The Nurse Practitioner Role in Evidence-Based Medication Strategies

Kidik, Patricia; Holbrook, K. F.

doi:10.1016/j.jopan.2007.09.013

Cited by 4 publications

(7 citation statements)

References 31 publications

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“…26,27 The role of the NP is well-suited to manage these and other responsibilities in the ASC (Table 1). By using evidence-based guidelines, the NP functions independently or collaboratively with the surgeon and the anesthesia professional.…”

Section: Professional Role Developmentmentioning

confidence: 99%

“…In the perioperative environment, the NP might obtain the patient's medical and surgical history, perform a physical assessment, perform the nursing and anesthesia assessments, provide patient teaching, order and interpret diagnostic tests, eliminate unnecessary tests, act as a resource person for perioperative personnel and patients before and after surgery, prescribe necessary medications related to ACT, and perform medication reconciliation. 26,27 The role of the NP is well-suited to manage these and other responsibilities in the ASC (Table 1). By evaluating and assessing the patient, the NP can identify individuals who need thromboembolism prophylaxis, which is often missed.…”

Section: Professional Role Developmentmentioning

confidence: 99%

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Anticoagulation Management in the Ambulatory Surgical Setting

Eisenstein

2012

AORN Journal

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Many people receiving maintenance anticoagulation therapy require surgery each year in ambulatory surgery centers. National safety organizations focus attention toward improving anticoagulation management, and the American College of Chest Physicians has established guidelines for appropriate anticoagulation management to balance the risk of thromboembolism when warfarin is discontinued with the risk of bleeding when anticoagulation therapy is maintained. The guidelines recommend that patients at high or moderate risk for thromboembolism should be bridged with subcutaneous low-molecular-weight heparin or IV unfractionated heparin with the interruption of warfarin, and low-risk patients may require subcutaneous low-molecular-weight heparin or no bridging with the interruption of warfarin. The guidelines recommend the continuation of warfarin for patients who are undergoing minor dermatologic or dental procedures or cataract removal. The literature reveals, however, that there is not adequate adherence to these recommendations and guidelines. Management of anticoagulation therapy by a nurse practitioner may improve compliance and safety in ambulatory surgery centers.

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Section: Professional Role Developmentmentioning

confidence: 99%

Section: Professional Role Developmentmentioning

confidence: 99%

Anticoagulation Management in the Ambulatory Surgical Setting

Eisenstein

2012

AORN Journal

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“…33 This guide is intended to help close the gap between evidence and execution and cites the following elements to reach significant improvement in quality of care: 34 When an eligible patient is identified, the NP contacts the appropriate healthcare team to ensure implementation, provides instruction to the patient, and documents the recommended protocol in the medical record. With the use of this model, NPs may improve identification of high-risk patients, increase the application of evidence-based guidelines, and subsequently improve patient outcomes.…”

Section: Process Improvement Initiativesmentioning

confidence: 99%

Venous Thromboembolism

Worel

2009

Journal of Cardiovascular Nursing

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Venous thromboembolism (VTE) is a major cause of death and disability throughout the world. Evidenced-based guidelines and performance measures aimed at prevention of VTE have existed for over a decade, yet VTE occurrence rate appears to be increasing. This increase may, in part, be due to more aggressive surveillance; however, noncompliance with guideline recommendations for prophylaxis is a concern. Several barriers have been identified as contributing to lack of guideline adherence including lack of supportive systems, lack of individual responsibility for implementation, lack of acceptance, perceived lack of need in some clinical areas, no oversight or incentives, and conflicting guideline recommendations. Distribution of guidelines to healthcare providers does not result in increased guideline adherence. Applying multiple process improvement strategies appears to increase guideline utilization and may help achieve improved patient outcomes and higher performance measures.

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“…). Preanaesthesia care is a component of the preoperative environment and, depending on the model of care, is often carried out by anaesthesiologists or nurse practitioners (Kidik & Holbrook ). Early studies (prior to the implementation of the electronic medical record) found that at the time of the preanaesthesia visit, providers frequently lack the relevant medical information about the patient (Gibby & Schwab , Parker et al .…”

Section: Introductionmentioning

confidence: 99%

“…Once the need for surgical intervention is confirmed, the care of the patient transitions to include anaesthesia care providers who are responsible for assessing the patient's risks for surgery (Fleisher et al 2007). Preanaesthesia care is a component of the preoperative environment and, depending on the model of care, is often carried out by anaesthesiologists or nurse practitioners (Kidik & Holbrook 2008). Early studies (prior to the implementation of the electronic medical record) found that at the time of the preanaesthesia visit, providers frequently lack the relevant medical information about the patient (Gibby & Schwab 1998, Parker et al 2000.…”

Section: Introductionmentioning

confidence: 99%

A qualitative study of patient and provider experiences during preoperative care transitions

Malley

Young

2017

Journal of Clinical Nursing

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Aims To explore the issues and challenges of care transitions in the preoperative environment. Background Ineffective transitions play a role in a majority of serious medical errors. There is a paucity of research related to the preoperative arena and the multiple inherent transitions in care that occur there. Design Qualitative descriptive design was used. Methods Semi-structured interviews were conducted in a 975 bed academic medical center. Results 30 providers and 10 preoperative patients participated. Themes that arose were: (1) Need for clarity of purpose of preoperative care (2) Care coordination (3) Inter-professional boundaries of care (4) Inadequate time and resources. Conclusion Effective transitions in the preoperative environment require that providers bridge scope of practice barriers to promote good teamwork. Preoperative care that is a product of well-informed providers and patients can improve the entire perioperative care process and potentially influence post-operative patient outcomes. Relevance to Clinical Practice Nurses are well positioned to bridge the gaps within transitions of care and accordingly affect health outcomes.

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The Nurse Practitioner Role in Evidence-Based Medication Strategies

Cited by 4 publications

References 31 publications

Anticoagulation Management in the Ambulatory Surgical Setting

Anticoagulation Management in the Ambulatory Surgical Setting

Venous Thromboembolism

A qualitative study of patient and provider experiences during preoperative care transitions

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