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Biomedical subjects

Ruth M Kleinpell

Publications and source records attributed to Ruth M Kleinpell.

At least 19 recordsLinked to original sources
PubMed2005

Strategies for success in the acute care nurse practitioner role.

This article reviews issues related to development of the role of the acute care nurse practitioner (ACNP). Strategies for ensuring success in the role are outlined, including the importance of communication about the role, maintaining competency, forming collaborative relationships, and the value of networking. The ACNP represents an innovative role in advanced practice nursing. Demonstrating the outcomes of ACNP practice ensures recognition of the impact and value of this unique role.

Acute Disease↗
PubMed2005

Educational options for acute care nurse practitioner practice.

PURPOSE: During the Acute Care Interest Group Forum held on June 18, 2005, at the American Academy of Nurse Practitioner's Conference, it was identified that information on educational options for acute care nurse practitioner (ACNP) practice was needed, particularly for NPs who may have had other educational preparation but who were now working in acute care practice settings. As a result, a workgroup was formed to compile information on educational options for ACNP practice, including post-master's programs. DATA SOURCES: Web site descriptions of ACNP programs (n= 70) and, as needed, phone calls to ACNP programs to obtain information on program offerings including post-master's and distance-learning options. CONCLUSIONS: Educational options for ACNP practice include master's and post-master's programs, along with national certification. A growing number of educational programs offer post-master's options as well as distance-learning formats for coursework. IMPLICATIONS FOR PRACTICE: NPs interested in obtaining ACNP education, including those with other NP specialty education who are now working in acute care settings, have a number of choices for pursuing ACNP practice. NPs working in acute care need to ensure that their educational preparation meets the requirements set forth by the scope of standards for ACNP practice and national requirements and state regulations.

Decision Making↗
PubMed2005

Acute care nurse practitioner practice: results of a 5-year longitudinal study.

The role of acute care nurse practitioners (ACNPs) has developed in capacity. More than 3500 advanced practice nurses have been certified as ACNPs, and the number of practice settings where these professionals work is continually expanding. Beginning in 1996, a series of surveys were conducted of nurse practitioners seeking national certification as ACNPs. What started as an attempt to gather information on the role of ACNPs evolved into a national 5-year longitudinal survey of ACNP practice. The cumulative results of the project are reported, and how the role of the ACNP was established in advanced practice nursing is discussed.

Adult↗
PubMed2004

Randomized trial of an intensive care unit-based early discharge planning intervention for critically ill elderly patients.

BACKGROUND: Few investigators have targeted elderly patients and monitored outcomes of care in studies on discharge planning interventions after critical illness. OBJECTIVES: To pilot test an intensive care unit-based nursing screening intervention to assist in determining the discharge needs and outcomes of critically ill elderly patients. METHOD: A randomized clinical trial with in-hospital and mailed questionnaires was used. Patients 65 years and older who were hospitalized in 1 of 2 intensive care units at 2 midwestern university-affiliated medical centers were recruited for the study. Control patients (n = 53) received usual discharge planning, experimental patients (n = 47) were screened in the intensive care unit by using the Discharge Planning Questionnaire. Both groups were assessed for readiness for discharge when discharged from the hospital and were followed up 2 weeks later with a survey completed at home. RESULTS: One hundred patients 65 to 90 years old (mean 73, SD 5.78) completed the study. Sixty-six percent were men. The 2 groups did not differ with regard to age, race, sex, severity of illness, lengths of stay in the intensive care unit or hospital, education level, or income. Patients in the experimental group were more ready than patients in the control group for discharge (P =.06). Patients in the experimental group were also more likely to report they had adequate information, had less concern about managing their care at home, knew their medicines, and knew danger signals indicating potential complications. CONCLUSION: Intensive care unit-based early discharge planning can affect elderly patients' preparation for discharge.

Aged↗
PubMed2003

The role of the critical care nurse in the assessment and management of the patient with severe sepsis.

Sepsis with acute organ dysfunction is common, frequently fatal, and expensive. The critical care nurse is involved in the continuous bedside care of the critically ill patient; consequently, he or she has the opportunity to prevent sepsis through infection control practices and general nursing care, to identify patients at risk for the disease, to monitor these patients for the clinical signs of sepsis, and to detect developing organ dysfunction as a manifestation of severe sepsis. In addition, the nurse is responsible for monitoring the patient's response to organ support measures and specific antisepsis interventions. The role of the critical care nurse in the assessment and management of severe sepsis is significant and can greatly improve outcomes for the patient with this disease. Drotrecogin alfa (activated) is a promising new therapy in the treatment of severe sepsis. Nurses caring for patients with this disease need to understand the issues related to the administration of drotrecogin alfa (activated) and the monitoring of patients receiving this drug to promote optimal and appropriate use of this innovative therapy.

Anti-Infective Agents↗
PubMed2003

Lipid management and the elderly.

Advancing age is an independent risk factor for the development of coronary heart disease. However, the significance of hypercholesterolemia as a cardiovascular risk factor in the elderly, has been widely debated. While no large-scale, randomized clinical trial has been conducted to evaluate cholesterol lowering solely in the elderly, evidence from older subgroups in several intervention trials supports the efficacy of lowering elevated low-density lipoprotein cholesterol for reducing cardiovascular risk in the elderly. Furthermore, although the relative risk of hyper-cholesterolemia for coronary heart disease incidence may be attenuated with advancing age, the population-wide impact of treating elevated cholesterol levels in the elderly would be large, due to the high frequency of coronary heart disease in the elderly. This article reviews key issues in the management of hyper-cholesterolemia with respect to coronary heart disease risk reduction in the elderly.

Aged↗
PubMed2003

Advances in the understanding of clinical manifestations and therapy of severe sepsis: an update for critical care nurses.

Severe sepsis is a major public health concern and a burden on the healthcare system. Despite improvements in efforts to control the source of infection and increased recognition by healthcare providers of patients with the disease, the mortality rate remains unacceptably high, from 30% to 50%. The systemic inflammatory response syndrome criteria are used as diagnostic indicators of sepsis when they occur in patients with known or suspected infection. The outcome of a patient with severe sepsis is often related to the occurrence of sepsis-induced multiple organ dysfunction syndrome. Multiple organ dysfunction syndrome appears to result from a cascade of organism-related factors, inflammatory mediators, endothelial injury, disturbed hemostasis, and microcirculatory abnormalities. In patients with severe sepsis, derangements of inflammation and coagulation are tightly linked. Although numerous clinical trials focused on interventions in one or the other of the inflammatory and coagulation systems failed to show reduced mortality due to sepsis, a member of a new class of drugs called "cogins" was effective. In its active form, protein C has anti-inflammatory, antithrombotic, and profibrinolytic properties that can reduce organ injury associated with severe sepsis. A recombinant form of activated protein C, drotrecogin alfa (activated), significantly reduces 28-day mortality due to all causes in patients with severe sepsis and has an acceptable safety profile. This review provides an overview of severe sepsis, highlighting recent advances in treatment of the disease and the role of critical care nurses.

Blood Coagulation Disorders↗
PubMed2002

Quality of life of elderly patients after treatment in the ICU.

The purpose of this study was to determine the impact of intensive care unit (ICU) treatment on quality of life (QOL) outcomes for critically ill elderly patients 4-6 months after ICU discharge. A mean overall score of 21.4 (SD=6.3) was obtained with the Quality of Life Index (Ferrans & Powers, 1985), indicating that all the ICU survivors in the sample (N=164) reported good QOL and were satisfied with areas of life that were important to them. Greater social support, better perceived health status, fewer days of hospitalization, and a hospital readmission since discharge were associated with higher QOL (R2=.51). This sample of elderly ICU survivors maintained a good QOL after their critical illness regardless of age.

APACHE↗
PubMed2002

What advanced practice nursing outcomes research is out there?

With a traditional focus on primary care or selected patient populations, advanced practice nurses (APNs) are forging new roles in a variety of practice settings, including acute and critical care. APNs have become important members of the critical care team, yet the impact of their care on acute and critically ill patients has not been well studied. This article presents an overview of the research currently available on outcomes of APN practice for acute and critically ill patients. The findings from these studies are discussed and implications for the future of APN outcomes research are provided.

Data Interpretation, Statistical↗
PubMed2002

Collaborative practice in advanced practice nursing in acute care.

APN in the United States encompasses a variety of collaborative models of care. Collaborative relationships with other disciplines such as medicine, pharmacy, social service, and physical, respiratory, and occupational therapy are an important component of the APN role. The collaborative relationship of the APN and physician is a unique one for providing optimal patient and family care. As changes in healthcare in acute care settings continue to occur, additional collaborative models for APN and physician care will only continue to help in meeting the healthcare needs of patients.

Cooperative Behavior↗