Advanced Practice Nursing: An Integrative Approach, 4th edition

Covering all advanced practice competencies and roles, this book offers strategies for enhancing patient care and legitimizing your role within today\u27s health care system. It covers the history of advanced practice nursing, the theory behind the practice, and emerging issues. Offering a comprehensive exploration of advanced practice nursing, this edition also adds a focus on topics including the APN scope of practice, certification, and the ethical and legal issues that occur in clinical practice.https://digitalcommons.usm.maine.edu/facbooks/1036/thumbnail.jp

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

Lack of full practice authority (FPA) for advanced practice registered nurses (APRNs) is a barrier to the provision of efficient, cost-effective, high-quality, and comprehensive health care services for some of our most vulnerable citizens ( Agency for Healthcare Research and Quality, 2014 , Buerhaus et al., 2015 , Pohl et al., 2010a , Seibert et al., 2004 ). APRNs have the education, knowledge, skills, and experience necessary to provide basic and comprehensive primary care services; they are a ready workforce, ideally positioned to improve access to care, contribute to health disparities reduction efforts, and lower the cost of providing such care ( National Center for Workforce Analysis 2013 , Perloff et al., 2016 ). However, barriers at the state and national levels continue to prevent these highly qualified health care providers from practicing to the full extent to which their education and training have prepared them. It is the position of the American Academy of Nursing (academy) that FPA of APRNs is essential to achieving health equity

Polyunsaturated fatty acid synthesis de novo is required for calcium release in vascular smooth muscle

<p>Previous studies show that inhibition of delta-5 desaturase and delta-6 causes a<br>decrease in phenylepherine (PE)- induced vasoconstriction in human femoral artery,<br>and in rat aorta and mesenteric arteries. These data showed that the activity of the<br>polyunsaturated fatty acid (PUFA) biosynthesis pathway related to vasoconstriction is<br>specifically located in vascular smooth muscle (VSM). The study also showed that<br>inhibiting the PUFA-biosynthesis pathway causes a decrease in the release of the proconstriction<br>eicosanoids prostaglandin (PG) F2 alpha, PGE2 and thromboxane A2 (1).<br>Activity of the PUFA biosynthesis pathway has previously been shown in arterial<br>endothelial (2) and smooth muscle cells (3). However, there is no direct evidence of the<br>exact extent of the pathway and contribution of PUFA biosynthesis to vascular function<br>in VSM is currently unknown.</p

The effects of cognitive impairment on nursing home residents' emergency department visits and hospitalizations.

BackgroundLittle is known about the relationship of cognitive impairment (CI) in nursing home (NH) residents and their use of emergency department (ED) and subsequent hospital services.MethodsWe analyzed 2006 Medicare claims and resident assessment data for 112,412 Medicare beneficiaries aged &gt;65 years residing in US nursing facilities. We estimated the effect of resident characteristics and severity of CI on rates of total ED visits per year, then estimated the odds of hospitalization after ED evaluation.ResultsMild CI predicted higher rates of ED visits relative to no CI, and ED visit rates decreased as severity of CI increased. In unadjusted models, mild CI and very severe CI predicted higher odds of hospitalization after ED evaluation; however, after adjusting for other factors, severity of CI was not significant.ConclusionsHigher rates of ED visits among those with mild CI may represent a unique marker in the presentation of acute illness and warrant further investigation