RESUMEN
BACKGROUND: High-value healthcare focuses on improving healthcare to produce cost effective care, however limited information on the role of advanced practice registered nurses (APRNs) exists. PURPOSE: This descriptive report describes APRN-led initiatives implemented as part of a national collaborative promoting the Choosing Wisely® campaign and high-value care measures. METHOD: An APRN national collaborative focuses on developing and implementing high-value care initiatives. Monthly calls, podcasts, and a file sharing platform are used to facilitate the work of the national collaborative. FINDINGS: A total of 16 APRN teams from 14 states are participating and have implemented a number of initiatives to reduce unnecessary testing and treatments, promote appropriate antibiotic use, and promote optimal clinical practices such as mobility for hospitalized elderly patients, among others. DISCUSSION: A national collaborative has proven to be a successful way to engage APRN teams to focus on targeting high-value care and promoting evidence-based practices in clinical care.
Asunto(s)
Enfermería de Práctica Avanzada , Difusión de Innovaciones , Reforma de la Atención de Salud , Rol de la Enfermera , Anciano , Atención a la Salud , HumanosAsunto(s)
Displasia Ventricular Derecha Arritmogénica , Muerte Súbita Cardíaca/prevención & control , Enfermeras Practicantes , Adulto , Displasia Ventricular Derecha Arritmogénica/diagnóstico , Displasia Ventricular Derecha Arritmogénica/fisiopatología , Displasia Ventricular Derecha Arritmogénica/terapia , Educación Continua en Enfermería , Salud de la Familia , Pruebas Genéticas , Humanos , MasculinoRESUMEN
Cardiac and pulmonary transplantation has revolutionized end-stage heart and lung therapy. With the advent of cyclosporine and other immunosuppressive therapies, many patients lead productive lives. Unfortunately, other patients who have undergone cardiac and/or pulmonary transplantation do not have favorable results. In fact, some require retransplantation to live. Because of organ scarcity, healthcare professionals and patients must examine not only retransplantation survival rates but also the ethical considerations when dealing with resource-limited organs. Given that retransplantation survival rates are not as favorable as those for primary transplantation and that no studies involving quality of life and morbidity could be located, considerable thought should be given to this controversial practice.