Journal of the American Association of Nurse Practitioners

The journey: Legislative autonomy for nurse practitioners in Jamaica
McGrath H
Decreased mortality in patients with fragility fracture of a fracture liaison service coordinated by Chile's first nurse practitioner
Leyan S, Olate CV, Klaber I and Kelly-Weeder S
Fragility fractures have significant sequelae, including pain, loss of mobility, and increased risk of mortality. Fracture liaison services (FLS) represent a coordinated, interdisciplinary approach to secondary prevention and reduce mortality.
Defining the urology nurse practitioner in Australia and New Zealand: A Delphi study
Quallich S, Cuthbertson-Chin A and Crowe H
Nurse practitioners with roles in specialty environments face challenges including uncertain role expectations and achieve urology expertise with on-the-job training, mentoring, and independent study. This creates a wide variety of preparation and role descriptions.
The international nurse practitioner
DeSimone ME and Messner L
The case for geography in nursing practice
Krainak KS
The discipline of geography is an increasingly necessary lens required to understand population-level diseases. Syndemics, or co-occurring diseases or epidemics within a specific population, are contextualized by place-preexisting social, economic, and political structures. Nurse practitioners are well-positioned to critically assess the impact of geography on patient health and well-being. This perspective provides a brief summary of syndemic crises, with a case example in the West Virginia coalfields. The position of this paper is one that supports geography, in addition to social determinants of health, as a framework for syndemics. A geographic perspective provides a more comprehensive picture of marginalized populations and regions facing the phenomenon. Given the significance of holistic nursing, attention to the role of geography in syndemics provides an increased dimension of care and treatment.
The impact of a pediatric malnutrition telehealth clinic on anthropometric measurements in children aged 6-59 months in rural Guatemala
Sobczak B, Jennings G, Henderson R and Lyerla F
Guatemala, a country with high rates of pediatric malnutrition, has significant challenges including food and potable water insecurity and a lack of health care providers.
The impact of a pediatric malnutrition telehealth clinic on anthropometric measurements in children aged 6-59 months in rural Guatemala
The effects of health beliefs and acculturation on the acceptance of human papillomavirus vaccination among Asian Indian parents in the United States
Mullassery D and Posmontier B
The available limited literature and Centers for Disease Control data suggest that human papillomavirus (HPV) vaccination acceptance is lower among Asian Indians than the general population in the United States.
Integration of point-of-care ultrasound in a nurse practitioner-led heart failure clinic
Craigo CL, Brown T, Kedan I, Koniak-Griffin D and DeVon HA
Despite improved survival, one in five patients with heart failure (HF) is readmitted within 30 days of discharge. Assessing fluid status is challenging, with an estimated 50% accuracy when relying on physical examination alone. Pulmonary congestion is a risk factor for readmission and can manifest weeks before symptoms occur.
Importance of a thorough history and physical examination: Case report of atypical necrotizing fasciitis
Costa-Pattison D, Rush N, Gillespie S, Danford CA and Siedlecki SL
This case report presents a 34-year-old Middle Eastern woman with atypical symptoms of Type II Necrotizing Soft Tissue Infection (NSTI). Due to the difficulty in diagnosing Type II NSTI, the patient experienced protracted illness. Once diagnosed, the patient underwent multiple surgical debridement procedures requiring antibiotic and pain management therapy before being successfully discharged home. Initial diagnosis of Type II NSTI is challenging to the provider due to vague symptoms and late occurrence of cutaneous changes. When cutaneous lesions are identified, rapid surgical evaluation is imperative to minimize morbidity and mortality. This paper emphasizes the complexity of diagnosing Type II NSTI and the need for a comprehensive history and frequent physical examinations.
A call to action: Leveraging dual-certified APRNs to optimize holistic patient care
Verdi M and Ainslie M
An interview with Pennsylvania State representative Tarik Khan, PhD, FNP-BC
Chen L and Buscemi CP
Nurse practitioners (NPs) take on diverse and essential roles. In an exclusive interview, Representative Tarik Khan, PhD, FNP-BC, highlights the impact NPs can have in the political arena. Transitioning from an NP to a legislator in Pennsylvania, Dr. Khan's journey reflects his commitment to health care reform, driven by hospital closures, lack of patient care access, and the COVID-19 pandemic. Elected in 2022, Dr. Khan leverages his health care background to address a wide range of legislative issues, passing significant bills. He advocates for NPs to engage politically, emphasizing their unique perspective and problem-solving skills. Dr. Khan's story underscores the transformative potential of NPs in shaping public policy and advancing systemic change.
Integrating genomics and precision health knowledge into practice: A guide for nurse practitioners
Neonatal eating assessment tool-mixed breastfeeding and bottle-feeding: Reference values and factors associated with problematic feeding symptoms in healthy, full-term infants: Notice of concern
Icodec ONWARDS: A review of the first once-weekly diabetes treatment for nurse practitioners and physician assistants
Kruger D, Magwire M and Urquhart S
Diabetes management is challenged by the complexity of treatment regimens and the need for frequent injections, affecting patient adherence and quality of life. Insulin icodec, a once-weekly basal insulin analog, represents a significant innovation, potentially simplifying diabetes care and improving outcomes.
Professional Advancement Models for Nurse Practitioners and Physician Associates/Assistants: A historical overview and opportunities for future growth
Hillel L and Lasker L
Professional advancement models (PAM) are paramount in the growth of nurse practitioners (NP) and physician associates/assistants (PA) who seek professional challenges, clinical recognition, job satisfaction, upward mobility, and incentives for retention. Professional advancement models for NPs and PAs were born out of literature on clinical career ladders that date back to the 1970s for the nursing work force. Over time, PAMs have evolved to offer NPs and PAs structured pathways to guide and reward professional growth, education, advocacy, research, and quality improvement (QI). Although the first institutional account of PAM development for NPs and PAs was published in 1998, there has been a recent spike in case reports of PAMs from individual medical centers. This article (1) provides a historical timeline of published data on the development and implementation of PAMs for NPs and PAs, (2) critiques features of existing PAMs, and (3) offers recommendations regarding PAM innovation for more uniform adoption in medical institutions across the country.
Integrating genomics and precision health knowledge into practice: A guide for nurse practitioners
Walker T, Ersig AL, Dwyer AA, Kronk R, Snyder CT, Whitt K and Willis V
Nurse practitioners (NPs) are the fastest growing group of health care providers, with an increase of 8.5% over the past year and anticipated growth of more than 40% by 2031. Improving NPs' knowledge of how genes influence health enables them to assess, diagnose, and manage patients in all states of health in a safe, efficient, and competent manner. Nurse practitioners may also care for patients who obtain direct-to-consumer (DTC) genetic tests without provider oversight and share their results; improved knowledge of genetics can provide NPs with the information and resources needed to interpret and understand DTC test results. The literature indicates that NPs have limited understanding of basic genetic concepts and guidelines for prescribing drugs affected by genomic variability. As a result, NPs report low confidence in their ability to accurately interpret and apply genetic test results, which inhibits genomics-informed precision health care. This article provides resources and clinical recommendations for using the 2021 American Association of Colleges of Nursing Essentials and the American Nurses Association Essentials of Genomic Nursing to facilitate the integration of genomics into NP curricula and practice. These resources will help future and practicing NPs integrate genomics into practice and improve precision health care.
"I never thought of it as payment": Qualitative evaluation of workshops with advanced practice registered nurses on pharmaceutical industry payment reporting
Grundy Q, Rudner N, Klein T, Ladd E, Hart D, MacIsaac M and Bero L
With the expansion of professional autonomy and prescriptive authority of advanced practice registered nurses (APRNs), interactions with industry are under greater scrutiny. As of July 1, 2021, pharmaceutical and medical device companies must publicly report all payments to APRNs through the Centers for Medicare and Medicaid Services' Open Payments website.
The use of an online learning module to improve knowledge for prevention of back pain and injury in industrial workers
Spain SR, Li Z and Akbar R
Back pain is a significant public health problem that accounts for a high percentage of morbidity and disability worldwide. Low back pain is a frequent cause of missed workdays and job-specific disability and is associated with poor outcomes for employees and employers. An online learning module that focused on normal anatomy of the spine, common pathophysiologic diagnosis or findings that may contribute to back pain, and techniques for back pain reduction was created for employees at risk due to the nature of their labor-intensive jobs. This module also contained case studies and graphics that demonstrated ways to reduce risks or hazards by incorporating job-specific changes in the work environment. A mixed method statistical analysis of knowledge change was completed after participation in the online module. This demonstrated that participants had a marked increase in knowledge in all areas examined. In addition, participants perceived the module as beneficial for grasping anatomical concepts, understanding injury prevention and management strategies, valuing the shared information, leveraging visual aids, and applying practical examples per qualitative questions answered. Participants gained knowledge that can be used on the job to decrease risk of sustaining back pain or injury. The intervention approach enhances the understanding of back pain among industrial workers and holds profound implications for public health on a broader scale. Monitoring population health and preventing back pain and injury while at work is essential for safety and is also a core competency in public health.
To precept or not to precept: Perspectives from nurse practitioners
DeClerk L, Chasteen S, Wells C, Baxter J and Rojo M
Nurse practitioner (NP) preceptors are crucial to clinical education. Recent increases in the required direct patient care hours for NP students may worsen the current preceptor shortage. However, most studies of preceptorship only include NPs who are current preceptors and are therefore missing vital information from nonpreceptors. It is imperative to understand facilitators and barriers to preceptorship from the perspective of NPs who have stopped being or have never been preceptors.
Improving the evaluation of novice advanced practice nurse transition
Wyly DR
Novice advanced practice registered nurses (RNs) experience decreased self-confidence, anxiety, and identity confusion in their first year of practice, which leads to poor job satisfaction and turnover. Advanced practice RN fellowship programs, developed to bridge the gap from the RN to the advanced practice role, lack standardized measures for program evaluation.