Primary Care at Home: Nurse Practitioners\u27 Perceptions and Practices

Background: Primary care at home is not a new idea, but rather a reinvention of an old and almost forgotten practice. Today, only 1% of primary care visits are provided in a home setting; despite the increasing aging homebound population in the United States. Current primary care at home research relates improved patient outcomes with primary care at home visits. Primary care at home is reemerging in the United States, but currently is not generating many positive reviews. There is a gap in the current primary care at home literature regarding nurse practitioner home visit practices and perceptions. Methods: A quantitative quasi-experimental study design was utilized for this study. The underlying researcher hypothesis was that primary care home visits are underutilized. The purpose of this study was to examine the perceptions, barriers, knowledge and practices of nurse practitioners (NPs) regarding home visits in primary care and to evaluate changes in perceptions and practices following an educational intervention. The sample chosen for this study was volunteer nurse practitioners attending two pharmacology update conferences. Ninety eight nurse practitioners were included in this convenience sample study. The data collection of this study occurred in three phases. The first and second phases of the study used a face to face approach. The third phase occurred approximately six weeks later via email. The analysis methods were cross tabulations and descriptive statistics. Results: The nurse practitioner participants in this study indicated that 27% had made a primary care home visit, thus supporting the hypothesis for this study. Fifty four percent indicated that they had not considered making a primary care at home visit. Forty three percent stated that they would be more likely to make or increase a home visit based on the educational intervention. Eighty five percent of initial study participants were aware that Medicare could be billed for primary care home visit. Six percent of the Home Visit Implementation Post Survey participants indicated making primary care home visits since September 2013. Conclusions: The primary conclusion of this study was that primary care home visits are underutilized by nurse practitioner study participants. The findings from this study will add to the body of knowledge regarding nurses’ perceptions and practices of primary care at home. The researcher believes that by increasing awareness of benefits of primary care home visits; nurse practitioners will increase the amount of home visits being made. Ultimately, increasing access of primary care to homebound patients will improve their overall patient outcome

Practice Matters: Screening and Monitoring Hyperlipidemia

Abstract The purpose of this article is to provide Faith Community Nurses with current information on hyperlipidemia, a chronic disease responsible for the leading cause of death worldwide. Current guidelines for cholesterol screening and a risk calculator resource for estimating cardiovascular risk are provided. Myths and truths are presented for review with patients. Suggestions and resources for lifestyle modifications and patient education are included. Faith Community Nurses are at the center of community health and actively involved with improving health outcomes related to chronic disease

Practice Matters: Prevention and Care of Individuals with Type 2 Diabetes

A Faith Community Nurse (FCN) is tasked with promoting health within a faith-based community. As with any nursing role, the FCN must keep abreast of current issues and be aware of informational resources to keep his/her practice relevant. The area of focus in this issue is type 2 diabetes. During 2014, the global prevalence of diabetes among adults was estimated at 9%. There are numerous risk factors for type 2 diabetes including both modifiable and non-modifiable. The diagnosis of diabetes can be made based on plasma glucose or Hemoglobin A1C (A1C) criteria.Prediabetes and type 2 diabetes affect many people globally. It is important for FCNs to be able to teach others about the disease process, how to check blood glucose, and why adherence to the medication regimen is important. Furthermore, the patient should understand other actions they can take for a healthier life by eating well and exercising regularly

Nurses’ Knowledge and Attitudes toward Implementation of Electronic Medical Records

With the growth of Faith Community Nursing (FCN), one topic that needs further exploration is documentation. This includes the use of electronic medical records (EMRs). Nurses play a vital role in the planning and implementation of EMRs in the acute care setting and will also play a key role in Faith Community Nursing Programs that stand alone or partner with a health care agency. Individual computer expertise and/or attitude and knowledge of EMRs could be important in the successful implementation. Researchers utilized a modified version of the EMR questionnaire designed by Beiter and colleagues to examine nurses’ knowledge and attitudes regarding EMRs. Findings indicated as age increased, the level of experience regarding EMRs decreased. No difference was noted between the computer skills of RNs with an ADN and RNs with a BSN degree, but LPNs rated themselves as having higher computer skills than RNs. No statistical significance was noted regarding thoughts on saving time and reducing cost and other variables. Licensed practical nurses, more than RNs, indicated believing that EMRs have a positive effect on nurse-patient relationships. As implementation of EMRs occurs, plans for more training might be needed for certain groups of employees

Practice Matters: Red Flags in Adults with Mental Illnesses

Faith Community Nurses have common beliefs, principles, ethics, and a level of trust with their population making them well-positioned to positively impact parishioners. FCNs provide support for people’s spiritual needs and nursing care. This makes FCNs a vital and approachable resource for parishioners when seeking advisement and assistance regarding their mental healthcare. In this article, we define red flags as suicidal idealization, mania, and psychosis, which if not promptly assessed and referred for treatment may result in serious harm or death. These red flags are predominately found in people with schizophrenia, depression, bipolar disorder, and post-traumatic stress disorder. People with mental illnesses can develop red flags that require timely assessments. FCNs are readily accessible to people with mental illnesses and can screen for red flags of suicidal idealization, mania, and psychosis

Informatics: RN to BSN Students’ Perceived Competence

Background: Nurses utilize informatics to aide in providing safe, quality care to patients across the lifespan in a variety of settings; therefore, it is important that nurses have knowledge of nursing informatics. Nurses entering RN to BSN completion programs bring a range of clinical experience which often includes application of informatics. This poses a challenge for nursing faculty in designing programs to meet the needs of this specific population regarding informatics.Method: In this descriptive correlational research study, data were collected from a convenience sample of RN to BSN students using a demographic questionnaire and the Nursing Informatics Competency Assessment Tool (NICAT).Results: The total NICAT score supported all subjects being at the competent level or above and 37 subjects were noted to perceive themselves at the proficient or expert level.Conclusion: RN to BSN students reported informatics competency; however, they may benefit from specific informatics content

Promoting Socially Just Healthcare Systems: Social Work’s Contribution to Patient Navigation

Patient navigation is an emerging area of healthcare practice that uses an interdisciplinary and integrated care model designed to reduce health disparities and improve health outcomes. The authors define patient navigation, delineate the alignment of social work competencies with patient navigator requirements, and argue for a clear social work role and presence as patient navigators in interdisciplinary healthcare delivery. Social workers are well-equipped to carry out a variety of patient navigator responsibilities due to their unique skill of social justice advocacy as a macro-level intervention. Through involvement in patient navigation, social work leaders can promote the development of socially just healthcare systems that respect the dignity and worth of all patients

A Partnership to Enhance Community Health Education for RN to BSN Students.

This article shares a unique model of collaboration between a school of nursing and a community business to offer an on-site occupational health clinical experience for RN to BSN students. This activity could be easily replicated by others to provide a learning opportunity for nursing students. Hospitals remain the primary site of employment for nurses. However, with health care reform nurses are exploring many new opportunities including many settings in the community (Black, 2014). Incorporating community health into nursing curriculum is a necessity; however, providing meaningful clinical experiences can be a challenge for faculty. To meet students\u27 learning needs, faculty must be open to developing innovative clinical opportunities (Ellenbecker, 2002). This article describes a unique partnership between faculty in a RN to BSN completion program and employees of a local UPS. The partnership provided an opportunity for students to have a real on-site experience in health education for community members in a nontraditional clinical site. Faculty and employees of the UPS center\u27s health and safety committee worked together to plan a health fair for employees that took place at the workplace setting. One of the goals in the 2014-2018 strategic plan of the U.S. Department of Health and Human Services (HHS) is to Advance the Health, Safety, and Well-Being of the American People (HHS, n.d. p. 3). Strategies to promote prevention and wellness across the lifespan include educating individuals to adopt healthy lifestyles (HHS, n.d). This activity is just one example of how this can be accomplished

Engaging RN-To-BSN Students in Medical Reserve Corps Training

The events that occurred on September 11, 2001, changed the lives of many Americans. This disaster influenced nursing education by bringing attention to the need for disaster preparation for nurses. The American Association of Colleges of Nursing (AACN) noted nine Essentials to describe outcomes expected of baccalaureate-prepared nurses (AACN, 2008; Culley, 2010). Of the nine Essentials, both Essential VII and Essential IX reference the importance of knowledge regarding emergency preparedness (AACN, 2008; Culley, 2010). Thus, nurse educators are being challenged to find ways to include this topic in the nursing curriculum. This article describes a unique partnership between nursing faculty and experts in the community to engage students in Medical Reserve Corps (MRC) training