The Role of the Neonatal Nurse Practitioner in the Community Hospital Level I Nursery

2012 ◽  
Vol 31 (3) ◽  
pp. 141-147 ◽  
Author(s):  
Julie Hatch
Keyword(s):  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Neonatal Intensive Care ◽  
Community Hospital ◽  
Clinical Care ◽  
Advanced Practice Nursing ◽  
Tertiary Center ◽  
Neonatal Nurse Practitioners ◽  
Level I ◽  
Nursing Roles

Neonatal nurse practitioners (NNPs) have played a significant role in providing medical coverage to many of the country’s Level III neonatal intensive care units (NICUs). Extensive education and experience are required for a nurse practitioner (NP) to become competent in caring for these critically ill newborns. The NNP can take this competence and experience and expand her role out into the community Level I nurseries. Clinical care of the infants and close communication with parents, pediatricians, and the area tertiary center provide a community service with the goal of keeping parents and babies together in the community hospital without compromising the health of the baby. The NNP service, with 24-hour nursery and delivery coverage, supports an ongoing obstetric service to the community hospital. The NNP’s experience enables her to provide a neonatal service that encompasses a multitude of advanced practice nursing roles.

Neonatal nurse practitioner ethics knowledge and attitudes

2018 ◽  
Vol 26 (7-8) ◽  
pp. 2247-2258
Author(s):  
Mobolaji Famuyide ◽  
Caroline Compretta ◽  
Melanie Ellis
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Nurse Practitioners ◽  
Neonatal Intensive Care ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Neonatal Nurse Practitioners

Background: Neonatal nurse practitioners have become the frontline staff exposed to a myriad of ethical issues that arise in the day-to-day environment of the neonatal intensive care unit. However, ethics competency at the time of graduation and after years of practice has not been described. Research aim: To examine the ethics knowledge base of neonatal nurse practitioners as this knowledge relates to decision making in the neonatal intensive care unit and to determine whether this knowledge is reflected in attitudes toward ethical dilemmas in the neonatal intensive care unit. Research design: This was a prospective cohort study that examined decision making at the threshold of viability, life-sustaining therapies for sick neonates, and a ranking of the five most impactful ethical issues. Participants and research context: All 47 neonatal nurse practitioners who had an active license in the State of Mississippi were contacted via e-mail. Surveys were completed online using Survey Monkey software. Ethical considerations: The study was approved by the University of Mississippi Medical Center Institutional Review Board (IRB; #2015-0189). Findings: Of the neonatal nurse practitioners who completed the survey, 87.5% stated that their religious practices affected their ethical decision making and 76% felt that decisions regarding life-sustaining treatment for a neonate should not involve consultation with the hospital’s legal team or risk management. Only 11% indicated that the consent process involved patient understanding of possible procedures. Participating in the continuation or escalation of care for infants at the threshold of viability was the top ethical issue encountered by neonatal nurse practitioners. Discussion: Our findings reflect deficiencies in the neonatal nurse practitioner knowledge base concerning ethical decision making, informed consent/permission, and the continuation/escalation of care. Conclusion: In addition to continuing education highlighting ethics concepts, exploring the influence of religion in making decisions and knowing the most prominent dilemmas faced by neonatal nurse practitioners in the neonatal intensive care unit may lead to insights into potential solutions.

Potential Crisis in Nurse Practitioner Preparation in the United States

2019 ◽  
Vol 20 (2) ◽  
pp. 57-63 ◽  
Author(s):  
Mary O'Neil Mundinger ◽  
Michael A. Carter
Keyword(s):  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
American Association ◽  
Clinical Care ◽  
The United States ◽  
Position Statement ◽  
Historical Background ◽  
Policy Position ◽  
Colleges Of Nursing ◽  
Practitioner Education

The Doctor of Nursing Practice (DNP) degree was established to expand nurse practitioner education by adding new competencies. In 2004, the American Association of Colleges of Nursing released a position statement that redefined practice from only clinical care of patients to include nonclinical care. This policy position likely contributed to the rapid growth of DNP programs. Historical background on the development of the DNP is provided. An analysis was conducted of the programs reported in the American Association of Colleges of Nursing list of accredited DNP programs between 2005 and 2018 to compare whether the programs prepared graduates for advanced clinical practice or administrative or leadership. During this time, 553 DNP programs were established, 15% ( n = 83) are clinical, and 85% ( n = 470) are nonclinical. The adequate production of nurse practitioners in the future may be in jeopardy with this imbalance in educational resources, especially with the nation's growing need for primary care clinicians.

scholarly journals P080: Clinical lead nurse practitioner Strathcona Community Hospital

CJEM ◽  
2018 ◽  
Vol 20 (S1) ◽  
pp. S85-S85
Author(s):  
D. K. Klemmer ◽  
C. Ziebel ◽  
N. Sharif ◽  
S. Grubb ◽  
S. Sookram
Keyword(s):  
Emergency Department ◽  
Quality Improvement ◽  
Patient Satisfaction ◽  
Service Delivery ◽  
Nurse Practitioner ◽  
Community Hospital ◽  
Clinical Care ◽  
Family Physicians ◽  
Lost To Follow Up

Introduction: Prior to opening Strathcona Community Hospital (STCH) site leadership were tasked to develop an innovative care model. The central aim was quality improvement and patient safety optimization in the emergency department (ED) utilizing a nurse practitioner (NP) model. They developed 3 pillars: collaboration, multidisciplinary approach, and integration with the plan of improving patient satisfaction and ensuring no patient gets lost to follow up. NPs work in the STCH ED and the NP led Emergency Department Transition (EDT) Clinic in Ambulatory Care. In the ED NPs provide direct clinical care, judicious review of DI and microbiology reports, and care coordination for patients at risk of lost to follow up. The EDT clinic is an innovative NP lead clinic with the purpose of providing timely, high-quality follow up care for ED patients. Methods: Data for the service delivery indicators came from data repository and manual data collection looking at the following outcomes: timely review of DI/micro results; decreased ED visits for non-urgent/emergent issues; safe transitions in care and improved patient satisfaction. Quantitative data from service delivery, patient and surveys were analyzed using Microsoft Excel and SPSS 19. Results: From June 2016 to January 2017 ED NPs at STCH reviewed 3000 positive microbiology reports and made 517 f/u calls to those patients, and reviewed 3181 DI results. This has freed up approximately 2 hrs per day of ED physician time. When NPs were working in the ED, the number of patients who left without treatment (LWT) was approximately 50% less, and improved STCH ED wait times to be among the lowest in the Edmonton Zone. From June 2016 to January 2017, EDT NPs completed 837 patient visits; 371 letters to family physicians (FPs); 215 referrals; and connected 520 patients to a new FP. Patient satisfaction survey show 88-90% of the patients were satisfied with their care. Conclusion: NPs are integral members of the ED team at STCH, providing direct clinical care and several valuable follow up services for ED patients. The EDT clinic provides urgent follow up for ED patients unable to get a timely appointment with their FP or no access to primary care. The clinic also prevents unnecessary returns to ED, and aids to bridge ED services to family physicians or specialist. NPs are the common thread through all departments at STCH, contributing to quality improvement and high patient satisfaction.

Holistic Nursing Values in Nurse Practitioner Education

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Elizabeth Kinchen
Keyword(s):  
Nursing Education ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
High Reliability ◽  
Reliability And Validity ◽  
Advanced Practice Nursing ◽  
Patient Centered ◽  
Holistic Nursing ◽  
Nursing Values ◽  
Practitioner Education

AbstractMuch has been written about the inclusion of holistic nursing values and practices in undergraduate nursing education, but their inclusion and influence in advanced practice nursing education has not been fully explored. Nurse practitioners (NPs) are nurses, so it is assumed that the nursing perspective provides a framework for NP education and practice, and that NP education represents the blending of a holistic nursing approach with medical diagnosis and treatment. Nurse practitioners are taking increasing responsibility for filling the gap in primary healthcare availability in the U.S., and in the current political and economic healthcare climate, NPs are in a position to promote primary care models that honor comprehensive, patient-centered, and relationship-based care. As a result, it becomes essential to quantify the inclusion of these values in NP educational programs and coursework, as instilling core values for practice begins in educational environments. This quantitative, descriptive study explored the inclusion of holistic nursing values by NP faculty, using the Nurse Practitioner Holistic Caring Instrument (NPHCI). The NPHCI exhibited quite high reliability and validity in the sample, including confirmation of its three subscales. Survey results suggest that NP faculty actively incorporate holistic nursing values in educational coursework, and that age, length of time teaching in NP programs, highest educational degree, and academics as the primary area of practice were important indicators of the inclusion of holistic nursing values in NP program curricula. Findings add to knowledge of NP education, but further study is warranted.

Yet Another Degree for the Nursing Profession

2005 ◽  
Vol 24 (4) ◽  
pp. 7-7
Author(s):  
Gail McCain
Keyword(s):  
Nurse Practitioners ◽  
Position Statement ◽  
Nurse Anesthetists ◽  
Advanced Practice Nursing ◽  
Advanced Practice ◽  
Doctor Of Nursing Practice ◽  
Clinical Nurse Specialists ◽  
Neonatal Nurse Practitioners ◽  
Professional Degree ◽  
Practice Doctorate

THE AMERICAN ASSOCIATION OF COLLEGES OF NURSING (AACN) issued a position statement on the practice doctorate in nursing in October of 2004.1 It proposes a terminal professional degree, doctor of nursing practice (DNP), to replace the master’s degree in nursing as preparation for advanced practice nursing. Advanced practice nursing refers to certified nurse practitioners (e.g., neonatal nurse practitioners), certified nurse midwives, certified nurse anesthetists, and clinical nurse specialists.

scholarly journals Using the PEPPA Framework to Develop and Implement a Nurse Practitioner Role Within Canada’s National Ballet School

2021 ◽  
Vol 1 (1) ◽  
pp. 10-22
Author(s):  
Erin Ziegler ◽  
Sophia Kim ◽  
Rachel J. Bar
Keyword(s):  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Advanced Practice Nursing ◽  
Health And Wellness ◽  
Physical And Mental Health ◽  
Wellness Program ◽  
Nursing Role ◽  
Dance Training ◽  
Timely Access ◽  
Practitioner Role

Aim: To outline the successful development and implementation of a nurse practitioner role within a professional ballet school. Background: Nurse practitioners are well integrated into primary and acute care in Ontario, yet the role within schools and private athletic institutions is not well documented. Canada’s National Ballet School is a professional ballet school with a combination of day students and those living in residences. Students complete both dance training and academics at the School. The physical and mental health of students was identified as a key priority by the school, leading to the development of an integrated health and wellness program. To facilitate more timely access to healthcare and provide an opportunity for collaboration and consultation within the school, a plan to implement a nurse practitioner role into the school was developed. Methods: In order to develop and implement the role of the nurse practitioner within the institution, the participatory, evidence-based, patient-focused process for advanced practice nursing role development, implementation, and evaluation (PEPPA) framework was used. The first seven steps of the PEPPA framework were applied in this project. Findings: The PEPPA framework allowed for us to identify key barriers and facilitators for the role implementation and successfully implement the nurse practitioner role. While the initial plan was for a slower implementation, the COVID-19 pandemic highlighted the need for a nurse practitioner in the institution more urgently. Conclusion: The PEPPA framework provided us with an organized process for developing and implementing the nurse practitioner role at Canada’s National Ballet School.

scholarly journals 23 Current Trends in Canada in Neonatal Palliative Care

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e8-e9
Author(s):  
Gillian MacLean ◽  
Alessia Gallipoli ◽  
Ayla Raabis
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Nurse Practitioners ◽  
Policy Development ◽  
Neonatal Intensive Care ◽  
Vital Role ◽  
Primary Objective ◽  
Provider Education ◽  
Palliative Care Teams ◽  
Neonatal Nurse Practitioners

Abstract Background The area of palliative care in pediatrics has been expanding, as evidence emphasizes the benefits of providing pediatric patients and their families with optimized care in cases of chronic illness and end-of-life. The majority of pediatric deaths occur in infants under one year, with significant portions of these deaths taking place in Neonatal Intensive Care Units (NICU). The expansion of palliative care into neonatal medicine is of significant importance, as symptom management and end-of-life care plays a vital role in providing complete care to these infants. Guidelines that have been put into place can vary significantly between centers. Published studies in neonatal palliative care (PC) describe these challenges, however little data currently exists specific to Canadian NICUs. Objectives The primary objective was to gather information about current practice trends and themes around barriers in neonatal PC. Design/Methods An anonymous survey was distributed to Canadian Level 3 NICU staff, including neonatologists, neonatal nurse practitioners (NP), and neonatal fellows through the Qualtrics platform. Surveys were distributed through email and responses tracked in the Qualtrics system. Results The survey response rate was 57. The majority of respondents were neonatologists (50%), with many having more than 5 years of experience. Provision of palliative care was common with 20/57 respondents being involved in 5 or more cases in the past year. Only 40% of respondents reported that neonatologists and neonatal NPs received palliative care training at their center. When education did exist, lectures (31%) and workshops (26%) were most common. 97% said their centre would benefit from more education. 53% of respondents said their center had an established guideline around neonatal PC, 20% did not know and 27% answered no. Only 8% of respondents who work at centres with a guideline found that it was consistently followed. Respondents were asked to identify barriers to implementation at their place of practice. Common responses noted challenges in NICU collaborations with maternal-fetal medicine and palliative care teams, as well as lack of education and providers’ personal beliefs. Lastly, respondents provided details of their guidelines or common practices in PC which has been collated and summarized. Conclusion The results provide a snapshot of the current palliative care practices in academic NICUs across Canada. Overall the results were positive with many centers having a guideline and some provider education. The perceived barriers highlight focus areas for future education and policy development, and emphasize the importance of improved collaboration moving forward.

Using the PEPPA framework to develop the nurse practitioner role in emergency care: Critical reflections

2021 ◽  
pp. 205715852098847
Author(s):  
Erika Boman ◽  
Kim Gaarde ◽  
Rika Levy-Malmberg ◽  
Frances Kam Yuet Wong ◽  
Lisbeth Fagerström
Keyword(s):  
Emergency Department ◽  
Nurse Practitioner ◽  
Current Model ◽  
Models Of Care ◽  
Advanced Practice Nursing ◽  
Model Of Care ◽  
New Model ◽  
New Models ◽  
Nursing Roles ◽  
Practitioner Role

In this article, we describe and critically reflect on how the PEPPA framework, a Participatory Evidence-based Patient-focused Process for Advanced Practice Nursing, was used to develop a new model of care including the nurse practitioner (NP) role in an emergency department in Norway, where the role is in its infancy. While there is limited earlier research on the applicability of the PEPPA framework, it was here found to be useful. Supported by the framework, we mapped the current model of care, identified stakeholders and participants, determined the need for a new model of care, identified priority problems and goals, and defined the new model of care and the NP role. The PEPPA framework is recommended to develop new models of care including the NP role. Nonetheless, the process has not been straightforward. It is noted that to communicate and establish the new role in a setting as demanding as an emergency department takes time. Support from the management team is essential to succeed in developing and establishing new models of care and new nursing roles, such as the nurse practitioner role.

Handbook of Neonatal Intensive Care (6th Edition)

2007 ◽  
Vol 26 (2) ◽  
pp. 136-136 ◽  
Author(s):  
Gerald Merenstein ◽  
Sandra Gardner
Keyword(s):  
Intensive Care ◽  
Nurse Practitioners ◽  
Neonatal Intensive Care ◽  
Multidisciplinary Care ◽  
Spelling Error ◽  
Reference Book ◽  
Sixth Edition ◽  
Entry Level ◽  
Neonatal Nurse Practitioners ◽  
Multidisciplinary Care Team

Handbook of Neonatal Intensive Care (6th Edition) is a comprehensive, well-written clinical reference book that remains a cornerstone reference for the neonatal nurse. The sixth edition continues to provide an inclusive reference for the neonatal intensive multidisciplinary care team, from staff nurses to house staff and entry-level neonatal nurse practitioners. There are a few distractions in this professional and quality reference book, including some figures that are dated, if not antiquated, and the occasional noteworthy spelling error.

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