Acute Care Nurse Practitioners: Creating and Implementing a Model of Care for an Inpatient General Medical Service

2002 ◽  
Vol 11 (5) ◽  
pp. 448-458 ◽  
Author(s):  
Jill N. Howie ◽  
Mitchel Erickson
Keyword(s):  
Acute Care ◽  
Nurse Practitioners ◽  
Medical Service ◽  
Medical Center ◽  
Academic Medical Center ◽  
Public Funding ◽  
General Medical Service ◽  
Care Nurse ◽  
Insurance Reimbursement ◽  
Academic Medical

Changes in medical education and healthcare reimbursement are recent threats to most academic medical centers’ dual mission of patient care and education. Financial pressures stem from reduced insurance reimbursement, capitation, and changes in public funding for medical residency education. Pressures for innovation result from increasing numbers of patients, higher acuity of patients, an aging population of patients with complex problems, and restrictions on residency workloads. A framework for addressing the need for innovation in the medical service at a large academic medical center is presented. The framework enables acute care nurse practitioners to provide inpatient medical management in collaboration with a hospitalist. The model’s development, acceptance, successes, pitfalls, and evaluation are described. The literature describing the use of nurse practitioners in acute care settings is reviewed.

Impact of Clinical Nurse Specialist Roles on COVID-19 Pandemic Care

2020 ◽  
Vol 14 (3) ◽  
pp. 141-146
Author(s):  
Kathleen Posa-Kearney ◽  
Samantha M. Aranda ◽  
Elizabeth M. Day ◽  
Erin Dowding ◽  
Kristen Fisher ◽  
...  
Keyword(s):  
Nurse Practitioners ◽  
Medical Center ◽  
Academic Medical Center ◽  
Nurse Specialist ◽  
Critical Care Nursing ◽  
Clinical Nurse ◽  
Certified Registered Nurse Anesthetists ◽  
Practice Nurses ◽  
Clinical Nurse Specialists ◽  
Academic Medical

Advanced practice nurses including nurse practitioners, clinical nurse specialists (CNS), certified registered nurse anesthetists, and certified nurse midwives contribute in many ways to improve care in the intensive care unit. This article reports on the roles of the CNS at an academic medical center and how they contribute to improving patient outcomes and support critical care nursing practice during the COVID-19 pandemic.

Implementation of the Acute Care Nurse Practitioner Role

1994 ◽  
Vol 5 (3) ◽  
pp. 404-407
Author(s):  
Lynn A. Kelso ◽  
Lori M. Massaro
Keyword(s):  
Acute Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Medical Center ◽  
Care Nurse ◽  
University Of Pittsburgh ◽  
Acute Care Nurse Practitioner ◽  
The University ◽  
Pittsburgh Medical ◽  
Practitioner Role

In this article, the experiences of two new acute care nurse practitioners working at the University of Pittsburgh Medical Center arc described. Included are the experiences they encountered in initiating the role and some of the responsibilities they assumed.

A chemotherapy privileging process for advanced practice providers at an academic medical center

2019 ◽  
Vol 26 (1) ◽  
pp. 116-123
Author(s):  
Michelle A Carrasquillo ◽  
Tyler A Vest ◽  
Jill S Bates ◽  
Aimee Faso ◽  
Jessica Auten ◽  
...  
Keyword(s):  
Supportive Care ◽  
Nurse Practitioners ◽  
Medical Center ◽  
Academic Medical Center ◽  
Physician Assistants ◽  
Advanced Practice ◽  
Training Process ◽  
Academic Medical ◽  
The Creation ◽  
Oncology Practice

Purpose Nurse practitioners, physician assistants, and pharmacists are advanced practice providers who are highly trained and qualified healthcare professionals that can help support traditional demands on oncologists' increased time in direct patient care. The purpose of this study was to detail and assess the creation of a privileging process for this group of medical professionals within an academic medical center. Obtaining the designation of limited oncology practice provider (LOPP) gives the right to modify chemotherapy orders and to order supportive care medications. Methods An interdisciplinary team developed a comprehensive training process inclusive of required educational domains, knowledge goals, and educational activities to become an LOPP. In 2018, five years after the implementation of the privileging process, a survey was distributed to assess perceptions of the training process and integration of LOPPs within oncology practice. Results Most oncologists noted that working with LOPPs is beneficial to oncology practice (94%) and that they make modifying chemotherapy orders more efficient (87%). Greater than 82% of LOPPs also reported that their privileges streamline the chemotherapy process and make them feel valuable. Conclusion The creation of the LOPP designation is an effective way to integrate nurse practitioners, physician assistants, and pharmacists within oncology practice. The inclusion of a focused privileging process ensures the safety of cancer care provided and has created a streamlined process for chemotherapy modifications and supportive care.

Discovery and Development of Pregabalin (Lyrica): The Role of Public Funding

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012730
Author(s):  
Rachel Barenie ◽  
Jonathan Darrow ◽  
Jerry Avorn ◽  
Aaron Kesselheim
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Public Funding ◽  
Publicly Funded ◽  
Fda Approval ◽  
Academic Medical ◽  
Northwestern University ◽  
Core Project ◽  
Key Terms

Background:Pregabalin (Lyrica), a widely used drug that has generated billions in revenue as a treatment for diabetic neuropathy and other conditions, was originally discovered in an academic medical center, largely supported by public funding.Objective:To define the extent of direct federal public funding that contributed to various stages of pregabalin’s development prior to Food and Drug Administration (FDA) approval.Methods:We identified key research, scientists and organizations involved in the development of pregabalin from its discovery through FDA approval. Using key terms (e.g., its indications and mechanism of action), we searched PubMed for relevant publications and determined whether each publication was based on federal public funding, using the National Institutes of Health RePORTER. For each award prior to the drug’s FDA approval, we scored its potential relatedness to pregabalin’s development based on its title, investigator, and organization, and then examined descriptions of the most relevant awards to aid in defining these relationships. The budgets for all related awards were converted to 2020 dollars.Results:Pregabalin was discovered largely on the basis of publicly funded research at Northwestern University; in 1990, it was licensed to Parke-Davis which further developed it through its FDA approval in 2004. Most key terms were related to the drug and drug-target (n=5) and organizations involved (n=5), followed by patent-listed inventors (n=3). These key terms linked 6,438 core project awards, and we identified 37 NIH awards related to pregabalin’s development: 9 awards through 1990 ($3.3 million) and 28 from 1991-2004 ($10.5 million).Conclusions:Like many other widely-sold medications, the development of pregabalin relied on public-sector as well as industry contributions to its discovery, with relevant NIH awards totaling $13.8 million during its pre-approval development.

scholarly journals Physician Workforce Response to the COVID-19 Pandemic at an Academic Medical Center

2020 ◽  
pp. 1-4
Author(s):  
Laurie G. Jacobs ◽  
Jason A. Korcak ◽  
Marygrace Zetkulic
Keyword(s):  
Acute Care ◽  
Medical Center ◽  
Academic Medical Center ◽  
Care Physician ◽  
Physician Workforce ◽  
Acute Hospital Care ◽  
Face To Face ◽  
Personal Risk ◽  
Academic Medical ◽  
Training Compensation

ABSTRACT Objectives: The aim of this study was to describe the planning, implementation, and outcome of an acute care physician supplemental workforce during the local coronavirus disease 2019 (COVID-19) surge at a 771-bed academic medical center, from March 25 to May 5, 2020, in New Jersey, United States. Methods: The Department of Medicine sought participation by “independent” and redeployed “employed” physicians to provide acute hospital care, as well as assistance with occupational health and family communication. Plans addressed training, compensation, clinical privileges, malpractice, and collaboration with the existing hospitalist service. Results: Redeployed employed physicians (81% internists) selected either acute care (n = 68; median age, 52 y [range, 32-72 y]; 28% female) or non-face-to-face supportive roles (n = 69; median age, 52 y [range, 32-84 y]; 28% female). The redeployed physician group totaled 474 twelve-h daytime shifts typically caring for 10 patients per day. Six employed physicians refused redeployment, and only 3 independent physicians participated (all acute care). Of note, COVID-19 infection occurred in 10 hospitalists and intensivists, and in several redeployed physicians. Conclusions: Successful physician workforce staffing for medical disasters, such as the COVID-19 pandemic, requires consideration of personal risk, as well as medicolegal, financial, and clinical competency issues.

Deprescribing Medications Among Older People to Reduce Polypharmacy at a Comprehensive Academic Medical Center

2021 ◽  
Vol 36 (4) ◽  
pp. 208-216
Author(s):  
Stella Ye ◽  
Sarah Boyko ◽  
Melissa Patel ◽  
Kruti Shah ◽  
Sara Turbow ◽  
...  
Keyword(s):  
Older People ◽  
Acute Care ◽  
Medical Center ◽  
Academic Medical Center ◽  
The Elderly ◽  
Control Group ◽  
Control Groups ◽  
Care For The Elderly ◽  
Academic Medical ◽  
And Control

OBJECTIVE: To evaluate deprescribing of select high-risk medications (HRMs) in an Acute Care for the Elderly (ACE) unit with pharmacist involvement compared with usual care in older people. DESIGN: Retrospective, single-center case-control study. SETTING: Medical-surgical units at an urban academic medical center. PARTICIPANTS: Patients 65 years of age and older admitted April-June 2019, with 1 or more of the following target HRMs prior to admission were included in the study: acid suppressants, antipsychotics, or insulin. Patients admitted to the ACE unit were included in the case group; all other patients were randomly matched by HRMs in a 2:1 ratio into the control group. INTERVENTIONS: The Acute Care for the Elderly pharmacist reviewed patients' medications to identify and deprescribe select HRMs. Deprescribing was defined as discontinuation, dose or frequency reduction. RESULTS: A total of 47 patients with 56 HRMs and 89 patients with 126 HRMs were included in the case and control groups, respectively. The primary outcome of HRMs deprescribed were similar between the case and control groups (21.4% and 25.4%; P = 0.56). Among the HRMs deprescribed (discontinued, dose or frequency reduced), 83.2% were complete discontinuations in case patients and 34.4% were complete discontinuations in control patients.

Development and Acceptance of a Visual Menu for Non-English Speaking Acute Care Patients in an Academic Medical Center

2016 ◽  
Vol 116 (9) ◽  
pp. A48
Author(s):  
B. Atkinson ◽  
M. Nordlund ◽  
B. Pullar ◽  
C. Felix ◽  
A. Shah ◽  
...  
Keyword(s):  
Acute Care ◽  
Medical Center ◽  
Academic Medical Center ◽  
Academic Medical ◽  
English Speaking

scholarly journals Physical Therapists Make Accurate and Appropriate Discharge Recommendations for Patients Who Are Acutely Ill

2010 ◽  
Vol 90 (5) ◽  
pp. 693-703 ◽  
Author(s):  
Beth A. Smith ◽  
Christina J. Fields ◽  
Natalia Fernandez
Keyword(s):  
Acute Care ◽  
Physical Therapists ◽  
Discharge Planning ◽  
Medical Center ◽  
Academic Medical Center ◽  
Patient Discharge ◽  
Limited Information ◽  
Academic Medical ◽  
Discharge Location ◽  
The Impact

BackgroundAcute care physical therapists contribute to the complex process of patient discharge planning. As physical therapists are experts at evaluating functional abilities and are able to incorporate various other factors relevant to discharge planning, it was expected that physical therapists’ recommendations of patient discharge location would be both accurate and appropriate.ObjectiveThis study determined how often the therapists’ recommendations for patient discharge location and services were implemented, representing the accuracy of the recommendations. The impact of unimplemented recommendations on readmission rate was examined, reflecting the appropriateness of the recommendations.DesignThis retrospective study included the discharge recommendations of 40 acute care physical therapists for 762 patients in a large academic medical center. The frequency of mismatch between the physical therapist's recommendation and the patient's actual discharge location and services was calculated. The mismatch variable had 3 levels: match, mismatch with services lacking, or mismatch with different services. Regression analysis was used to test whether mismatch status, patient age, length of admission, or discharge location predicted patient readmittance.ResultsOverall, physical therapists’ discharge recommendations were implemented 83% of the time. Patients were 2.9 times more likely to be readmitted when the therapist's discharge recommendation was not implemented and recommended follow-up services were lacking (mismatch with services lacking) compared with patients with a match.LimitationsThis study was limited to one facility. Limited information about the patients was collected, and data on patient readmission to other facilities were not collected.ConclusionsThis study supports the role of physical therapists in discharge planning in the acute care setting. Physical therapists demonstrated the ability to make accurate and appropriate discharge recommendations for patients who are acutely ill.

Orientation Program for Hospital-Based Nurse Practitioners

2009 ◽  
Vol 20 (1) ◽  
pp. 82-90
Author(s):  
Mona N. Bahouth ◽  
Mary Beth Esposito-Herr
Keyword(s):  
Nurse Practitioners ◽  
Medical Center ◽  
Academic Medical Center ◽  
Orientation Program ◽  
Team Members ◽  
University Of Maryland ◽  
Academic Medical ◽  
Key Variables ◽  
Preceptor Programs ◽  
The University

The transition from student to practicing clinician is often a challenging and difficult period for many nurse practitioners. Newly graduated nurse practitioners commonly describe feelings of inadequacy in assuming clinical responsibilities, lack of support by team members, unclear expectations for the orientation period, and role isolation. This article describes the formal nurse practitioner orientation program implemented at the University of Maryland Medical Center, a large urban academic medical center, to facilitate the transition of new nurse practitioners into the workforce. This comprehensive program incorporates streamlined administrative activities, baseline didactic and simulation-based critical care education, ongoing and focused peer support, access to formalized resources, and individualized clinical preceptor programs. This formalized orientation program has proven to be one of the key variables to successful integration of nurse practitioners into our acute care clinical teams.

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