High nursing turnover and a shortage of nurses in acute hospital settings in Sweden challenge hea... more High nursing turnover and a shortage of nurses in acute hospital settings in Sweden challenge health care systems to deliver and ensure safe care. Advanced nursing roles implemented in other countries have offered nurses new career opportunities and had positive effects on patient safety, effectiveness of care, and patient satisfaction. The advanced nursing position of Nurse Practitioner has existed for many years in the United States, while similar extended nursing roles and changes in the scope of nursing practice are being developed in many other countries. In line with this international trend, the role of Nurse Practitioner in surgical care has been proposed for Sweden, and a master's programme for Acute Nurse Practitioners has been in development for many years. To optimize and facilitate the introduction of this new nursing role and its supporting programme, we elicited the experiences and support of the group who developed a Nurse Practitioner programme for a university...
Background Standards for advanced practice registered nurse (APRN) licensure in the United States... more Background Standards for advanced practice registered nurse (APRN) licensure in the United States require certification programs to analyze practice in order to document the knowledge and skills necessary for entry-level adult-gerontology acute care nurse practitioners (AGACNPs) and wellness-through-acute-care clinical nurse specialists (AGCNSs). The practice analysis done every 5 years by the AACN Certification Corporation provides research data for use in establishing test plans for certification of APRNs. Objectives To describe the development of a survey to collect information on the current practice of AGACNPs and AGCNSs, and to compare the results from practitioners in the 2 roles. Methods In 2016, a task force of subject matter experts created a survey of the practice activities and competencies of AGACNPs and AGCNSs. Respondents rated activities and competencies according to their applicability and significance to APRN practice. The subject matter experts analyzed the rating...
Aacn Clinical Issues Advanced Practice in Acute and Critical Care, 2005
Advanced practice nurses (APNs) have extraordinary opportunities in acute and critical care setti... more Advanced practice nurses (APNs) have extraordinary opportunities in acute and critical care settings. However, new obstacles accompany these opportunities and these obstacles can needlessly hamper APN practice and reduce the APN's contributions to patient care. Contributions by APNs can be maximized by deliberately and thoughtfully creating a practice culture that is APN-friendly. This article analyzes eight characteristics important to creating the APN-friendly culture: clarity of vision and values, commitment, communication, collaboration, credibility, contributions, confidence, and complexity. Creating an APN-friendly culture is a worthwhile organizational investment in order to enhance optimal APN practice and to benefit patients and families.
Delivering succinct, clear explanations to help students easily grasp key concepts, this book pro... more Delivering succinct, clear explanations to help students easily grasp key concepts, this book provides a comprehensive, multifaceted approach to EKG interpretation for nurse practitioner and physician assistant students, as well as practicing clinicians who need a quick refresher.
High nursing turnover and a shortage of nurses in acute hospital settings in Sweden challenge hea... more High nursing turnover and a shortage of nurses in acute hospital settings in Sweden challenge health care systems to deliver and ensure safe care. Advanced nursing roles implemented in other countries have offered nurses new career opportunities and had positive effects on patient safety, effectiveness of care, and patient satisfaction. The advanced nursing position of Nurse Practitioner has existed for many years in the United States, while similar extended nursing roles and changes in the scope of nursing practice are being developed in many other countries. In line with this international trend, the role of Nurse Practitioner in surgical care has been proposed for Sweden, and a master's programme for Acute Nurse Practitioners has been in development for many years. To optimize and facilitate the introduction of this new nursing role and its supporting programme, we elicited the experiences and support of the group who developed a Nurse Practitioner programme for a university in the US. This paper describes this collaboration and sharing of experiences during the process of developing a Swedish Nurse Practitioner programme. We also discuss the challenges of implementting any new nursing role in any national health care system. We would like to share our collaborative experiences and thoughts for the future and to open further national and international dialogue about how best to expand the scope of practice for nurses in acute hospital care, and thereby to improve patient care in Sweden and elsewhere.
American Journal of Respiratory and Critical Care Medicine, 2014
The high costs of health care in the United States and other developed nations are attributable, ... more The high costs of health care in the United States and other developed nations are attributable, in part, to overuse of tests, treatments, and procedures that provide little to no benefit for patients. To improve the quality of care while also combating this problem of cost, the American Board of Internal Medicine Foundation developed the Choosing Wisely Campaign, tasking professional societies to develop lists of the top five medical services that patients and physicians should question. Objectives: To present the Critical Care Societies Collaborative's Top 5 list in Critical Care Medicine and describe its development. Methods: Each professional society in the Collaborative nominated members to the Choosing Wisely task force, which established explicit criteria for evaluating candidate items, generated lists of items, performed literature reviews on each, and sought external input from content experts. Task force members narrowed the list to the Top 5 items using a standardized scoring system based on each item's likely overall impact and merits on the five explicit criteria. Measurements and Main Results: From an initial list of 58 unique recommendations, the task force proposed a Top 5 list that was ultimately endorsed by each Society within the Collaborative. The five recommendations are: (1) do not order diagnostic tests at regular intervals (such as every day), but rather in response to specific clinical questions; (2) do not transfuse red blood cells in hemodynamically stable, nonbleeding ICU patients with an Hb concentration greater than 7 g/dl; (3) do not use parenteral nutrition in adequately nourished critically ill patients within the first 7 days of an ICU stay; (4) do not deeply sedate mechanically ventilated patients without a specific indication and without daily attempts to lighten sedation; and (5) do not continue life support for patients at high risk for death or severely impaired functional recovery without offering patients and their families the alternative of care focused entirely on comfort. Conclusions: These five recommendations provide a starting point for clinicians and patients to make decisions leading to higherquality, lower-cost care. Future work is needed to promote adherence to these recommendations and to develop additional ways for intensive care clinicians to take leadership in reining in health-care costs.
How do conceptual models help you in clinical practice? How can you select the best model to guid... more How do conceptual models help you in clinical practice? How can you select the best model to guide successful interventions for your critical care patients? These authors present three guidelines for selection of a conceptual model for your patient situation. Six case studies of patients requiring critical care nursing demonstrate the fit of the patient's problems and goals for care with particular conceptual models of nursing.
AACN Clinical Issues: Advanced Practice in Acute and Critical Care, 2005
Advanced practice nurses (APNs) have extraordinary opportunities in acute and critical care setti... more Advanced practice nurses (APNs) have extraordinary opportunities in acute and critical care settings. However, new obstacles accompany these opportunities and these obstacles can needlessly hamper APN practice and reduce the APN's contributions to patient care. Contributions by APNs can be maximized by deliberately and thoughtfully creating a practice culture that is APN-friendly. This article analyzes eight characteristics important to creating the APN-friendly culture: clarity of vision and values, commitment, communication, collaboration, credibility, contributions, confidence, and complexity. Creating an APN-friendly culture is a worthwhile organizational investment in order to enhance optimal APN practice and to benefit patients and families.
American journal of critical care : an official publication, American Association of Critical-Care Nurses, 2006
Accreditation standards for certification programs require use of a testing mechanism that is job... more Accreditation standards for certification programs require use of a testing mechanism that is job-related and based on the knowledge and skills needed to function in the discipline. To describe critical care advanced practice by revising descriptors to encompass the work of both acute care nurse practitioners and clinical nurse specialists and to explore differences in the practice of clinical nurse specialists and acute care nurse practitioners. A national task force of subject matter experts was appointed to create a comprehensive delineation of the work of critical care nurses. A survey was designed to collect validation data on 65 advanced practice activities, organized by the 8 nurse competencies of the American Association of Critical-Care Nurses Synergy Model for Patient Care, and an experience inventory. Activities were rated on how critical they were to optimizing patients' outcomes, how often they were performed, and toward which sphere of influence they were directed....
High nursing turnover and a shortage of nurses in acute hospital settings in Sweden challenge hea... more High nursing turnover and a shortage of nurses in acute hospital settings in Sweden challenge health care systems to deliver and ensure safe care. Advanced nursing roles implemented in other countries have offered nurses new career opportunities and had positive effects on patient safety, effectiveness of care, and patient satisfaction. The advanced nursing position of Nurse Practitioner has existed for many years in the United States, while similar extended nursing roles and changes in the scope of nursing practice are being developed in many other countries. In line with this international trend, the role of Nurse Practitioner in surgical care has been proposed for Sweden, and a master's programme for Acute Nurse Practitioners has been in development for many years. To optimize and facilitate the introduction of this new nursing role and its supporting programme, we elicited the experiences and support of the group who developed a Nurse Practitioner programme for a university...
Background Standards for advanced practice registered nurse (APRN) licensure in the United States... more Background Standards for advanced practice registered nurse (APRN) licensure in the United States require certification programs to analyze practice in order to document the knowledge and skills necessary for entry-level adult-gerontology acute care nurse practitioners (AGACNPs) and wellness-through-acute-care clinical nurse specialists (AGCNSs). The practice analysis done every 5 years by the AACN Certification Corporation provides research data for use in establishing test plans for certification of APRNs. Objectives To describe the development of a survey to collect information on the current practice of AGACNPs and AGCNSs, and to compare the results from practitioners in the 2 roles. Methods In 2016, a task force of subject matter experts created a survey of the practice activities and competencies of AGACNPs and AGCNSs. Respondents rated activities and competencies according to their applicability and significance to APRN practice. The subject matter experts analyzed the rating...
Aacn Clinical Issues Advanced Practice in Acute and Critical Care, 2005
Advanced practice nurses (APNs) have extraordinary opportunities in acute and critical care setti... more Advanced practice nurses (APNs) have extraordinary opportunities in acute and critical care settings. However, new obstacles accompany these opportunities and these obstacles can needlessly hamper APN practice and reduce the APN's contributions to patient care. Contributions by APNs can be maximized by deliberately and thoughtfully creating a practice culture that is APN-friendly. This article analyzes eight characteristics important to creating the APN-friendly culture: clarity of vision and values, commitment, communication, collaboration, credibility, contributions, confidence, and complexity. Creating an APN-friendly culture is a worthwhile organizational investment in order to enhance optimal APN practice and to benefit patients and families.
Delivering succinct, clear explanations to help students easily grasp key concepts, this book pro... more Delivering succinct, clear explanations to help students easily grasp key concepts, this book provides a comprehensive, multifaceted approach to EKG interpretation for nurse practitioner and physician assistant students, as well as practicing clinicians who need a quick refresher.
High nursing turnover and a shortage of nurses in acute hospital settings in Sweden challenge hea... more High nursing turnover and a shortage of nurses in acute hospital settings in Sweden challenge health care systems to deliver and ensure safe care. Advanced nursing roles implemented in other countries have offered nurses new career opportunities and had positive effects on patient safety, effectiveness of care, and patient satisfaction. The advanced nursing position of Nurse Practitioner has existed for many years in the United States, while similar extended nursing roles and changes in the scope of nursing practice are being developed in many other countries. In line with this international trend, the role of Nurse Practitioner in surgical care has been proposed for Sweden, and a master's programme for Acute Nurse Practitioners has been in development for many years. To optimize and facilitate the introduction of this new nursing role and its supporting programme, we elicited the experiences and support of the group who developed a Nurse Practitioner programme for a university in the US. This paper describes this collaboration and sharing of experiences during the process of developing a Swedish Nurse Practitioner programme. We also discuss the challenges of implementting any new nursing role in any national health care system. We would like to share our collaborative experiences and thoughts for the future and to open further national and international dialogue about how best to expand the scope of practice for nurses in acute hospital care, and thereby to improve patient care in Sweden and elsewhere.
American Journal of Respiratory and Critical Care Medicine, 2014
The high costs of health care in the United States and other developed nations are attributable, ... more The high costs of health care in the United States and other developed nations are attributable, in part, to overuse of tests, treatments, and procedures that provide little to no benefit for patients. To improve the quality of care while also combating this problem of cost, the American Board of Internal Medicine Foundation developed the Choosing Wisely Campaign, tasking professional societies to develop lists of the top five medical services that patients and physicians should question. Objectives: To present the Critical Care Societies Collaborative's Top 5 list in Critical Care Medicine and describe its development. Methods: Each professional society in the Collaborative nominated members to the Choosing Wisely task force, which established explicit criteria for evaluating candidate items, generated lists of items, performed literature reviews on each, and sought external input from content experts. Task force members narrowed the list to the Top 5 items using a standardized scoring system based on each item's likely overall impact and merits on the five explicit criteria. Measurements and Main Results: From an initial list of 58 unique recommendations, the task force proposed a Top 5 list that was ultimately endorsed by each Society within the Collaborative. The five recommendations are: (1) do not order diagnostic tests at regular intervals (such as every day), but rather in response to specific clinical questions; (2) do not transfuse red blood cells in hemodynamically stable, nonbleeding ICU patients with an Hb concentration greater than 7 g/dl; (3) do not use parenteral nutrition in adequately nourished critically ill patients within the first 7 days of an ICU stay; (4) do not deeply sedate mechanically ventilated patients without a specific indication and without daily attempts to lighten sedation; and (5) do not continue life support for patients at high risk for death or severely impaired functional recovery without offering patients and their families the alternative of care focused entirely on comfort. Conclusions: These five recommendations provide a starting point for clinicians and patients to make decisions leading to higherquality, lower-cost care. Future work is needed to promote adherence to these recommendations and to develop additional ways for intensive care clinicians to take leadership in reining in health-care costs.
How do conceptual models help you in clinical practice? How can you select the best model to guid... more How do conceptual models help you in clinical practice? How can you select the best model to guide successful interventions for your critical care patients? These authors present three guidelines for selection of a conceptual model for your patient situation. Six case studies of patients requiring critical care nursing demonstrate the fit of the patient's problems and goals for care with particular conceptual models of nursing.
AACN Clinical Issues: Advanced Practice in Acute and Critical Care, 2005
Advanced practice nurses (APNs) have extraordinary opportunities in acute and critical care setti... more Advanced practice nurses (APNs) have extraordinary opportunities in acute and critical care settings. However, new obstacles accompany these opportunities and these obstacles can needlessly hamper APN practice and reduce the APN's contributions to patient care. Contributions by APNs can be maximized by deliberately and thoughtfully creating a practice culture that is APN-friendly. This article analyzes eight characteristics important to creating the APN-friendly culture: clarity of vision and values, commitment, communication, collaboration, credibility, contributions, confidence, and complexity. Creating an APN-friendly culture is a worthwhile organizational investment in order to enhance optimal APN practice and to benefit patients and families.
American journal of critical care : an official publication, American Association of Critical-Care Nurses, 2006
Accreditation standards for certification programs require use of a testing mechanism that is job... more Accreditation standards for certification programs require use of a testing mechanism that is job-related and based on the knowledge and skills needed to function in the discipline. To describe critical care advanced practice by revising descriptors to encompass the work of both acute care nurse practitioners and clinical nurse specialists and to explore differences in the practice of clinical nurse specialists and acute care nurse practitioners. A national task force of subject matter experts was appointed to create a comprehensive delineation of the work of critical care nurses. A survey was designed to collect validation data on 65 advanced practice activities, organized by the 8 nurse competencies of the American Association of Critical-Care Nurses Synergy Model for Patient Care, and an experience inventory. Activities were rated on how critical they were to optimizing patients' outcomes, how often they were performed, and toward which sphere of influence they were directed....
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