ONP / Oklahoma Nurse Practitioners News

Survey Finds More Nurses Use Mobile Devices

A survey of more than 1,000 nurses, most of them nurse educators with advanced degrees, revealed that 74.6% were smartphone or tablet computer owners. Researchers from Springer Publishing also found that 68.4% are on Facebook, while 37.3% are on LinkedIn. "These findings indicate the rapid growth of mobile technology use among those in the health care industry," a company official said.

ICU Outcomes No Different Without Physician Staffing

Reprint from Nurse.com (Wednesday June 8, 2011)

With ICUs facing staff shortages that are predicted to worsen in the future, a recent study suggests that non-physician providers can help address these deficits.

The study by physicians from Beth Israel Medical Center and Columbia University Medical Center in New York City found no significant differences in hospital mortality or other patient outcomes between high-acuity, adult ICUs staffed by nurse practitioners and physician assistants when compared with those staffed by intensivists or other physicians.

The study included a retrospective review of 590 daytime (7 a.m. to 7 p.m.) admissions to two ICUs at one hospital. Nurse practitioners and physician assistants staffed one of the ICUs during the day, with attending physician coverage overnight. In the other ICU, medical residents were present around the clock.

In addition to patient mortality, the researchers found no significant difference between the two ICUs in ICU length of stay and hospital length of stay. Discharge to a skilled care facility, as opposed to home, also was similar after adjusting for other factors.

The researchers noted that as "the number of ICU beds and demand for intensivists increase, alternative solutions are needed to provide coverage for critically ill patients."

"Staffing models including daytime use of nonphysician providers appear to be a safe and effective alternative to the traditional house staff-based team in a high-acuity, adult ICU," they concluded

This article appears in the June issue of Chest, the peer-reviewed journal of the American College of Chest Physicians. View the data at http://chestjournal.chestpubs.org/content/139/6/1347.abstract.

5 Tips for Busy Nurses

By Connie Merritt, RN, BSN, PHN

As nurses we have a great commitment to our profession in the care of our patients but often we don't take care of our OWN lives. It is widely reported that we sacrifice a little of ourselves: our time, our energy, our lunch, and yes, our needs. Almost all of us know the challenge of back-to-back shifts! Inconsistent work schedules! Eating on the run! Standing on our feet too long! The stress of work obligations, family demands, and professional responsibilities often interferes with nurses' ability to do what's right for their own health.

As a nurse and business owner, I have seen the physical and the practical symptoms of America's busyness and stress epidemic. I am on a mission to help people maintain their spark for life. Here are some practical tips from my recent research and book released from McGraw-Hill: TOO BUSY FOR YOUR OWN GOOD that help unravel the issues to reduce stress levels and make a positive difference with your career, family, health, relationships and finances.

TIP 1: ACCEPT IT! Your care starts with YOU! Accept it's your responsibility to help reduce stress and manage busyness and that you can manage it! (Even if you are getting multiple demands from different areas.) By taking responsibility for your time, it enables you to find the solutions far more quickly and you're more likely to have the life you want this year.

TIP 2: BE PRESENT Nurses live in a world that is always "on." Hospitals and healthcare needs never close. It's up to you to work your hours and then leave your concerns and worries. This involves confidence in your coworkers and strong interpersonal communications skills. An exercise you must commit to in order to be successful to reduce stress and insure balance in your life is to be PRESENT:

Prioritize what's important for your purpose
Rest and restore your body
Eliminate clutter and enjoy what you have
Set "smart" goals ("specific, measurable, attuned to your life, realistic, with a timetable")
Encourage harmonious relationships
No, politely needs to be communicated more often
Trust in something greater than yourself

This is a vital exercise that needs to be reviewed almost daily! In fact, when you read the exercise – did you make plans to work through being PRESENT? Or, are you glossing over the exercise thinking you could not possibly fit this into your schedule? This is about you and your essential energy for life – your spark! When you live in the present, you are living where life is happening – and living in the present will change your life. Promise yourself you will do the work to be PRESENT.

TIP 3: ADMIT IT! Admit that you can do it – it's possible – you can take control.

TIP 4: LET GO! What can you let go of ? This one takes some figuring out – what and how to let go. Take the time and make the necessary changes (that includes people, places and things).

TIP 5: SAY NO! A big part of letting go is saying NO. No, may be the most powerful word to use to help relieve stress and find more time to take care of things that matter most to you. No, can save you time, enable you to focus on what's important to you and – protect you from your own good-heartedness! While saying 'no' can be a challenge, you can express it pleasantly with a smile (in your heart and tone) with these "no" phrases:

"I have a prior commitment."
"Sorry, can't – let me know how it goes."
"I am tempted, but I'll have to pass."
"You know I'd never refuse you if I could help it....but I'm afraid that won't work for me."

Research indicates that we all get busy and do not take the necessary time to do what we really need to do to manage our lives. Busyness destroys our balance, scrambles our priorities and leads us into stress and a cluttering of our lives with too many activities, endless to-do lists and not enough time to re-charge to do the things we really need to do. These tips will help you manage your time, make good choices with less stress and more balance– enabling you to take better care of you and your special spark for life!

Medicare Fee-for-Service Health Care

As a condition for payment, the Affordable Care Act mandates that prior to certifying a patient's eligibility for the home health benefit, the certifying physician must document that he or she, or an allowed non-physician practitioner (NPP) has had a face-to-face encounter with the patient. Documentation regarding these encounters must be present on certifications for patients with starts of care on and after January 1, 2011.

Nursing Covering More Health Care

By Deborah Yetter and Jessie Halladay, USA TODAY | March 11, 2010

FRANKFORT, Ky. — Each year, Wendy Fletcher says, she and two partners see more than 5,000 patients at their practice in Morehead, Ky. They are not doctors, but rather registered nurse practitioners who say they are able to increase access to health care and make it more affordable.

"None of us are trying to play doctor," she said. "If we'd wanted to be doctors, we would have gone to medical school," added nurse practitioner Melinda Staten of Louisville.

Pharmacy Board Rule As It Pertains To Prescriptive Authority And ARNPs

53.1a. Advanced practice nurses - Prescribing authority. Prescribing authority shall be allowed, under the medical direction of a supervising physician, for an advanced practice nurse recognized by the Oklahoma Board of Nursing in one of the following categories: advanced registered nurse practitioners, clinical nurse specialists, or certified nurse midwives. The advanced practice nurse may write or sign, or transmit by word of mouth, telephone or other means of communication an order, for drugs or medical supplies that is intended to be filled, compounded, or dispensed by a pharmacist. The supervising physician and the advanced practice nurse shall be identified at the time of origination of the prescription and the /name of the advanced practice nurse shall be printed on the prescription label.

Health Information Technology: A User's Guide For Nurse Practitioners

Health information technology (HIT), also known as "informatics," is a relatively new discipline, which combines computer literacy with information literacy. This knowledge, combined with your expertise as a nurse practitioner (NP) or other health care professional can be a valuable tool to help you provide high quality, safe, and effective health care.

Many excellent internet sources exist which can help you learn more about IT applications that will help you in your practice. This user's guide will provide you with basic information to get started, and to help you locate credible sources for ongoing learning.