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Practitioner, Nurse

A practitioner is a healthcare professional who provides direct patient care, often in a specialized field.
Nurses are a subcategory of practitioners who are responsible for assessing, planning, implementing, and evaluating patient care.
Practitioners and nurses play a critical role in the delivery of healthcare services, utilizing their expertise to promote patient wellbeing.
This MeSH term encompasses the various roles and responsibilities of these vital members of the healthcare team.

Most cited protocols related to «Practitioner, Nurse»

The Provider Order Entry Team (POET) at Oregon Health & Science University in Portland, OR was funded to adapt RAP to study clinical decision support (CDS) systems in community hospitals. Subsequently, POET received further funding to use these methods to study CDS systems in outpatient clinics. We have defined computerized provider order entry (CPOE) as a system that allows a provider, such as a doctor or nurse practitioner, to directly enter medical orders via computer. We have defined clinical decision support as “passive and active referential information as well as reminders, alerts, ordersets, and guidelines.”(32 (link))
We generated a fieldwork guide and process for conducting rapid assessments that can be applied to a range of workplace studies in clinical informatics. Please see Appendix A for a sample fieldwork guide. The guide and process have been refined over the course of two years (2007–2009), as we first visited two community hospitals and subsequently visited five ambulatory settings. Starting by using existing examples of protocols and fieldwork guides from public health settings as templates, (23 ;24 ;26 ;27 ) we have been able to successfully and reliably create a fieldwork guide to conduct RAP across a variety of organizations ranging from primary to tertiary care settings.
Our adaptation of RAP for clinical informatics has been informed by guidelines for designing and reporting such evaluations, such as Utarini, Winvist and Pelto’s “11 critical criteria” for conducting RAP(33 ) and the STARE-HI statement of reporting clinical informatics evaluations.(22 (link)) Scrimshaw and Hurtado (23 ) provide numerous examples of data collection guides to be used by RAP team members, including observation guides for studying health-care providers, suggestions for documenting specific health-care processes, and focused interview questions for specific types of health-care personnel. We used these as starting points for creating data collection tools that related to clinical decision support in community hospital and outpatient settings. At the end of each site visit, we discussed changes to our protocol and we met frequently before each site visit in order to tailor our protocol for site-specific conditions.
To date, our fieldwork guide includes the following: 1) a site visit preparation schedule, 2) a pre-visit site profile, 3) a site visit schedule, 4) a fact sheet to be given to subjects, 5) a typical interview guide, 6) a form for field notes, 7) a brief field survey instrument, and 8) an agenda for team debriefings. Data analysis procedures evolved over time to promote reflexivity (awareness of how each team member’s perspective may influence the research process), documentation, and triangulation. Within a few months of a site visit, we conduct our data analysis and write a report of our findings. As we visit multiple sites, we compare themes and findings across sites in order to produce research reports that examine focused topics across various sites. Previously published rapid assessment protocols have emphasized the importance of a fieldwork guide for rigorously documenting evaluation activities, gaining a clear understanding of what team members are expected to do, and ensuring replicability. (23 ;24 ;26 ;27 ) In developing and adapting our procedures over time, we have found that lesson extremely valuable.
Publication 2010
Acclimatization Awareness Clinical Decision Support Health Personnel Outpatients Physicians Practitioner, Nurse Process Assessment, Health Care Reflex
The four continuity measures - the Bice-Boxerman Continuity of Care (COC) Index,14 (link) Herfindahl Index (HI), usual provider of care (UPC),15 (link) and Sequential Continuity of Care Index (SECON)16 (link) —are described in Table 1.
The COC index reflects “the extent to which a given individual’s total number of visits for an episode of illness or a specific time period are with a single or group of referred providers.”14 (link) The HI, which is most commonly used in economic analyses of market concentration, is similar to the COC index in that it reflects the extent to which an individual’s visits during an episode of care are concentrated with a single or group of providers. Although conceptually similar to the COC index, it is calculated using a different mathematical formula. Both measures sum the squared number of visits to a given providers. UPC reflects the “density” of care, or the extent to which visits are concentrated with a single usual provider or group of providers during an episode.11 (link) It equals the number of visits to the provider or practice group with the highest number of visits divided by the total number of visits. SECON varies from the others in that it considers the order of visits, not just their concentration or dispersion among providers. It equals the fraction of sequential visits pairs at which the same provider is seen, i.e. same provider being seen at both the previous and current visits.
We limited the calculation of these measures to outpatient evaluation and management visits defined as Berenson-Eggers Type of Service codes M1A, M1B, M4A, M4B, M5C, M5D, and M6. Only a single E&M visit per day for each patient-provider dyad was counted, where providers were determined using the National Provider Identifier. Visits that were related to complications, hospitalizations, or emergency department visits were excluded from our calculation of the COC index. In addition, we counted only visits to those clinicians that were most likely to be involved in outpatient management for each of the three conditions. For CHF, this included primary care providers (PCPs - general practitioners, family practitioners, internal medicine without subspecialty training, and nurse practitioners), cardiologists, and pulmonologists. For COPD, we included PCPs and pulmonologists; for DM, we included PCPs, cardiologists, endocrinologists, podiatrists, and ophthalmologists. Physician specialty was determined using the specialty code from the Carrier file. With the exception of general practitioners, each specialty class of provider accounted for more than 2% of outpatient E&M visits, and the included providers accounted for 90.6% of total outpatient E&M visits for CHF, 89.6% for COPD, and 86.0% for DM. Practice groups were defined using the tax identification number assigned to each outpatient evaluation and management claim for the above provider types. Each measure was constructed separately using visits to providers and to practice groups.
Publication 2014
BMP1 protein, human Cardiologists Chronic Obstructive Airway Disease Continuity of Patient Care Endocrinologists Episode of Care General Practitioners Hospitalization Ophthalmologists Outpatients Patients Physicians Practitioner, Nurse Primary Health Care Pulmonologists Vision
Using state-of-the-art telehealth technology, ECHO trains and supports primary care providers from underserved areas to develop knowledge and self-efficacy so they can deliver best practice care for complex health conditions like chronic HCV. At each of these ECHO partner sites, participants include a lead clinician (a physician, nurse practitioner, or physician's assistant) as well as a nurse or medical assistant who will help manage patient care. None of the community practice sites had treated HCV patients before joining the ECHO network.
Community providers take part in weekly HCV clinics, called “Knowledge Networks” by joining a videoconference or calling into a teleconference line. (See online supplement at www.nejm.org ) The providers present their cases by sharing patient medical histories, lab results, treatment plans, and questions about best practices and individual challenges. UNMHSC specialists from the fields of hepatology, infectious diseases, psychiatry, and pharmacology provide advice and clinical mentoring during these clinics. Working together, the community providers and specialists manage patients following evidence-based protocols. These case-based discussions are supplemented with short didactic presentations by inter-disciplinary experts to improve content knowledge.
This case-based approach creates a “Learning Loop“ which builds deep knowledge, skills and self-efficacy in several ways. Longitudinal co-management of patients with specialists allows community providers to practice their expanded knowledge and skills in a manner that builds self-efficacy in handling real-world situations with their actual patients, while ensuring that they follow best practices as they learn. Learning from other community-based providers with similar challenges and patient profiles is facilitated through shared case management decision making.
There are currently 16 community sites and 5 prisons that deliver HCV treatment using the ECHO model. Since ECHO's inception in 2003 there has been over 5,000 case presentations and 800 patients treated. We conducted a prospective cohort study to assess the safety and efficacy of ECHO model-based treatment in comparison to university clinic-based HCV treatment. Our hypothesis was that when HCV treatment is delivered using the ECHO model it is as effective as that provided on-site at the AMC.
Publication 2011
Case Management Communicable Diseases Disease, Chronic ECHO protocol Infantile Neuroaxonal Dystrophy Nurses Patients Physicians Practitioner, Nurse Primary Health Care Safety Specialists Telemedicine
Data on nursing home residents were collected from chart reviews, interviews with nurses, and brief physical examinations at baseline and once per quarter for up to 18 months; for residents who died during the study period, data were also collected within 14 days after the death. These data included sociodemographic characteristics, health status, clinical complications, distressing symptoms, burdensome interventions (hospitalization, emergency room visit, parenteral therapy, or tube feeding), and use of hospice care.
The sociodemographic data (from the baseline chart review) included information on age, sex, length of nursing home stay, race or ethnic group, marital status, and whether the resident lived in a special care unit for dementia. Data on health status included the underlying cause of dementia documented in the chart (Alzheimer’s disease, vascular dementia, or another cause), functional and cognitive status, and coexisting conditions. Functional status was quantified by nurses with the use of the Bedford Alzheimer’s Nursing Severity Subscale (on which scores range from 7 to 28, with higher scores indicating greater functional disability).16 (link) A brief cognitive examination included the Test for Severe Impairment (on which scores range from 0 to 24, with lower scores indicating greater impairment).17 (link)
All clinical complications occurring between assessments were determined from a chart review, including suspected pneumonia, febrile episodes, eating problems, and other sentinel events. If pneumonia was suspected, documentation by a physician, nurse practitioner, or physician assistant was required. Febrile episodes (exclusive of suspected pneumonia episodes) were defined according to temperature (oral, ≥37.8°C [100°F]; rectal, ≥38.3°C [101°F]; or axillary, ≥37.2°C [99°F]) and timing (at least once within a 7-day period, with more than one occurrence of fever recorded within 7 days considered to be a single episode). Eating problems included documentation of weight loss, swallowing or chewing problems, refusal to eat or drink, suspected dehydration, and persistently reduced oral intake. Other sentinel events were defined as acute medical conditions that had the potential to lead to a clinically significant change in health status (e.g., hip fracture).
Signs of pain and dyspnea as observed and documented by the residents’ care providers were quantified as follows: “none,” “rarely” (<5 days per month), “sometimes” (5 to 10 days per month), “often” (11 to 20 days per month), and “almost daily” (more than 20 days per month). These variables were dichotomized as none or rarely versus sometimes, often, or almost daily. Aspiration, agitated behavior, and pressure ulcers were documented on the basis of interviews with nurses. (For pressure ulcers, the number and stage — I through IV — were recorded18 and categorized as “any pressure ulcer stage II or greater” or “none or stage I only.”)
The exact dates on which residents underwent the following interventions were ascertained from charts: parenteral therapy (defined as intravenous or subcutaneous hydration or administration of intravenous or intramuscular antimicrobial agents), hospitalizations, emergency room visits, and tube feeding. Referral to hospice care was also determined as recorded on patient charts.
Data on health care proxies were collected at baseline and included information on age, sex, relationship to the resident, whether the proxy understood the type of clinical complications expected in advanced dementia, and whether a nursing home physician had informed the proxy of the prognosis or the clinical complications expected in advanced dementia. At each quarterly assessment, the health care proxy was asked whether he or she thought the resident had less than 6 months to live. Health care proxies were also asked to estimate the number of years since the diagnosis of dementia had been made.
Publication 2009
Acute Disease Axilla Cognition Dehydration Dementia, Vascular Diagnosis Disabled Persons Dyspnea Ethnicity Fever Hip Fractures Hospice Care Hospitalization Hypodermoclysis Intravenous Infusion Microbicides Nurses Pain Parenteral Nutrition Physical Examination Physician Assistant Physicians Pneumonia Practitioner, Nurse Presenile Dementia Pressure Ulcer Prognosis Rectum Therapeutics
This study was part of a larger project, the Vermont Diabetes Information System (VDIS), a cluster-randomized trial of a laboratory-based diabetes decision support system in a region-wide sample of 8808 adults with diabetes from 73 Primary Care practices in Vermont and nearby parts of the United States [7 (link)]. Primary care in these predominantly rural practices is provided by General Internists, Family Physicians, Physician Assistants, and Nurse Practitioners who provide the bulk of long-term care for these and other patients. There are few diabetes specialists in the region and most diabetes care is provided in the practices. All 119 eligible primary care practices near the thirteen participating hospitals were invited to participate [7 (link)]. The participating practices range in size from one provider (in 41 practices) to two practices with six providers each.
A field survey targeted at a sub-sample of subjects was designed to provide a better understanding of the non-laboratory features of the patients before intervention. Field survey subjects were selected at random from the patients participating in the VDIS and invited by telephone to participate in an in-home interview. Patient names were randomly sorted and patients contacted until a sample of approximately 15% of the patients from each practice agreed to an interview. We attempted to contact 4,209 patients and reached 1,576 (37%). Of these, 1,006 (64%) agreed to be interviewed.
Subjects who agreed were mailed a questionnaire and were scheduled for an interview by a trained field interviewer. During the visit, the interviewer reviewed any missing or ambiguous questionnaire items. If necessary, the interviewer read the questions aloud for subjects and recorded their responses for them. Then the interviewer measured the subject as described below and administered a few more instruments that were not included in the questionnaire. The interviews took place during the baseline phase of the study before any interventions were in place. All subjects provided written informed consent. The protocol was approved by the institutional review board of the University of Vermont.
Publication 2006
Adult Diabetes Mellitus Dietary Fiber Ethics Committees, Research Interviewers Long-Term Care Patients Physician Assistant Physicians, Family Practitioner, Nurse Primary Health Care Specialists

Most recents protocols related to «Practitioner, Nurse»

The INCREASE study was a randomized controlled trial enrolling community-dwelling adults 65 years and older who did not have dementia and were using at least one PIM as defined in the 2015 Beers Criteria (the most recent version at the time of the study) [13 ]. Complete details of the INCREASE protocol and results are available elsewhere and briefly described below [11 (link), 12 (link)]. After 1:1 randomization that was stratified based on baseline amyloid burden, participants randomized to the control group received usual care with educational pamphlets on medication appropriateness for older adults and risks associated with polypharmacy. In addition to educational materials, participants randomized to the MTM intervention met with the BCGP and a non-pharmacist study clinician (e.g., nurse practitioner, neurologist) to discuss the baseline recommendations. This meeting allowed for 1) participant education on risks, benefits, and alternatives to optimize medication use; and 2) the collection of additional relevant information, including participant beliefs, preferences, and treatment goals. During the MTM team meeting, final recommendations were formalized, and the details of any relevant revisions to the baseline recommendation were noted in the pre-specified data collection forms.
The INCREASE study was approved by the University of Kentucky Institutional Review Board (IRB #43239) and all the study participants provided informed consent. The protocol for the study was registered on clinicaltrials.gov (NCT02849639) on 29/07/2016, in accordance with the relevant guidelines and regulations or in accordance with the Declaration of Helsinki. Study data were collected and managed using the Research Electronic Data Capture (REDCap), a secure, web-based software platform designed to support data capture for research studies [14 (link), 15 (link)].
Publication 2023
Adult Aged Amyloid Proteins Dementia Neurologists Pharmaceutical Preparations Polypharmacy Practitioner, Nurse
Eligible cases were those concerning a LTC resident or an age- and gender-matched community-dwelling older adult, submitted between January 1, 2019, and December 31, 2019. We identified LTC cases as those submitted by physicians or nurse practitioners who, upon registering with the service, indicated a LTC facility as their practice address. Community cases were selected from cases submitted by physicians or nurse practitioners who were not affiliated with a LTC home. One hundred and fourteen LTC cases were first randomly sampled, and community cases were then matched based on patient age and gender. LTC residents younger than 55 years were matched to community-dwelling patients aged 55 ± 1 year. Although an age threshold for older adults is commonly set at 65, in many cases frailty onset starts before this age [1 (link), 40 (link)]. We identified eConsult cases about older adults using a lower threshold to reflect this.
A completed eConsult case includes the initial communication by the referring PCP (including clinical question(s) posed), the response(s)/advice from a specialist, and any further exchange between the providers. Cases with missing communication logs and those containing communication in French were excluded.
Basic service utilization data is collected from all eConsult cases. For the present study, the following utilization data were collected from each case: the patient’s age and gender, the specialist response time and the specialists’ self-reported amount of time billed.
Publication 2023
Aged Patients Physicians Practitioner, Nurse Specialists Youth
PCs of children with medical complexity were recruited from Complex Care Programs at SickKids, RVH, and CVH. To be eligible for the Complex Care Program, children must meet at least 1 criterion from each of the following conditions: technology dependence and/or users of high-intensity care (eg, mechanical ventilator, constant medical/nursing supervision), fragility (eg, severe/life-threatening condition, an intercurrent illness causing immediate serious health risk), chronicity (condition expected to last at least 6 more months or life expectancy less than 6 months), and complexity (involvement of at least 5 health care practitioners/teams at 3 different locations or family circumstances that impede their ability to provide day-to-day care of decision-making for a child with medical complexity) [18 ]. Children with medical complexity were also between 0 and 18 years of age at the time of study initiation. Purposive sampling guided parental participant selection to ensure diversity in role, communication experience, age, ethnicity, and location [19 (link),20 (link)].
PCs were eligible to participate if they were English-speaking, had access to the internet and a computer, and were the primary caregiver of a child with medical complexity. CTMs were approached prior to recruitment to ensure it was an appropriate time to engage in research for the families (eg, hospitalization, end-of-life, or PC physical/mental health concerns).
In this study, “NPs” refers to the nurse practitioners of children with medical complexity in the Complex Care Program, and “HCPs” refers to other hospital and community–based health care providers. CTMs comprise both NPs and HCPs together.
Every PC had their assigned Complex Care Program NP on the platform. PCs were also able to invite other members of their child’s care team (eg, CTMs like social workers, patient information coordinators, pediatricians, etc) to use C2. CTMs that registered on C2 were presented with the terms of use of the platform and the study information letter. If interested, they were approached by the study research coordinator (RC) and presented with information about the research study and the opportunity to participate. CTMs that declined to participate in the research study were still able to use C2. PCs and NPs received training before registering on C2 (duration of 30 to 60 minutes), and the training presentation was later made available on C2. In addition, CTMs could set up a disclaimer on C2 if they were away or designate time slots in which they would respond to messages (eg, 8 AM to 4 PM) to aid in setting expectations with PCs.
All research study participants received remuneration for participating in the research study. PCs were given CAD $60 (US $44.59) in gift cards (CAD $20 at baseline and CAD $40 after completing the study), and HCPs that completed the end-of-study questionnaire were entered into a draw for a CAD $100 (US $74.32) gift card. Participants that completed the end-of-study semistructured interview received an additional gift card worth CAD $20 (US $14.86). C2 also had a built-in points system where PCs received a specified number of points when completing a platform activity (ie, accessing educational material). As a usage incentive, PCs received a gift card worth CAD $5 (US $3.72) when they reached predetermined point milestones. NPs also received a CAD $5 (US $3.72) gift card for every 50 messages that they sent through C2.
Publication 2023
Child cyclohexane-1,2,4-tris(methylenesulfonate) Day Care, Medical Ethnicity Hospitalization Intensive Care Mechanical Ventilator Medical Care Team Mental Health Parent Patients Pediatricians Physical Examination Practitioner, Nurse Supervision
Electronic medical records updated on January 1, 2020, were used to obtain date of birth to calculate age at infection, obstructive airway disease and upper respiratory disease diagnoses, lifetime posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) diagnoses, and the most recent available measure of body mass index (BMI). Obstructive airway disease category includes diagnoses of asthma and bronchitis, upper respiratory disease includes chronic rhinitis and chronic sinusitis [18 ]. Respiratory diagnoses were determined based on systemic examination by a physician or nurse practitioner and included repeated pulmonary function tests, physical examination, and medical history. BMI scores were analyzed as continuous variable to maximize statistical power [19 , 20 (link)]. Genetic data were used to obtain sex and ancestry information.
Publication 2023
Asthma Bronchitis Diagnosis Diagnostic Techniques, Respiratory System Index, Body Mass Infection Lung Diseases, Obstructive Physical Examination Physicians Post-Traumatic Stress Disorder Practitioner, Nurse Respiration Disorders Respiratory Rate Rhinitis Sinusitis Tests, Pulmonary Function Unipolar Depression
Survey recruitment occurred in two waves, and the sample was restricted to Indiana clinicians who performed cervical cancer screening on at least one asymptomatic average-risk woman aged 21–65 years in the past month. The online survey was programmed into Qualtrics and advertised to the research team’s network of contacts that practice among underserved groups by posting in the Indiana Cancer Consortium and the ACOG district V newsletters, and emailing invitations through the Indiana University Simon Comprehensive Cancer Center’s Office of Community Outreach and Engagement, federally qualified health center (FQHC) partners, and Planned Parenthood clinicians in Indiana. This first wave began May 5th, 2021 and closed October 5th, 2021. In order to increase our sample size and collect responses from a broader sample of Indiana physicians and nurse practitioners in OB/GYN, family practice, and internal medicine specialties, a second wave was launched October 11, 2021 and closed November 17, 2021, where the same Qualtrics survey was distributed by Dynata, a market research firm. All survey respondents volunteered and were compensated upon completion of the survey with a $20 electronic gift card. Informed consent from participants was obtained electronically for the survey questionnaire and verbally for the in-depth interviews prior to participating in the research. All participant information was kept in password protected files only available to the study team. This study was approved by the Institutional Review Board at Purdue University (protocols: IRB-2019-132; IRB-2021-12; IRB-2021-617).
The self-reported questionnaire included items about demographic characteristics, professional information, POC testing, self-sampling, and self-testing for HPV detection, among other topics as part of a larger study about cervical cancer screening. A literature search was conducted for other surveys of clinician perspectives on cervical cancer screening, and adaptations of previously validated survey items [25 (link)–30 (link)] were used whenever possible. In the absence of validated items, the investigator-generated questions were developed with two iterations of survey drafts tested among a group of clinicians in the sampling frame population and pilot tested for clarity, clinical accuracy, and to ensure that the items were measuring the intended concept. The final survey instrument had 77 questions and took approximately 15 minutes to complete.
For each testing modality (POC, self-sampling, self-testing with a rapid test) respondents were primed with the clinical scenario of “a 35 year-old asymptomatic patient that had a normal last screening test (normal Pap/HPV-negative) 5 years ago, like all of her previous screening tests.” Respondents reported their familiarity with each testing modality, using a 5-point Likert scale from “This is my first time hearing about it” to “I currently use this frequently”. To gauge user-perceived benefit, respondents were asked the extent to which they believed each testing modality would improve or not improve cervical cancer screening, on a 4-point scale ranging from ‘Would not improve’ to ‘Would greatly improve’. Finally, to assess willingness to adopt each testing modality, respondents were asked to rate their agreement on a 5-point Likert scale from “strongly agree” to “strongly disagree” with the statement “I would support adopting [testing modality] in my practice as the preferred cervical cancer screening method for asymptomatic average-risk women ages 30–65.” Respondents that believed a method could improve screening but disagreed with supporting its adoption were prompted to answer a free-response item to explain why. All respondents were queried “Do you think COVID has influenced your view of rapid testing as a screening modality (in any way)” and those who selected ‘yes’ were prompted with the optional free-response item “How has COVID influenced your view of rapid testing.”
Publication 2023
Acclimatization Cervical Cancer Malignant Neoplasms Neck Patients Physicians Practitioner, Nurse Reading Frames Woman

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More about "Practitioner, Nurse"

Healthcare practitioners, also known as clinicians or providers, are vital members of the medical team responsible for delivering direct patient care.
This diverse group includes physicians, nurses, pharmacists, therapists, and other specialized healthcare professionals.
Nurses, a subcategory of practitioners, play a crucial role in assessing, planning, implementing, and evaluating patient care.
They utilize their expertise and training to promote patient wellbeing and support positive health outcomes.
Practitioners and nurses leverage a wide range of tools and technologies to enhance their practice.
This includes software like SAS version 9.4, Stata 15, and EpicCare electronic health record systems, as well as medical devices such as the ADVIA Centaur platform TnI-Ultra™ assay and height measurement tools.
Cutting-edge research platforms like PubCompare.ai also empower practitioners and nurses to streamline their workflow, optimize research protocols, and make data-driven decisions.
By staying up-to-date with the latest advancements in healthcare technology and leveraging powerful AI-driven tools, practitioners and nurses can provide the highest quality of care and improve patient outcomes.
Whether you're a seasoned clinician or just starting your career, understanding the diverse roles and responsibilities of this vital healthcare team is crucial for delivering exceptional patient-centered care.