bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutritional Health Promotion for Older Adults, Where Is the Content?
Authors: PhD Wanda Bonnel 
Published: May 2005

PurposeTo describe nurse practitioners' (NPs') educational experiences related to older adult nutrition and eating abilities.Data SourcesDescriptive research with written survey data collected from 80 gerontological NPs recruited from a national nursing conference.ConclusionsOlder adults' nutritional health has been related to acute illness, pressure sore development, prolonged hospital stays, and other health problems. Current literature suggests that although nutrition screening and intervention promote older adults' health, practitioners may not consistently receive education on this content. Participants indicated that gerontological‐nutrition content was important, that it was missing from their educational programs, and that it needed to be a part of the NP curriculum. Specific nutrition content concerns were organized by the categories (a) disease and functional issues, (b) psychosocial support and environmental impact, and (c) health care team and system considerations.Implications for PracticeNP programs need to self‐evaluate for adequate and appropriate nutrition screening and intervention content. Frameworks such as those developed by the Nutrition Screening Initiative and others provide beginning guidance for further content development.
Nurse Practitioner Coding Practices in Primary Care: A Retrospective Chart Review
Authors: Allen Kymberly R. , Reinke Caroline B. , Pohl Joanne M. , Martyn Kristy K. , Mclntosh Elaine P. 
Published: May 2005

PurposeTo describe the coding and documentation practices of nurse practitioners (NPs) when using evaluation and management (E & M) codes in an academic primary care center.Data SourcesA randomized retrospective review of ten charts from a nurse‐managed primary care clinic affiliated with a midwestern research‐intensive university.ConclusuionThe findings demonstrate that the documentation in the chart for six of the ten client encounters did not support the E & M codes assigned by the clinicis NPs. Four of these six client encounters were overcoded; the remaining two encounters were undercoded.Implications for PracticeFindings of this study support the need for additional education of NPs in the areas of coding and documentation.
Diagnosis and Treatment of Idiopathic Thrombocytopenic Purpura
Authors: Blackwell James , Goolsby Mary Jo 
Published: May 2005

ABSTRACTThis month's clinical practice guideline (CPG) review is on the diagnosis and treatment of idiopathic thrombocytopenic purpura (ITP). ITP is not a condition that would be seen in great numbers by nurse practitioners (NPs) in general practice. However, due to the current lack of consensus on how to diagnosis and treat ITP and the potential for patients to have serious adverse sequelae, NPs may want to have a copy of this CPG on file in their offices for future reference.
Balneo‐Phototherapy: A New Holistic Approach To Treating Psoriasis
Authors: Mikula Colleen 
Published: May 2005

PurposeTo present and describe a new holistic therapy for the treatment of psoriasis and demonstrate its outcomes through a case study presentation.Data SourcesSelected scientific literature and patient case study.ConclusionBalneo‐phototherapy, though new to the United States, has effective, safe outcomes as a new holistic treatment for psoriasis.Implications for PracticeNurse practitioners (NPs) and patients have an additional choice in psoriasis treatment that provides efficacious outcomes with fewer side effects compared to current therapies.
Optimal Management of Outpatients With Heart Failure Using Advanced Practice Nurses in a Hospital‐Based Heart Failure Center
Authors: Crowther Maryanne 
Published: May 2005

PurposeTo examine the benefits of an advanced practice nurse (APN) driven, hospital‐based heart failure center.Data SourcesSelected multidisciplinary studies, review articles, Heart Failure Society of America practice guidelines, and American College of Cardiology/American Heart Association clinical practice guidelines.ConclusionsAPN specialists in this hospital‐based heart failure center provide heart failure patients with high quality multidisciplinary health care in a single environment, which leads to optimal outcomes. Patients experience positive outcomes as evidenced by spared hospitalizations, improved scores on the Minnesota Living With Heart Failure Survey, and the 6‐min walk.Implications for PracticeAPNs with prescriptive authority can effectively direct heart failure care for outpatients by utilizing multidisciplinary resources of the hospital. Treatment strategies include titrating medication, frequent symptom monitoring, tracking medication and dietary compliance, telemonitoring, and providing aggressive multidisciplinary education. This approach is highly effective for reducing hospital readmissions as well as for improving quality of life and functional status for outpatients with left ventricular systolic dysfunction.
Policy on Acute Toxic Ingestion or Dermal or Inhalation Exposure
Authors: Goolsby Mary Jo 
Published: May 2005

ABSTRACTMany nurse practitioners (NPs) practice in emergency and urgent‐care settings, and far more practice in remote settings. NPs in each of these settings should be familiar with the assessment, stabilization, and treatment of patients who seek treatment for suspected intentional or accidental poisoning. This month's clinical practice guideline (CPG) column reviews the “Clinical Policy for the Initial Approach to Patients Presenting With Acute Toxic Ingestion or Dermal or Inhalation Exposure.”
What Nurse Practitioners Should Know About Direct‐to‐Consumer Advertising of Prescription Medications
Authors: Viale Pamela Hallquist 
Published: May 2005

PurposeTo describe the marketing strategies of direct‐to‐consumer (DTC) advertising and the risks, benefits, and potential influence on the prescribing practices of nurse practitioners (NPs).Data SourcesJournal articles, media sources, and clinical experience.ConclusionsThe effect of DTC advertising of prescription medications on NPs has not been well studied. Although there are studies that examine the effects of DTC advertising on physician prescribing as well as the effects of this practice on the consumer, opinions on the benefits of DTC advertising are varied.Implications for PracticeNPs need to recognize the potential influence of DTC advertising and to be prepared to guide patients toward appropriate medication choices by participating in a partnership with patients. Health care providers, including NPs, need to work with the pharmaceutical industry to encourage accountability of DTC advertising, thus improving dissemination of correct information and promoting positive outcomes for health consumers and patients.
Simplified Regimens for Treating HIV Infection and AIDS
Authors: Piliero Peter J. , Colagreco Joseph P. 
Published: May 2005

PurposeTo r eview the variables that greatly affect adherence to the complex treatment regimens used in HIV disease and to examine available options that could improve patient outcomes.Data SourcesComprehensive review of current medical and scientific literature, drug‐prescribing literature, and randomized clinical trials of drug treatments.ConclusionsEffective treatment of HIV infection is dependent on consistent adherence to prescribed antiretroviral medications. A large pill burden, multiple daily doses, and adverse events are some of the complexities that negatively impact patient adherence. For example, lipodystrophy and hyperlipidemia are two serious side effects associated with some agents. Once‐daily antiretroviral agents offer many advantages over historical treatment options but are associated with possible drawbacks.Implications for PracticeCurrently, four single agents are available for once‐daily administration, and a few others are under investigation. In addition, combination therapy with either dual or boosted protease inhibitor regimens is becoming a popular way of overcoming the poor pharmacokinetic characteristics of individual protease inhibitors.
Optimizing Mental Health in an Academic Nurse‐Managed Clinic
Authors: Sousa Karen H. , Zunkel Gretchen M. , Holman Elizabeth Jordan 
Published: May 2005

PurposeTo evaluate the initial results of tracking the health outcomes, specifically mental health outcomes, for clients at an academic nursing clinic and to describe an approach to mental health treatment in this setting.Data SourcesDescriptive‐survey design with convenience sampling of patients from a nurse‐managed clinic (N = 151). As part of the routine documentation for clinic clients, the Medical Outcomes Study Short‐Form 36‐Item Health Survey (SF‐36) was selected to monitor client health outcomes.ConclusionsThis health status evaluation indicated that the mental health scores for clinic clients were lower than national normed data. This result could reflect unmet mental health needs in clinic clients. Mental health reasons for the visit were reported in only 3% of the sample. Most clients in this sample sought treatment in the clinic for physical health screening and episodic health problems.Implications for PracticeIntegration of mental health interventions in primary care settings may help providers to optimize the management of clients' overall health status.
Impact of the New National Cholesterol Education Program (NCEP) Guidelines on Patient Management
Authors: Harmel Anne Peters , Berra Kathy 
Published: May 2005

PurposeTo update nurse practitioners (NPs) on the latest National Cholesterol Education Program (NCEP) guidelines for the management of high blood cholesterol in adults.Data SourcesThe 2001 NCEP Adult Treatment Panel (ATP) III guidelines and supporting scientific reviews and reports of clinical trials related to the evidence upon which the guidelines are based.ConclusionsThe many new features of the ATP III guidelines include an increased emphasis on the patient with multiple risk factors in order to identify appropriate candidates for primary prevention and on more stringent classifications of elevated lipid/lipoprotein levels. However, elevated levels of low‐density lipoprotein (LDL) cholesterol continue to be the focus for both primary and secondary prevention, and 3‐hydroxy‐3‐methylglu‐tarylcoenzyme A (HMG‐CoA) reductase inhibitors (statins) are clearly the drugs of choice for decreasing LDL cholesterol in most patients.Implications for PracticeBecause NPs play key roles in optimizing treatment management, it is important that they become familiar with, and be prepared to help implement, these latest guidelines. By embracing the global risk assessment approach of ATP III and aggressively treating all at‐risk patients, NPs can take a proactive role in helping to halt the progression of coronary heart disease and its consequences.
Nurse Practitioners' Knowledge, Practice and Attitudes About Tobacco Cessation & Lung Cancer Screening
Authors: Lawvere Silvana , Mahoney Martin C. , Englert Jessica J. , Murphy Jill M. , Hyland Andrew , Klein Susan B. , Loewen Greg M. 
Published: May 2005

PurposeTo determine nurse practitioners' (NPs') knowledge, practice, and attitudes about tobacco cessation counseling and lung cancer early detection.Data SourceA descriptive, cross‐sectional survey design was used to examine NPs' approaches to primary and secondary prevention of tobacco use among patients in western New York.ConclusionsAmong the 175 respondents, NPs appropriately counseled tobacco users on tobacco cessation. However, there was limited understanding of first‐line pharmacological agents used for tobacco cessation and of how to manage treatment for a patient at high risk for lung cancer.Implications for PracticeThese findings suggest the need to implement professional educational programs aimed at conveying not only the importance of tobacco cessation counseling but also information on the most effective first‐line pharmacological agents and appropriate management options for patients at increased risk of developing lung cancer.
Sickle Cell Disease: Health Promotion and Maintenance and the Role of Primary Care Nurse Practitioners
Authors: Tanyi Ruth A. 
Published: May 2005

PurposeTo discuss the role of nurse practitioners (NPs) with regard to early identification of affected individuals, effective monitoring and screening, effective pain management and prophylaxis, and health education for patients with sickle cell disease (SCD).Data SourcesElectronic database searches were performed using Medline, Cinahl, and PsycINFO. Data were obtained from medical textbooks, research, and review articles.ConclusionsSCD is a chronic inherited disease belonging to a group of conditions called hemo‐globinopathies. Individuals with SCD often require close medical care from specialists. Nonetheless, NPs are in ideal positions to facilitate the health promotion and health maintenance necessary to decrease the high rate of morbidity and mortality associated with this disease.Implications for PracticeNPs must understand the importance of early identification of affected individuals, effective monitoring and screening, effective pain treatment, and prophylaxis. The unpredictable trajectory of SCD can lead to frustration, fear, helplessness, hopelessness, and emotional distress. Ineffective pain management is a major problem for people with SCD. NPs can overcome this problem by initiating effective and prompt pain management in a nonjudgmental manner.
Recognizing And Treating Non‐Infectious Rhinitis
Authors: Mastin Terrye 
Published: May 2005

PurposeTo increase clinicians' familiarity with nonallergic and mixed rhinitis and to differentiate these from allergic rhinitis, thus providing for an accurate diagnosis and facilitating a successful initial treatment program.Data SourcesA Medline search of published journal articles was supplemented with known books and proceedings pertaining to rhinitis.ConclusionsAlthough there is significant overlap of symptoms among the three types of rhinitis (i.e., allergic, nonallergic, and mixed), the patient history often contains clues that can aid in establishing a correct diagnosis. The new Patient Rhinitis Screen, a questionnaire developed for use in the primary care arena, facilitates the diagnostic process.Implications for PracticeAs the most common condition in the outpatient practice of medicine, rhinitis is frequently treated by primary care practitioners. Recent guidelines for the diagnosis and management of rhinitis suggest that a specific diagnosis of allergic, nonallergic, or mixed rhinitis leads to more effective treatment strategies. The result is successful and efficient care utilizing, as appropriate, broad‐based and symptom‐specific therapies.
The Regulation of Dietary Supplements
Authors: Larsen Larissa L. , Berry Judith A. 
Published: May 2005

PurposeTo discuss the regulatory history of dietary supplements, define the term dietary supplement, clarify ingredient and nutrition information labeling, and discuss safety issues and implications for practice.Data SourcesReview of primary and secondary sources, including both Internet sites and journal articles.ConclusionsIn the United States, 6 out of every 10 people use dietary supplements. For decades, the Food and Drug Administration (FDA) protected the public from mislabeled and unsafe products by regulating as foods those dietary supplements that included only essential nutrients. The Nutrition Labeling and Education Act of 1990 included herbs as dietary supplements. When the Dietary Supplement and Health and Education Act (DSHEA) of 1994 was passed, the FDA lost its regulatory power. The DSHEA expanded the definition of dietary supplements beyond essential nutrients. Dietary supplements are no longer considered food additives, which makes them exempt from prescreening or any safety and efficacy studies before they are released to the public. Under the DSHEA, the FDA may take action if a product poses a direct health threat and only after adverse health effects have already occurred.Implications for PracticeA good understanding of the regulatory procedures for dietary supplements will aid nurse practitioners (NPs) in patient education regarding these products. Patients should be advised to choose supplements that are made by nationally known food and drug manufacturers that belong to trade groups. NPs and patients can contact the manufacturer directly and can access government Internet sites for more product information.
Integrating the Principles of Evidence‐Based Practice: Testing and Diagnosis
Authors: Goolsby Mary Jo , McNaughton Molly Ann , Klardie Kathleen , Meyers Wendy 
Published: May 2005

ABSTRACTThe intention of the clinical practice guideline (CPG) column has included increasing readers’ familiarity with the range of available evidence‐based recommendations, while stimulating dialogue regarding application of those recommendations in practice. This column introduces the first article in a series of three written to describe a framework in which the principles of evidence‐based practice can be applied. This article uses a clinical scenario to illustrate considerations relevant to the selection and application of a CPG in practice.
Adherence to Oral Therapy for Type 2 Diabetes: Opportunities for Enhancing Glycemic Control
Authors: Bartels David 
Published: May 2005

PurposeAlthough diet and exercise are important parts of type 2 diabetes treatment, most patients require pharmacological intervention with multiple agents to maintain adequate glycemic control. This article addresses the numerous patient‐related, disease‐related, and demographic variables affecting medication adherence in this patient population.Data SourcesExtensive review of scientific literature, clinical practice guidelines, and Internet sources.ConclusionsStudies have demonstrated that treatments including multiple medications or frequent dosing had a negative impact on adherence. Practitioners have used several approaches in an effort to improve adherence to oral antidiabetic medical therapy, including increased communication between health care providers and patients, implementation of multidisciplinary programs, and use of treatment regimens with easier dosing (i.e., reduced number of drugs or doses taken per day).Implications for PracticeOptions for type 2 diabetes treatments that combine effective medications into a simpler oral‐dosage form may motivate and improve patient adherence. Ultimately, simplifying dosing may lead to better glycemic control, thereby reducing the risks associated with long‐term consequences of the disease.
Factors Influencing the Utilization of Lyme Disease‐Prevention Behaviors in a High‐Risk Population
Authors: McKenna Donna , Faustini Yolanda , Nowakowski John , Wormser Cary P. 
Published: May 2005

PurposeTo evaluate factors motivating high‐risk individuals to implement Lyme disease—prevention behaviors.Data SourcesPatients presenting to the Lyme Disease Diagnostic Center in New York State completed a voluntary, anonymous questionnaire.ConclusionsOf the 219 persons completing the questionnaire, participants who reported having had Lyme disease in the past were significantly more likely to use preventive behaviors than those without a history of Lyme disease (p = .01). Additionally, persons who reported having a family member or close friend with Lyme disease were more likely to use preventive behaviors than those without such a relationship (p = .02). Increasing age was associated with increased use of preventive behaviors only for participants without a history of Lyme disease (p = .04).Implications for PracticeThese findings provide information that may be important in developing community prevention programs for Lyme disease. Younger persons without a history of Lyme disease should be targeted for programs that will educate them about Lyme disease. Table 1 Clinical Resources for Diagnosing and Treating Lyme disease
The Need to Bleed: Women's Attitudes and Beliefs About Menstrual Suppression
Authors: Andrist Linda C. , Hoyt Alex , Weinstein Dawn , McGibbon Chris 
Published: May 2005

PurposeTo describe how women feel about monthly menstruation in general and menstrual suppression in particular.Data SourcesThis descriptive, exploratory study used a convenience sample of 221 women who completed a self‐administered questionnaire on attitudes toward monthly menstruation and menstrual suppression. Descriptive statistics and correlations were used to analyze the data.ConclusionsWomen not using oral contraceptives (OCs) had more menstrual symptoms than women using OCs. Negative feelings about menstruation were correlated with interest in menstrual suppression. Over two thirds expressed interest in reducing menstrual pain and the amount of menstrual discharge, particularly if not taking OCs. Women who were not interested in changing their menstrual pattern said they would be anxious about not having a menstrual flow and said it would not be normal.Implications for PracticeAdvanced practice nurses play an important role in educating women about menstrual health. Clinicians can use this information to assess women's attitudes and beliefs about menstrual symptoms and to educate them about misconceptions. The FDA approved Seasonale® in September 2003, the first dedicated OC created to reduce the number of menstrual cycles yearly. Women need to be educated about the pros and cons of suppression; some women will benefit from suppression, and others will consider it unnatural.
Tort Reform: An Issue for Nurse Practitioners
Authors: Klutz Diane L. 
Published: May 2005

PurposeTo inform nurse practitioners (NPs) about the issues related to tort reform and its relationship to malpractice insurance costs.Data SourcesCurrent journals, newspapers, professional newsletters, and Internet sites.ConclusionsNPs are paying more for their malpractice premiums, and many are losing their places of employment as clinics close due to the increased cost of premiums. One method proposed for curbing the flow of monies spent on premiums and litigation is tort law reform. California serves as an example; its Medical Injury Compensation Reform Act (MICRA) tort reform law was passed 25 years ago, and has maintained stable malpractice premiums. Other states have proposed similar laws, but some have not had similar success. To curb litigation costs, not only should tort laws be reformed, but NPs and physicians should keep abreast of current practice standards in order to provide quality medical care.Implications for PracticeLike physicians, NPs are affected directly by tort laws. These laws hold NPs accountable the same level as physicians. In addition, many states limit NPs’ practice to delegation of authority by a physician. Liability is therefore transferred from the NP to the physician and vice versa in cases of injury or wrongful act. In addition, many NPs are finding it increasingly difficult to locate insurers who will write policies for medical liability.
The Health Styles of Nurse Practitioners
Authors: Blackwell James 
Published: May 2005

PurposeTo examine the formal and informal health care beliefs, behaviors, and practices of nurse practitioners (NPs).Data SourcesA self‐administered questionnaire with a primarily closed‐ended format was distributed over a 3‐day period to a convenience sample of 321 NPs attending a national NP conference.ConclusionsThe overall health status and health practices of NPs were found to be fairly good, but there was room for improvement, particularly with regard to nutrition, health responsibility, physical activity, and stress management.Implications for PracticeRespondents were more likely to self‐diagnose and self‐treat minor illnesses and largely received their primary health care from physicians. The majority of NPs indicated a willingness to receive health care from an NP; however, the nonavailability of NPs restricted this option.