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Biomedical subjects

K C McDermott

Publications and source records attributed to K C McDermott.

4 recordsLinked to original sources

Prescriptive authority for advanced practice nurses: current and future perspectives.

PURPOSE: To present an overview of the issues related to prescriptive authority and advanced practice nurses (APNs) in oncology. DATA SOURCES: Professional journals and books, print media, and professional and government releases. DATA SYNTHESIS: Discussion of issues related to complex political, educational, economic, and healthcare environmental factors. Strategies to achieve increased recognition for APN prescriptive authority include increasing APNs' knowledge about the effects of the political process on prescriptive authority, educating legislators and consumers, promoting standardization of pharmacology curricula, and encouraging formation of coalitions. CONCLUSIONS: Failure to pass a national healthcare plan, escalating managed-care markets, and the reform efforts of individual states to forge their own healthcare initiatives will challenge the APN's ability to practice and prescribe. IMPLICATIONS FOR NURSING PRACTICE: The subject of prescriptive authority highlights the controversies and debates that APNs encounter in a dynamic healthcare environment. These include the complexity of state-to-state regulations, non-nursing professions making key decisions regarding scope of practice and prescriptive authority, and the challenge for APNs to carve out new roles while overcoming state regulatory inconsistencies and market-reform barriers. If not resolved, these issues will continue to prevent qualified APNs from providing appropriate and comprehensive care to patients with cancer.

Drug Prescriptions

Healthcare reform: past and future.

PURPOSE: To review changes in the healthcare delivery system and project the challenges that practitioners and consumers will face in a reformed environment. DATA SOURCES: Professional journals and books, print media, and government releases. DATA SYNTHESIS: Analysis of projected reform plans, discussions of issues related to complex social, economic, and political factors, and considerations for practice changes for oncology nurses. CONCLUSIONS: The pending dominance of healthcare delivery through managed-care systems will challenge oncology care providers and consumers. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses must identify the opportunities, master the challenges, and adapt to the trends of the reformed healthcare system. The delivery of long-term care to senior citizens, patients with AIDS, and individuals from diverse cultures will shift to more community, ambulatory, and rural managed-care settings. Oncology nursing practice in these environments raises questions about prevention and screening, diagnosis, treatment, follow-up, alternative care, and research. Oncology nurses, especially advanced practice nurses, will play a pivotal role in reshaping the delivery of patient care and in designing the future of their profession.

Delivery of Health Care

The diagnosis and management of hypomagnesemia: a unique treatment approach and case report.

Hypomagnesemia is a common but frequently overlooked electrolyte disorder that occurs as part of a complex metabolic profile. It often is associated with a spectrum of nonspecific symptoms secondary to other electrolyte deficiencies. These symptoms then are associated with the primary illness, thereby masking the presence of this disorder. In most clinical situations, magnesium deficiency is transitory and responds well to short-term supplementation. Certain populations of patients with cancer may have an increased risk of developing severe hypomagnesemia requiring continued supplementation; patient populations receiving aminoglycoside antibiotics or cisplatin therapy are considered to be high-risk groups. This paper describes the causes, signs, and symptoms of chronic hypomagnesemia; patient populations at risk of developing this disorder; and a unique treatment approach using a subcutaneous pump infusion system. A case study illustrates the complexity of clinical and nursing management of this disorder.

Chronic Disease