Advanced Practice Registered Nurses: Gateway to Screening for Bipolar Disorder in Primary Care

Objective: The goal of this mixed methods descriptive study was to explore Advanced Practice Registered Nurses’ (APRNs’) knowledge of bipolar disorder (BPD) and their perceptions of facilitators and barriers to screening patients with known depression for BPD. Methods: A mixed method study design using surveys on BPD knowledge and screening practices as well as focus group data collection method for facilitators and barriers to screening. Results: 89 APRNs completed the survey and 12 APRNs participated in the focus groups. APRNs in any practice setting had low knowledge scores of BPD. No significant differences in screening for BPD for primary and non primary care APRNs. Qualitative findings revealed screening relates to tool availability; time, unsure of when to screen, fear of sigma, symptoms knowledge of BPD, accessible referral system, personal experiences with BPD, and therapeutic relationships with patients. Conclusion: Misdiagnosis of BPD as unipolar depression is common in primary care settings, leading to a long lag time to optimal diagnosis and treatment. The wait time to diagnosis and treatment could be reduced if APRNs in primary care settings screen patients with a diagnosis of depression by using validated screening tools. These results can inform APRN practice and further research on the effectiveness of screening for reducing the morbidity and mortality of BPDs in primary care settings; underscores the need for integration of mental health care into primary care as well as the need for more APRN education on the diagnosis and management of bipolar disorders.

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Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care

Nursing Outlook ◽

10.1016/j.outlook.2017.10.002 ◽

2017 ◽

Vol 65 (6) ◽

pp. 761-765 ◽

Cited By ~ 6

Author(s):

Jordon Bosse ◽

Katherine Simmonds ◽

Charlene Hanson ◽

Joyce Pulcini ◽

Lynne Dunphy ◽

...

Keyword(s):

Primary Care ◽

Registered Nurses ◽

Position Statement ◽

Advanced Practice ◽

Advanced Practice Registered Nurses

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Health Care Provider Perceptions of Consumer-Grade Devices and Apps for Tracking Health: A Pilot Study (Preprint)

10.2196/preprints.9929 ◽

2018 ◽

Author(s):

Bree Holtz ◽

Kerri Vasold ◽

Shelia Cotten ◽

Michael Mackert ◽

Mi Zhang

Keyword(s):

Physical Activity ◽

Primary Care ◽

Mobile Phone ◽

Registered Nurses ◽

Primary Care Physicians ◽

Future Research ◽

Advanced Practice ◽

Provider Perceptions ◽

Clinical Encounters ◽

Advanced Practice Registered Nurses

BACKGROUND The use of Web- or mobile phone–based apps for tracking health indicators has increased greatly. However, provider perceptions of consumer-grade devices have not been widely explored. OBJECTIVE The purpose of this study was to determine primary care physicians’ and advanced practice registered nurses’ perceptions of consumer-grade sensor devices and Web- or mobile phone–based apps that allow patients to track physical activity, diet, and sleep. METHODS We conducted a cross-sectional mailed survey with a random sample of 300 primary care physicians and 300 advanced practice registered nurses from Michigan, USA. Providers’ use and recommendation of these types of technologies, and their perceptions of the benefits of and barriers to patients’ use of the technologies for physical activity, diet, and sleep tracking were key outcomes assessed. RESULTS Most of the respondents (189/562, 33.6% response rate) were advanced practice registered nurses (107/189, 56.6%). Almost half of the sample (93/189, 49.2%) owned or used behavioral tracking technologies. Providers found these technologies to be helpful in clinical encounters, trusted the data, perceived their patients to be interested in them, and did not have concerns over the privacy of the data. However, the providers did perceive patient barriers to using these technologies. Additionally, those who owned or used these technologies were up to 6.5 times more likely to recommend them to their patients. CONCLUSIONS Our study demonstrated that many providers perceived benefits for their patients to use these technologies, including improved communication. Providers’ concerns included their patients’ access and the usability of these technologies. Providers who encountered data from these technologies during patient visits generally perceive this to be helpful. We additionally discuss the barriers perceived by the providers and offer suggestions and future research to realize the potential benefits to using these data in clinical encounters.

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