Improving access to care in Virginia: Reaching nurse practitioner training capacity through preceptor incentives

Workforce data reinforces the notion that educating nurse practitioners in Virginia is critical in helping to improve access to care in the Commonwealth, particularly in underserved communities. Six of Virginia’s thirty-nine state funded colleges and universities offer nurse practitioner programs. All of these universities report their capacity to train nurse practitioners is not limited by qualified applicants but rather by a shortage of clinical preceptors. This paper provides a summary of public policy initiatives that support preceptors as an example for Virginia to consider

Pulse Wave Velocity in Korean American Men and Women

Arterial stiffness is an important clinical marker of cardiovascular diseases. Although many studies have been conducted on different racial groups, less is known about arterial stiffness in Asian Americans. Korean Americans constitute the fifth largest subgroup in the Asian American population and reportedly have a noticeably high prevalence of hypertension. The aims of this study were to assess arterial stiffness and blood pressure and to examine the effect of age and gender on arterial stiffness and blood pressure in 102 Korean American men and women aged 21 to 60 years. The values of arterial stiffness for Korean Americans in this study were compared to published reference values for other racial and ethnic groups. Arterial stiffness was measured by carotid-femoral pulse wave velocity, which is the gold standard for determining arterial stiffness. Findings indicated that aging was an important determinant of arterial stiffness, which increased linearly with age. Although there was no gender difference observed in arterial stiffness, the effect of age on arterial stiffness was greater in women than in men. After adjusting for covariates including age, body mass index, and smoking, multiple regression models showed that arterial stiffness and gender were significant predictors of systolic and diastolic blood pressure. The comparisons of these findings to those from several other studies that used the same method to measure arterial stiffness showed that Korean Americans may have levels of arterial stiffness that are similar to or slightly higher than those of other racial groups. Considering that arterial stiffness is an independent predictor of future development of hypertension, more studies are required to examine cardiovascular risk of this understudied group

The Patient-Centered Outcomes Research Institute (PCORI): Information for academic nursing

AbstractAs part of the Patient Protection and Affordable Care Act of 2010, the U.S. Congress created the Patient-Centered Outcomes Research Institute (PCORI). Its goal is to fund research that will assist patients, caregivers, clinicians, and others in making informed health decisions. Because nurses play a critical role in engaging patients in health care, they are valued participants in setting the institute's agenda and carrying out its programs. In this article, we provide an overview of PCORI and describe how nurses can participate in institute activities and apply for research grants

Hypertension Self - Management Support in Primary Care: A Quality Improvement Study

This nurse practitioner-led quality improvement (QI) study was designed to improve clinical performance in hypertension (HTN) management that focused on self-management support (SMS) among adult patients at a primary care clinic with a high rate of cardiovascular disease. The design included retrospective baseline of meaningful use population data (N=1,210) generated six months prior to study start date and an analysis of the data during the six-month QI study (N=1,409). Interventions included staff QI training along with patient education and lifestyle goal setting for SMS of HTN. Electronic medical record data included blood pressure, cholesterol, tobacco use, body mass index, and self-management goals. The primary objective, >80% of adults would have documented self-management goals, was achieved and significantly improved from baseline. Nurse practitioners have an important role in meeting the current demand for HTN management in primary care and supporting patients in self-management. Keywords: Cardiovascular disease, Hypertension, Primary care, Quality Improvement, Self-managemen

Psychological stress and arterial stiffness in Korean Americans

Arterial stiffness is identified as a causative factor for hypertension. The purpose of this study was to explore the relationship between psychological stress and arterial stiffness in Korean Americans

Racial Discrimination and Blood Pressure: Perceptions, Emotions, and Behaviors of Black American Adults

Abstract available at publisher's web site

The American Academy of Nursing on Policy Emerging Role of Baccalaureate Registered Nurses in Primary Care

Increased access to health insurance and health care, increased complexity of patients in our aging society, and challenges in primary care team staffing are among many current challenges to providing high quality, effective, and satisfying care to all patients. At the same time, the team is expected to attend to the equally important need for prevention, health promotion, and care coordination and management of the population at large. The demand to manage multiple, comorbid complex chronic illnesses are overwhelming the primary care system and causing waits, delays, and a shifts toward receiving primary care in inappropriate settings such as the emergency room (ER). Solutions cannot be limited to producing more physicians, nurse practitioners (NPs), and physician\u27s assistants (PAs) as primary care providers, but rather in looking at all members of the primary care team and ensuring that each member is contributing at their highest level based on education, training, and licensure/certification. One professional, the registered nurse with a Bachelor of Science in Nursing (BSN-RN), has traditionally been underutilized as a core member of the primary care team. Supporting BSN-RN practice as a key member of the primary care interprofessional team is a strategy that will help meet the needs of our patients. BSN-RNs have the knowledge, skills, and abilities to assume critical roles in prevention, health promotion, management of acute and episodic illness, chronic illness management, transition management, and complex care management and coordination, as well as supporting the work of the entire interprofessional team (Josiah Macy, Jr. Foundation, 2016; American Academy of Ambulatory Care Nursing ([AAACN], 201). Transforming the role of the BSN-RN in primary care requires the coordinated responses of policy makers, academic institutions, accrediting bodies, primary health care providers and other primary care team members. In 2015, the Health Resources and Services Administration (HRSA) provided financial support (HRSA-16-066) to nine universities to develop educational models that provide BSN students to gain more clinical experience in community settings (HRSA, 2015). In late 2017, building on those successes, HRSA initiated a new funding initiative (HRSA-18-012) and called for proposals addressing strategies focused on recruiting both current and future nurses to practice careers in primary care, utilizing their full scope of practice as a member of primary care teams (HRSA, 2017). Fundamental learning from these projects demonstrated that BSN-RNs are an essential component for quality care. Therefore, policies which impede primary care organizations from investing in the BSN-RN as a core member of the primary care team must be addressed

Relationship Between Medication Adherence and Health Beliefs Among Patients with Hypertension in Oman : Pilot study

Objectives: The prevalence of hypertension (HTN) in Oman is alarmingly high and patient adherence to antihypertensive medications is inadequate. This study aimed to assess the relationship between medication adherence and health beliefs among Omani patients with HTN. Methods:This descriptive cross-sectional pilot study was conducted in December 2015 and included 45 patients with HTN recruited from four primary health centres in Al Dakhiliyah and Muscat governorates, Oman. Medication adherence and health beliefs were assessed using the Morisky Medication Adherence Scale (MMAS), Beliefs about Medicines Questionnaire, Brief Illness Perception Questionnaire and the revised Medication Adherence Self-Efficacy Scale. Results: The mean MMAS score was 5.3 ± 2.0, with 48.9% of patients reporting high adherence. Higher self-efficacy and stronger beliefs regarding medication necessity were significantly related to adherence (P = 0.012 and 0.028, respectively). Conclusion: The findings of this pilot study emphasise the role of health beliefs with regards to Omani patients’ adherence to antihypertensive medications