The role of nurse practitioners in delivering rheumatology care and services: Results of a U.S. survey.

BACKGROUND AND PURPOSE: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation, pain, joint stiffness, and progressive joint destruction. An increased demand for rheumatology healthcare professionals is anticipated in coming years; utilizing more nurse practitioners (NPs) in rheumatology may help meet this demand, and improve early detection and diagnosis of RA. METHODS: The American Association of Nurse Practitioners surveyed, via e-mail, members who were working in primary care settings to understand their educational and professional needs to help manage their patients with RA. Respondents were surveyed about their NP certifications, patient panel, information received from rheumatologists on shared patients, RA tools or resources that would be helpful, confidence in diagnosing and managing patients with RA, interest in learning about particular topics regarding RA medications, and preferences for exchanging educational information with their professional colleagues. CONCLUSIONS: The results from this survey indicate that the role of NPs in managing RA could be optimized by improved communication with treating rheumatologists, access to educational tools and resources, and further education and training in the management of RA. IMPLICATIONS FOR PRACTICE: NPs in primary care can fill a resource gap and provide access to health care for patients with RA.

Gastrointestinal decontamination of the poisoned patient.

Gastrointestinal decontamination has been a historically accepted modality in the emergency management of oral intoxicants. Theoretically, gastric and whole-bowel emptying procedures hinder absorption, remove toxic substances, prevent clinical deterioration, and hasten recovery. This article presents a current overview of gastrointestinal decontamination. It challenges the accepted precepts of gut decontamination and assesses the utility of syrup of ipecac-induced emesis, orogastric lavage, single-dose-activated charcoal, cathartics, and whole-bowel irrigation.