scholarly journals Knowledge and Opinions Regarding the Interface between Oral and Overall Health among California Physicians, Dentists, Pharmacists and Advanced Practice Registered Nurse Practitioners

2017 ◽  
Vol 15 (2) ◽  
pp. 59-68 ◽  
Author(s):  
Paul Gavaza ◽  
Wonha Kim ◽  
Thomas Rogers ◽  
Eileen Fry-Bowers ◽  
Rashid Mosavin
Keyword(s):  
Oral Health ◽  
Registered Nurses ◽  
Nurse Practitioners ◽  
Health Professionals ◽  
Dental Health ◽  
Primary Care Providers ◽  
Advanced Practice ◽  
Care Providers ◽  
Total N ◽  
Advanced Practice Registered Nurses

Background and Purpose: Oral health is often related to other medical conditions. This study investigated the knowledge and opinions of California physicians, dentists, pharmacists, and advanced practice registered nurses (APRNs) regarding the interface between oral and overall health and their suggestions for strengthening this interface. Methods: A survey packet was mailed to randomly-selected California healthcare providers in Winter 2015. Twenty five-point Likert-type questions were used to measure the providers’ knowledge and opinions of the oral and overall health interface. Results: Sixtytwo physicians, 117 dentists, 136 pharmacists, and 289 Advanced Practice Registered Nurses (APRNs) responded (total N= 604). A majority of all health professionals agreed/strongly agreed that oral health topics received little attention in the education of non-dental health professionals (n=499, 82.6%), and that the dental discipline remains relatively segregated from other healthcare disciplines (n=500, 82.8%). Dentists and APRNs were more likely to agree/agree strongly that the inadvertent prescribing of medications that can have xerostomic effects without considering their oral health implications is a major problem. Conclusion: There is a need for more inter-professional collaboration by all primary care providers in managing the patients’ oral and overall health, as well as more oral health education and training for all non-dental health professionals.

Understanding the Roles, Responsibilities, and Competencies of Advanced Practice Registered Nurses: Instrument Development and Psychometric Testing

2019 ◽  
Vol 27 (1) ◽  
pp. 33-48 ◽  
Author(s):  
Polly Petersen ◽  
Christina Sieloff ◽  
Lillian S. Lin ◽  
Susan J. Wallace Raph
Keyword(s):  
Factor Analysis ◽  
Registered Nurses ◽  
Content Validity ◽  
Psychometric Testing ◽  
Primary Care Providers ◽  
Advanced Practice ◽  
Care Providers ◽  
New Instrument ◽  
Advanced Practice Registered Nurses ◽  
Using Data

Background and PurposeDemand for primary care providers increases value for advanced practice registered nurses (APRNs) to assume more independent roles. The purpose was to develop a reliable, valid instrument to measure roles, responsibilities, and competencies reflective of autonomous practice for APRNs.MethodsConceptual literature motivated development of a new instrument. Validity was initially evaluated through expert content review. Reliability of proposed scales was evaluated and possible underlying constructs were identified through factor analysis using data from a pilot study.ResultsContent validity for the instrument was high (content validity index [CVI] 88). The 16-item instrument is highly reliable (Cronbach's alpha of 0.81). Cronbach's alphas for subscales ranged from 0.60 to 0.75. Factor analysis identified four components.ConclusionsThe Petersen Sieloff Assessment of Advanced Practice (PSAAP) demonstrated initial reliability. Additional examination is warranted to further improve the factor structure.

scholarly journals Current Weight Management Approaches Used by Primary Care Providers in Six Multidisciplinary Healthcare Settings in Ontario

2018 ◽  
Vol 50 (4) ◽  
pp. 169-178 ◽  
Author(s):  
Stephanie Aboueid ◽  
Monika Jasinska ◽  
Ivy Bourgeault ◽  
Isabelle Giroux
Keyword(s):  
Primary Care ◽  
Weight Management ◽  
Nurse Practitioners ◽  
Health Professionals ◽  
Primary Care Providers ◽  
Management Approach ◽  
Care Providers ◽  
Allied Health Professionals ◽  
Income Status ◽  
Management Approaches

Background Obesity management in primary care has been suboptimal due to lack of access to allied health professionals, time, and resources. Purpose To understand the weight management approaches used by primary care providers working in team-based settings and how they assess the most suitable approach for a patient. Methods A total of 20 primary care providers (13 nurse practitioners and 7 family physicians) working in 6 multidisciplinary clinics in Ontario were interviewed. All interviews were recorded, transcribed verbatim, and coded using NVivo qualitative software. Conventional content analysis was used to inductively elucidate codes, which were then clustered into categories. Results A referral to on-site programming was the most frequent weight management approach used. The pharmacological approach was underutilized due to adverse side effects and cost to patients. Primary care providers assessed the most suitable weight management approach based on patients’: preference, level of motivation, income status and access to resources, body mass index and comorbidities, and previous weight loss attempts. Primary care providers perceived that referring to health professionals and educational resources were the approaches preferred by patients. Conclusions The team-based nature of these clinics allowed for referrals to various on-site professionals and/or programs. Some barriers to pursuing weight management avenues with patients were patient dependent.

scholarly journals VitalSign6: A Primary Care First (PCP-First) Model for Universal Screening and Measurement-Based Care for Depression

2019 ◽  
Vol 12 (2) ◽  
pp. 71 ◽  
Author(s):  
Madhukar Trivedi ◽  
Manish Jha ◽  
Farra Kahalnik ◽  
Ronny Pipes ◽  
Sara Levinson ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Universal Screening ◽  
Primary Care Providers ◽  
The United States ◽  
Care Providers ◽  
Similar Treatment ◽  
Measurement Based Care

Major depressive disorder affects one in five adults in the United States. While practice guidelines recommend universal screening for depression in primary care settings, clinical outcomes suffer in the absence of optimal models to manage those who screen positive for depression. The current practice of employing additional mental health professionals perpetuates the assumption that primary care providers (PCP) cannot effectively manage depression, which is not feasible, due to the added costs and shortage of mental health professionals. We have extended our previous work, which demonstrated similar treatment outcomes for depression in primary care and psychiatric settings, using measurement-based care (MBC) by developing a model, called Primary Care First (PCP-First), that empowers PCPs to effectively manage depression in their patients. This model incorporates health information technology tools, through an electronic health records (EHR) integrated web-application and facilitates the following five components: (1) Screening (2) diagnosis (3) treatment selection (4) treatment implementation and (5) treatment revision. We have implemented this model as part of a quality improvement project, called VitalSign6, and will measure its success using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework. In this report, we provide the background and rationale of the PCP-First model and the operationalization of VitalSign6 project.

Improving Primary Care Access to Respirologists Using eConsult

2021 ◽  
Author(s):  
Jean-Grégoire Leduc ◽  
Erin Keely ◽  
Clare Liddy ◽  
Amir Afkham ◽  
Misha Marovac ◽  
...  
Keyword(s):  
Primary Care ◽  
Median Time ◽  
Nurse Practitioners ◽  
Clinical Course ◽  
Primary Care Providers ◽  
Clinical Question ◽  
Care Providers ◽  
Provider Perspectives ◽  
Course Of Action ◽  
The Impact

Abstract Background: Patients and primary care providers (PCP) can experience frustration about poor access to specialist care. The Champlain Building Access to Specialists through eConsultation (BASETM) is a secure online platform that allows PCPs to ask a clinical question to 142 different specialty groups. The specialist is expected to respond within 7 days. Methods: This is a retrospective review of the Champlain BASETM respirology eConsults from January 2017 to December 2018. The eConsults were categorized by types of question asked by the referring provider, and by the clinical content of the referral. Specialists’ response time and time spent answering the clinical question was analyzed. Referring providers close out surveys were reviewed to assess the impact of the respirology eConsult service on traditional referral rates and clinical course of action. Results: Of the 26,679 cases submitted to the Champlain BASE TM eConsult service 268 were respirology cases (1%). 91% were sent by family physicians, 9% by nurse practitioners. The median time to respond by specialists was 0.8 days, and the median time billed by specialists was 20 minutes. The most common topics were pulmonary nodules and masses (16.4%), cough (10.4%), infective problems (8.6%), COPD (8.6%) and dyspnea NYD (7.8%). The most common types of question asked by PCP were related to investigations warranted (43.1% of cases), general management (17.5%), monitoring (12.6%), need for a respirology referral (12.3%), and drug of choice (6.3%). In 23% of cases the PCP indicated they were planning to refer the patient and no longer need to (avoided referrals) and in 13% of cases the PCP was not going to refer but did after receiving the eConsult advice (prompted referrals). The eConsult led to a new or additional clinical course of action by the PCP in 49% of cases. In 51% of cases the PCP suggested the clinical topic would be well suited to a CME event. Conclusions: Participation in eConsult services can improve timely access to respirologists while potentially avoiding clinic visit and significantly impacting referring PCPs clinical course of action. Using the most common clinical topics and types of question for CME planning should be considered. Future research may include a cost analysis, and provider perspectives on the role of eConsult in respirology care.

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