Nurse practitioners' experiences of polypharmacy in community-dwelling older adults.

BACKGROUND: Numerous studies have defined polypharmacy and its impact on health. The literature is also rich in studies documenting the benefits of care provided by nurse practitioners (NPs). A gap in research exists at the intersection of the value of NPs in caring for older adults and their management of polypharmacy. PURPOSE: Coinciding with growth in America's older adult population and the need for adequate care, the purpose of this study was to explore the experiences of NPs caring for community-dwelling older adults experiencing polypharmacy. METHODOLOGICAL ORIENTATION: A qualitative descriptive study was conducted. Interviews were conducted, and data were analyzed for themes. SAMPLE: This study was conducted using a purposive sampling of NPs who care for older adults (n = 15). CONCLUSIONS: Four themes emerged: defining polypharmacy, communicating and collaborating, clinical judgement of NPs in relation to polypharmacy, and medication issues of older adults. The themes depict the complexity of medication management in older adults and the important role of NPs in providing care to older adults. IMPLICATIONS FOR PRACTICE: The significance of the study findings to future practice includes improving communication and collaboration between prescribing health care providers, better identification and management of polypharmacy, and improving the health care delivered to older adults. Safe and effective prescribing for older adults requires that NPs consider the unique needs of each older adult while using technology to support collaboration and decision making.

Professional Conference Poster Presentation: Innovative Professional Development Assignment in Nurse Practitioner Education.

BACKGROUND: This innovative assignment converted a traditional presentation to an assignment that addressed several National Organization of Nurse Practitioner Faculties competencies and the growing trend toward nurse practitioner professional advancement models. METHOD: The professional conference poster assignment spanned two semesters. The first semester assignment included a focused literature review and abstract development. The second semester assignment included a formal presentation using a digital poster format. RESULTS: Only three of the 23 respondents indicated ever having developed an abstract or a professional conference poster prior to the assignment. Students identified new skills acquired as a result of the professional conference poster assignment: writing an abstract (78%), writing a biographical statement (87%), constructing a digital poster (91%), speaking at a conference (87%), and searching the evidence (48%). CONCLUSION: Nurse practitioner students evaluated this assignment highly, learned valuable dissemination skills that met core competencies, and were instilled with a culture of clinical scholarship and dissemination. [J Nurs Educ. 2020;59(6):345-348.].

Development of Prelicensure Nursing Competencies in Caring for People With Disabilities Through Delphi Methodology.

BACKGROUND: People with disabilities (PWDs) experience significant health disparities. The complex experience of disability requires that nurses are adequately and deliberately prepared to care for PWDs. However, there are no recognized nursing competencies to direct education and care. PURPOSE: The purpose of this study was to develop a set of nursing competencies to better prepare prelincensure nursing students to provide competent care to PWDs. METHODS: A 2-round Delphi survey was administered to experts in the field of disabilities (n = 47, n = 35). Quantitative and qualitative methods were used to analyze data. RESULTS: Three major themes emerged: unique knowledge, volume and repetition, and distinct disability culture. Competencies were reduced with a focus on 4 dimensions: environment and care, communication, culture, and referral. CONCLUSIONS: The 12 new competencies can serve as the foundation for the inclusion of disability content in nursing curricula.

Precepting nurse practitioner students in the graduate nurse education demonstration: A cross-sectional analysis of the preceptor experience.

BACKGROUND: The Graduate Nurse Education (GNE) Demonstration seeks to increase the number of advanced practice registered nurses (APRNs) in clinical practice. With the overall increase in APRN programs and, particularly, enrollment in nurse practitioner (NP) programs, there is growing competition among students to secure quality clinical precepting experiences. PURPOSE: This study describes NPs' and physicians' experiences with precepting APRN students within the Greater Philadelphia GNE Consortium. METHODS: This was a cross-sectional descriptive survey of 1,021 NP and physician preceptors who provided clinical practicum experiences for at least one of the nine Greater Philadelphia GNE Consortium schools. RESULTS: Differences between NP and physician precepting experiences regarding the importance of various factors in their decisions to precept were explored. Both NP and physician preceptors provide clinical practicum experiences to APRN students because they enjoy doing so. However, they differ regarding what they find important in their decisions to precept such as having protected time to precept and educational opportunities. IMPLICATIONS FOR PRACTICE: As universities work to recruit quality preceptors, they should consider tailoring their approach based on the preceptor's clinical role. In addition, schools located within the same region should consider streamlining administrative processes to form sustaining and productive clinical partnerships.

After-hours/on-call experience during primary care nurse practitioner education utilizing standard scenarios and simulated patients.

BACKGROUND AND PURPOSE: Few nurse practitioner (NP) programs include an after-hours/on-call component in their clinical preparation of NP students. This role is expected in many primary and specialty care practices, and is one that students feel unprepared to competently navigate. METHODS: Utilizing simulated callers as patients or parents, NP students participated in a simulated after-hours/on-call experience that included receiving the call, managing the patient, and submitting documentation of the encounter. Students completed pre- and postparticipation evaluations, and were evaluated by the simulated patient callers and faculty using standardized evaluation tools. CONCLUSIONS: NP students rated the experience as an educationally valuable experience despite feeling anxious and nervous about the experience. Several essential skills were identified including critical thinking, clear communication, self-confidence, and access to resources. After participation NP students were more receptive to an NP position with an on-call component. IMPLICATIONS FOR PRACTICE: Inclusion of a simulated on-call experience is a feasible component of NP education and should be added to the NP curriculum.

Inclusion of disability-related content in nurse practitioner curricula.

PURPOSE: To examine the integration of disability-content in a national sample of nurse practitioner curricula. DATA SOURCES: Responses of National Organization of Nurse Practitioner Faculties (NONPF) members to an online 34-item survey designed to assess disability-related content included in nurse practitioner (NP) curricula; populations of people with disabilities addressed; models of disability; and resources used to teach about disability, facilitators and barriers to inclusion of disability, and respondents' assessment of the adequacy of coverage of disability in their programs. A survey used previously to assess integration of disability content in undergraduate nursing programs was modified to make it relevant to NP curricula. Nursing faculty and people with disability validated the survey to ensure its completeness and sensitivity to the disability community. Participating programs represent 111 (33.6%) NP programs. CONCLUSIONS: Lack of disability-related content reported by NP faculty in the majority of programs suggests that there is considerable room for improvement in efforts to address this often vulnerable population. Because people with disabilities can be found in any setting where health care is provided, all NPs need to be prepared to care for people with disabilities across the life span. IMPLICATIONS FOR PRACTICE: Strategies need to be developed and implemented to increase the awareness of NP faculty about the health issues of people with disabilities and integration of disability-related content without disrupting existing overloaded NP curricula.

Diethylstilbestrol exposure: it's still an issue.

Persons exposed to diethylstilbestrol have higher risks of certain health problems. Nurses have an important role in identifying women who received diethylstilbestrol while pregnant and the children of those pregnancies. Identification of these persons allows for risk analysis and counseling, and assists in appropriate referrals for further evaluation and treatment. The following information will help you facilitate this role.