Nursing Synthesis Papers

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    Exploring the nurse practitioner role in palliative care in New Brunswick
    (University of New Brunswick, 2015) Duplessis, Lisa; Hamilton, Sarah
    Every individual will die, and people have a right to end-of-life (EOL) care. This natural life progression demands to be supported and managed by proficient, caring health care providers to deliver quality EOL care, both in the hospital and community setting (Heyland et al. 2010). In New Brunswick (NB), barriers at EOL care include a lack of access to primary care providers, limited knowledge or practice in the delivery of such care, and a lack of palliative care services available for dying patients. Nurse Practitioner (NP) practice includes management of all the domains of health by addressing psychological, social and spiritual distress, as well as the relief and management of physical symptoms throughout the illness trajectory. The evidence available clearly supports the NP as an integral provider in palliative care management and one who can bring much expertise to the interprofessional team whether in the institutional, community or primary health care settings. Research exploring how NPs can be integrated as active participants in interdisciplinary palliative care teams and in NB’s Extra Mural program is necessary to address gaps in care, accessibility to palliative care and to develop strategies for patients’ increased quality of life at EOL.
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    The transition from registered nurse to nurse practitioner
    (University of New Brunswick, 2015) Keir, Keltie P.; VanSlyke, Stephen
    Objectives: The meta-synthesis provides a collective qualitative understanding of the transition experience from a registered nurse (RN) to a nurse practitioner (NP). This understanding assists the NP student in the transition, offers recommendations for graduate programs, and addresses a mentorship relationship that offers benefits to the student and mentor. Design: Published qualitative studies about the transition from RN to NP were selected in order to integrate their findings in a meta-synthesis. Data Sources: Databases were searched including CINAHL, MEDLINE, Google Scholar, and Psych Info. Review Methods: The following search terms were used: Nurse Practitioner OR Advanced Nursing AND role transition, primary health care, and transition models. Findings along with direct quotes were extracted from the studies and thematic analysis was used within an interpretative framework. Results: Three studies were included in the meta-synthesis. The central theme was a shift from an insecure NP to a confident, autonomous practitioner which involved a progression through the following four phases throughout the first year of practice: 'laying the foundation'; 'launching'; 'meeting the challenge'; and 'broadening the perspective' (Brown & Olshansky, 1997). Conclusion: New NPs felt overwhelmed and uncertain in the initial phases of transition. These challenges are related in part to the difficulty of letting go of previous nursing expertise and immersion into an entirely different clinical role. The transition requires an identity shift which can take one year or more. Novice NPs need academic guidance, supportive clinical settings, and a sense of connection with one another throughout the transition to continue with the success of the NP role.
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    Screening tools to assess risk of opioid abuse in the primary healthcare setting
    (University of New Brunswick, 2015) Muir, Hollie; Seymour, Fran
    The prescribing of opioid therapy for patients suffering with chronic pain is increasing, along with rates of opioid abuse. With the advancement of the nurse practitioner scope of practice to include the prescribing of controlled substances, nurse practitioners who work in the primary healthcare settings are now initiating and managing chronic opioid therapy. To ensure that proper treatment and monitoring plans are implemented, nurse practitioners must be able to identify patients at risk of abuse or who are exhibiting aberrant drug related behaviors. There are many screening tools available to assess risk of abuse or identify aberrant drug related behaviors, however, only the Screener and Opioid Assessment for Patients with Pain Revised and Current Opioid Misuse Measure tools have been cross-validated for their validity and reliability for chronic pain patients in primary healthcare settings. A brief review of screening tools is presented, and a recommendation on the consistent use of screening tools when prescribing chronic opioid therapy is discussed.