bluuebunny/crossref_metadata_2025_split huggingface dataset:
URINARY INCONTINENCE: A CLASSIFICATION SYSTEM AND TREATMENT PROTOCOLS FOR THE PRIMARY CARE PROVIDER
Authors: MILLER JO ANN B. 
Published: May 2005

PURPOSE:To provide nurse practitioners (NPs) with an objective system for classification of urinary incontinence and protocols for treating the condition in the primary care setting.DATA SOURCE:Clinical practice guidelines and the author's clinical experience.CONCLUSIONS:By using tables of classifications of urinary inconti‐nence, management strategies, and protocols, NPs can successfully manage mild urinary incontinence in primary care settings in a cost‐effective manner.IMPLICATIONS FOR PRACTICE:A thorough history and objective classification of the severity of incontinence provides the framework for treating urinary incontinence in a methodical and effective manner.
SCREENING PATIENTS FOR LATEX ALLERGIES
Authors: Schumann Lorna , Buhr Vicky 
Published: May 2005

PURPOSE:To review the reasons for the recent increase in latex allergies and the five possible routes of exposure to latex.DATA SOURCES:Selected review articles from print and electronic sources; author's clinical experience; case studies.CONCLUSIONS:Latex allergies are now being documented in groups not previously considered to be at risk due to increased screening in primary care settings.IMPLICATIONS FOR PRACTICE:Nurse practitioners should question about latex sensitivity, flag the charts of latex‐sensitive clients, counsel those with a suspected latex sensitivity, refer those with known latex allergy to an allergist, and take the necessary precautions to move toward a latex‐safe environment.
Nurse Practitioner, Nurse Midwife and Physician Assistant Attitudes and Care Practices Related to Persons with HIV/AIDS
Authors: Martin Jane E. , Bedimo Ariane Lisann 
Published: May 2005

ABSTRACTAlthough multiple studies of nurses' attitudes toward people living with HIV/AIDS (PLWAs) can be found in the literature, little is known about the attitudes, beliefs and practices of nurse practitioners (NPs), certified nurse midwives (CNMs), and physician assistants (PAs). A survey including a 21‐item AIDS Attitude Scale measuring the constructs of Avoidance and Empathy was sent to 1,291 NPs, CNMs and PAs in Louisiana, Arkansas and Mississippi to describe their attitudes and care practices related to PLWAs. Respondents who were more comfortable treating PLWAs had significantly lower avoidance scores and significantly higher empathy scores than respondents with lower comfort levels in providing care. Greater than 80% of respondents indicated that they would provide health care to HIV‐infected individuals. Respondents who referred HIV/AIDS patients for all care did so primarily due to lack of experience with HIV and the availability of more experienced providers. Avoidance and empathy scores were not found to be significantly associated with referral for care. This study suggests that this group of providers has relatively low avoidance and high empathy toward PLWAs and is willing to care for HIV‐infected individuals. This study was supported by Grant No. 5U69PE00112‐06 from the Department of Health & Human Services, Health Resources and Services Administration, HIV/AIDS Bureau, National AIDS Education and Training Center.
Weight Management Practices Among Primary Care Providers
Authors: Timmerman Gayle M. , Reifsnider Elizabeth , Allan Janet D. 
Published: May 2005

ABSTRACTThis pilot study examined how primary care providers manage patients with weight problems, an important component of primary care. A convenience sample of 17 nurse practitioners and 15 physicians were surveyed about assessments and interventions used in practice for weight management along with perceived barriers to providing effective weight management. Practice patterns between gender, profession and practice setting of the nurse practitioners were compared.
Development of a Student Nurse Practitioner Computerized Clinical Log
Authors: Longworth Judith C. D. , Lesh Diane 
Published: May 2005

ABSTRACTA computerized clinical log was developed and revised over a period of three semesters by the family nurse practitioner students at the University of Texas Health Science Center in San Antonio, Texas. Students entered data on a disk formatted in Microsoft Access®, and results were analyzed by the Statistical Packages for the Social Sciences (SPSS®). More than 4,000 patient encounters were documented during three semesters. The development and refinement of the computerized log are described. Results are presented and the implications of the database for educational, curricular and employment purposes are discussed.
Evaluation of a Single Seizure: Guidelines for Advance Practice Nurses
Authors: Long Lucretia , Adams Cara 
Published: May 2005

ABSTRACTDeciding whether or not to treat a client after a single seizure can be challenging for the clinician. The risk of seizure recurrence is greatest in the first six months after the initial episode. The decision to treat a single seizure should be based on diagnostic and clinical findings that assess the client's risk for recurrence. When making treatment decisions, the clinician must consider the benefits and risks of single‐seizure therapy. Careful consideration should be given to differential diagnosis, factors that induce symptomatic seizures and risk factors for epilepsy.
Attitudes Toward Nurse Practitioners: Influence of Gender, Age, Ethnicity, Education and Income
Authors: Phillips Carol Y. , Palmer C. Virginia , Wettig Vicki S. , Fenwick James W. 
Published: May 2005

ABSTRACTSurvey research was undertaken to measure relationships between gender, age, ethnicity, education, income level, and an individual's attitude toward using a nurse practitioner (NP) for health care. Pender's Health Promotion Model provided the theoretical basis for the research initiative and instrument design. Following initial pilot work, 238 individuals were surveyed. While no significant differences on the basis of gender and race were found, high school graduates demonstrated significantly more positive attitudes toward NPs than non‐high school graduates, and older subjects and those with lower incomes were less positively inclined to use NP services. These findings have implications for the marketing of NP services, NP education, and public education, and should be used as a basis for additional research in this area.
The Use of Low Molecular Weight Heparin in the Initial Management of Patients with Deep Vein Thrombosis
Authors: Betten Karen Campbell 
Published: May 2005

ABSTRACTLow molecular weight heparins (LMWH) have been found to be a safe and effective treatment for the prevention of venous thromboembolism. Recent clinical trials have further investigated the use of this class of drugs in the initial treatment of venous thromboembolism. The interest surrounding this new group of anticoagulants is sparked by the reduction in intensive resources required to safely administer this medication in comparison to the traditional treatment with heparin. Low molecular weight heparins do not require laboratory monitoring and can be given once or twice a day by subcutaneous injection, thereby allowing safe administration in the home. The potential cost savings incurred is timely in light of cost containment needs surrounding the current health care climate.
Antimicrobial Resistance
Authors: Schumann Lorna , Nollette Kimberly Ann 
Published: May 2005

ABSTRACTAntimicrobial resistance is not a new concept. For over half a century, health care providers have been faced with this problem. The overuse and misuse of antimicrobial therapy by health care providers has contributed largely to the problem, but several other factors have also been associated with antimicrobial resistance. This article reviews current literature regarding antimicrobial resistance in an effort to educate health care providers to make judicious decisions in the treatment of bacterial infections and stem the rise of antibiotic resistance by carefully scrutinizing prescribing practices. Contributing factors to antimicrobial resistance and recommendations for the control of antimicrobial resistance will be reviewed. Treatment recommendations for common health ailments (i.e., acute otitis media, rhinitis, sinusitis, and pharyngitis) are provided.
International Collaboration: Initial Steps and Strategies
Authors: Sheer Barbara 
Published: May 2005

ABSTRACTThe nurse practitioner (NP) movement, which began in the United States in 1965, has caused sweeping changes both in nursing and in health care delivery. The concept of NPs then spread to the United Kingdom (U.K.) and continues to move globally. The international development of NPs has been streamlined through collaborative efforts of the U.S. and the U.K. There have been striking similarities in the evolution of expanded practice roles in both countries. In 1993, NPs from the U.S. and the U.K. came together to support the first international NP conference and, in the process, developed a framework for global international collaboration. This article summarizes the collective knowledge and the strategies for success developed through this collaborative effort.
Use of Complementary and Alternative Treatments By Individuals with Fibromyalgia Syndrome
Authors: Barbour Connie 
Published: May 2005

ABSTRACTAlthough muscle pain is the primary complaint of patients with fibromyalgia, there are myriad associated symptoms that cause them to seek healthcare. Some individuals try alternative treatments when conventional medicine does not provide symptom relief. A questionnaire was developed to collect information regarding complementary treatments and their effectiveness. Sixty individuals visited the researcher's web page and completed and submitted an online questionnaire on fibromyalgia. Literature, heat, walking, vitamins, and massage were the interventions tried most frequently. Literature, aromatherapy, support groups, heat, and massage were rated the most effective.
An Algorithm for Monitoring Phenytoin Therapy
Authors: Crowder Karen M. 
Published: May 2005

ABSTRACTNurse practitioners need an evidence‐based framework for monitoring clients on phenytoin (DilantinTM) therapy. A Med‐line search of published literature and a synthesis of 10 years of research was performed. The effect of phenytoin within the body is dependent on the amount of serum albumin and the functional status of the major organs in the body. The basic principles of pharmacotherapeutics holds true for phenytoin. Closer investigation of total serum phenytoin and serum albumin ratio by primary care providers is necessary for monitoring therapeutic levels of phenytoin therapy. An algorithm was developed to provide a quick reference for monitoring therapeutic phenytoin levels.
Minors' Rights to Refuse Medical Treatment Requested by Their Parents: Remaining Issues
Authors: Griswold Deborah P. , Griswold David B. 
Published: May 2005

ABSTRACTNurse practitioners are regularly faced with ethical and legal dilemmas when providing care to minors. Laws may not provide clear direction; there may even be conflicting precedents regarding the status of minors, particularly with regard to the juvenile justice system. This article reviews the status of minors' rights with regard to refusing or consenting to medical tests or treatments. Three cases from one author's (DPG) practice illustrate the issues involved.
The Challenge of Evaluating Fatigue
Authors: Schumann Lorna , Rodriguez Tom 
Published: May 2005

ABSTRACTFatigue, though a common complaint, presents a challenge to nurse practitioners who must evaluate its significance in the primary care setting. Fatigue is described as a multidimensional phenomenon and is classified as physiologic, acute, or chronic. A distinction is made between chronic fatigue and chronic fatigue syndrome (CFS). The use of the Piper Fatigue Scale is suggested in order to objectively quantify this symptom in clinical practice. In this article, the Habit and Lifestyle Form for the Evaluation of Fatigue is presented as a way to assist the provider in considering simple and obvious causes of fatigue that may otherwise be overlooked. Finally, an algorithm for the evaluation of fatigue is presented.
Augmentation Mammoplasty: Implications for the Primary Care Provider
Authors: Ruot‐Worley Joanne 
Published: May 2005

PurposeTo inform primary care nurse practitioners (NPs) of the risks and possible complications of augmentation mammoplasty and suggest guidelines for counseling and monitoring women who have undergone this procedure.Data SourcesSelected research and clinical articles, government documents, and the author's experience.ConclusionsBecause so many women have had breast augmentation mammoplasty, it is inevitable that NPs will see patients in the primary care settings who have complications related to the procedure or the type of implant. The most common complications include (a) changes in breast sensation, (b) capsular contracture, (c) calcifications, (d) mammography distortion or inaccuracies, (e) gel‐bleed, (f) implant rupture or leakage, and (g) possible systemic reactions involving the immune system.Implications for PracticeIn addition to providing support and high quality preventive care, NPs may need to take on the task of coordinating other specialties and services when treating complications or when screening for breast cancer or implant rupture.
Nurse Practitioners and Parent Education: A Partnership for Health
Authors: Clark Brenda S. , Rapkin Karen , Busen Nancy H. , Vasquez Elias 
Published: May 2005

PurposeTo present the findings from a pilot‐test of an innovative curriculum for parent education classes that included information about well child care and the care of sick children presented to substance abusing women at a residential drug treatment facility.Data SourcesSelected literature and the results of a comparison of pre‐ and post‐tests from the 37 women who received the classes over a 6 week period.ConclusionsThe Healthy Children, Happy Children parent education program was successful overall in increasing the knowledge of the mothers about common skin disorders, care of infants, toddlers, and preschoolers, and basic first aid.Implications for PracticeNurse practitioners (NPs) are well suited to teach parent education classes that contain information on growth and development, well child care and diagnosis and management of acute minor conditions. The Healthy Children, Happy Children curriculum can be adapted to a variety of settings and populations.
Diagnosis and Management of Chronic Prostatitis by Primary Care Providers
Authors: Schumann Lorna , Lovejoy Bruce 
Published: May 2005

PurposeTo describe the etiology, clinical manifesta‐tions, differential diagnosis, and treatment of chronic bacterial and chronic abacterial prostatitis (CBP and CAP respectively) in the primary care setting.Data SourcesSelected research, clinical guidelines, and research‐based articles in the scientific literature.ConclusionsMost cases of CBP can be appropriately diagnosed and treated in the primary care office. In the case of a diagnosis of CAP, initial therapy can be started by the nurse practitioner (NP) with referral to a urologist for refractory cases.Implications for PracticeComplete eradication of pathogens in CBP is not always possible. Assisting patients to carefully follow their treatment regimens, including completion of all antibiotic therapy, will reduce the frequency and severity of symptoms. Successful management of chronic pro‐statitis symptoms can result in an improved quality of life and an increased ability to perform activities of daily living for patients. Chronic abacterial prostatitis may require referral to a urologist or mental health professional for co‐management of symptoms.
An Analysis of Research and Clinical Practice in Neonatal Pain Management
Authors: Rouzan Ivy A. 
Published: May 2005

PurposeTo review the literature on neonatal pain management with a focus on historical misconcep‐tions, ethical issues, barriers to practice, the role of the advanced practice nurse (APN), and suggested improvements.Data SourcesSelected research and review articles in nursing and medical literature.ConclusionsHealth care professionals agree that neonates experience pain and in turn deserve effective treatment. Research is controversial regarding the extent of pain management necessary in relation to short‐term benefits and long‐term consequences. Ethical issues arise when research supporting pain management is not consistently utilized in nursing practice.Implications for PracticeProtocols and standardized pain management strategies have demonstrated a beneficial effect on overall patient outcomes. The APN is identified as being in the optimal position to facilitate enhanced neonatal pain management through research, education, and direct clinical care.
Cardioprotective Benefits of Hormone Replacement Therapy
Authors: Schumann Lorna , Vega Victorio 
Published: May 2005

PurposeTo examine the effect of hormone replacement therapy (HRT) on adverse cardiac events in postmenopausal women.Data SourcesA systematic review of all available scientific literature (513 articles) on the cardioprotective benefits of HRT, including research reports, meta‐analyses, and commentaries.ConclusionsEpidemiological studies have consistently suggested that HRT administered to post‐menopausal women significantly lowers the risks of cardiovascular events. However, the claimed benefits might have been exaggerated. The results of the only large randomized clinical trial did not show similar benefits as those reported from observational studies. Research findings about cardiovascular protection of HRT remain inconclusive.Implications for PracticeWhile waiting for more definitive data, it is appropriate to consider other options that have been proven safe and effective in the prevention of cardiovascular disease.
Health Care Provider Communicator Style and Patient Comprehension of Oral Contraceptive Use
Authors: Schrader Elizabeth L. , Schrader David C. 
Published: May 2005

PurposeTo explore reasons for the incorrect usage of oral contraceptive pills (OCPs) by examining the relationship between patients' abilities to comprehend and/or recall information presented to them by nurse practitioners (NPs) and the communicator style of their NP.Data SourcesA convenience sample of 46 OCP users completed an instrument designed to test their comprehension of OCP use and an instrument designed to measure the communicator style of their NP.ConclusionsA multiple stepwise regression revealed that attentive and friendly communicator styles were positive predictors and the communicator image and dramatic styles were negative predictors of comprehension.Practice ImplicationsUnwanted pregnancies that result from non‐compliance with OCP regimens can have significant social and financial effects. A lack of understanding of proper OCP use may depend on the style of communication a NP uses to convey crucial information regarding the regimen.
Developing an Economic IQ in Primary Care
Authors: Abel Elizabeth , Longworth Judith C.D. 
Published: May 2005

PurposeTo describe elements of an economic intelligence quotient (IQ) that can be used to enhance the nurse practitioner's (NP) fiscal viability in a primary care setting.Data SourcesAnecdotal data from providers and administrators; clinical experiences of the authors; scientific and government publications and guidelines.ConclusionsIn the United States, managed care cost‐containment initiatives have led to competition among physicians and NPs for patients and jobs. An understanding of the economic base of a practice is essential to fiscal viability in this market.Practice ImplicationsWhen turf and job competition are the norm, it is essential that the NP develop an economic IQ. Knowledge of coding, billing, reimbursement, and documentation are critical to identifying the NP's value to the practice and promoting job retention. The challenge is for the NP to give high‐quality, cost‐effective, and safe patient care and to be a productive provider.
Managing Oral Anticoagulant Therapy
Authors: Goolsby Mary Jo 
Published: May 2005

Clinical practice guidelines (CPG) provide recommendations based on the summary of large volumes of literature and expert opinion. They are not absolute care directives, but are intended to facilitate individualized decision making related to patient care situations. Each month this column reviews a CPG of direct relevance to clinical practice. Readers are urged to contact the author, Mary Jo Goolsby (mjgoolsby@aanp.org) with requests for reviews of specific clinical guidelines or submissions of manuscripts addressing major guidelines that readers have found helpful in their practice.The Clinical Practice Guideline column is designed to inform practitioners of the wide range of accessible and current recommendations on a myriad of clinical topics. The guideline reviewed this month is actually one part of a large report stemming from the Sixth American College of Chest Physicians (ACCP) Consensus Conference on Antithrombotic Therapy. The management of oral anticoagulant therapy is but one portion of the overall report, complemented and supported by other components, including a preceding chapter that summarizes the mechanisms of action, clinical effectiveness, and therapeutic range of oral agents.This CPG focuses on following issues: (a) initiating and maintaining dosage, (b) managing non‐therapeutic dosages, (c) managing the agents during invasive procedures, and (d) recognizing and responding to adverse events. Special situations are discussed, including management of patients who are elderly or pregnant, and comparisons of the management in different models of care. There is in‐depth discussion of the literature, accompanied by a summary of recommendations.
Mutual Timing: An Essential Component of Provider/Patient Communication
Authors: Summers Linda C. 
Published: May 2005

PurposeTo present a concept clarification in an effort to give a name to a commonly experienced but poorly understood communication process: mutual timing.Data SourcesExtensive literature review of scientific and nursing literature; relevant theories; standardized process for concept clarification as delineated in the literature.ConclusionsGood communication involves many familiar concepts, including good eye contact, attentive listening and the use of silence and touch. Mutual timing is the difference‐making moment, creating common ground in the midst of engagement. Concept clarification is a critical step to understanding important practice concepts. Wedding the concept to everyday practice provides the beginning for development of guidelines, which can be used by nurse practitioners (NPs) for making decisions while caring for patients.Implications for PracticeNursing has claimed to be privy to a special relationship with patients that differs from other health care professions. When asked to differentiate their care from that of physicians, NPs are often quoted as valuing the psychosocial aspect of care and stressing the importance of their relationship with patients. Many NPs define themselves in terms of relationship, emphasizing strong moral obligations and mutual commitments with their patients. One of the core processes of the effective patient/provider relationship is good communication.