mental health nurse practitioners, offering comprehensive mental health services and coordinated interventions. RESULTS: All clients were housed and none incarcerated. From 2008 to 2010, only 3% of clients were hospitalized, compared with 7.5% of adults with SMI. Clinical, academic, and community partnerships increased value, but Medicaid reimbursement was not available. CONCLUSION: Mental health provisions in the recently passed 21st Century Cures Act support community mental health specialty treatment. The SPC provides a template for similar nurse practitioner–led models.

Telehealth in Psychiatric Nursing Education: Lessons From the Field

2018 ◽  
Vol 25 (4) ◽  
pp. 266-271 ◽  
Author(s):  
R. Lee Tyson ◽  
Susan Brammer ◽  
Diana McIntosh
Keyword(s):  
Mental Health ◽  
Nursing Education ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Clinical Education ◽  
Best Practice ◽  
Future Research ◽  
Clinical Placements ◽  
College Of Nursing ◽  
Clinical Internship

BACKGROUND: This article summarizes the experiences that a Midwest college of nursing had when telepsychiatry was introduced for psychiatric-mental health post-master’s nurse practitioner students to use in a clinical internship. AIMS: Implications for nurse practitioner educators will be identified, and recommendations for future research will be explored. METHOD: Described are the following: (1) policies and procedures the institution considered, (2) challenges that were encountered by faculty and students, and (3) strategies and limitations of these strategies defining best practice, what didactic content should be taught, and how clinical placements needed to be structured. RESULTS: Implications for nurse practitioner educators, practice, and research are identified. CONCLUSIONS: It is clear that telepsychiatry has an important role in the clinical education of psychiatric-mental health nurse practitioners. It is working well as a clinical internship option. The college of nursing is continuing to examine and address issues and is looking forward to enhancing the telepsychiatry experiences for students in the future.

Potential scope and impact of a transboundary model of nurse practitioners in aged care

2009 ◽  
Vol 15 (3) ◽  
pp. 232 ◽  
Author(s):  
Kasia Bail ◽  
Paul Arbon ◽  
Marlene Eggert ◽  
Anne Gardner ◽  
Sonia Hogan ◽  
...  
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Health Service Delivery ◽  
Aged Care ◽  
Residential Aged Care ◽  
Care Providers ◽  
Care Nurse ◽  
Residential Aged Care Facilities

Aged care is a growing issue in Australia and other countries. There are significant barriers to meeting the health needs of this population. Current services have gaps between care and lack communication and integration between care providers. Research was conducted in the Australian Capital Territory to investigate the potential role of the aged care nurse practitioner in health service delivery in aged care settings. A multimethod case study design was utilised, with three student nurse practitioners (SNP) providing care to aged care clients across three sectors of health service delivery (residential aged care facilities, general medical practices and acute care). Data collection consisted of in-depth interviews and journal entries of the SNP, as well as focus groups and surveys of multidisciplinary staff and patients over the age of 65 years in the settings frequented by the SNP. The aged care SNP were found to cross professional and organisational boundaries, cross intra- as well as interorganisational boundaries and to contribute to more seamless patient care as members of a multidisciplinary aged care team. The aged care nurse practitioner role consequently has the potential to function in a networked rather than a hierarchical manner, and this could be a key element in addressing gaps in care across care locales and between disciplines.

The Future of Pediatric Nurse Practitioners

PEDIATRICS ◽  
1979 ◽  
Vol 64 (1) ◽  
pp. 113-114
Author(s):  
Loretta C. Ford
Keyword(s):  
Nursing Education ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Master's Level ◽  
Pediatric Nurse ◽  
Funding Sources ◽  
Physician Participation ◽  
The Future ◽  
Pediatric Nurse Practitioners

Kahn's article, "The Influence of Funding on the Future of Nurse Practitioner Programs" (p 106) presents the thesis that despite the effectiveness of and the need for nurse prcb actitioners, future programs are in jeopardy because funding sources are inadequate and, further, that the trend to prepare nurse practitioners at the master's level will discourage physician participation to the detriment of the program. I share some of Kahn's concerns on the former issue and challenge him on the latter. My response to Kahn's work, focusing first on the latter issue, offers information and opinion on historic, academic, and professional dimensions of the discussion; clarifies some misconceptions of the nurse practitioner movement and nursing education; and raises questions about the future.

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