Literature Collection

The aim of this Policy Watch column is to provide an update on a much anticipated legislation, enacted in 2016, which enabled office-based opioid treatment (OBOT) with buprenorphine prescribing for the treatment of opioid addiction by nurse practitioners (as well as physician assistants). First, an overview of the Drug Addiction Treatment Act of 2000, which only permitted OBOT prescribing by physicians, will be described. It will be followed by a summary of the Recovery Enhancement for Addiction Treatment Act of 2015-2016. Finally, a review of the Comprehensive Addiction Recovery Act of 2016 will be provided, which includes information about important changes to OBOT regulations that enable NP prescribing of buprenorphine for the treatment of opioid addiction.

BACKGROUND: As the fastest growing segment of the healthcare workforce, understanding NP enrollment is vital. PURPOSE: This work aimed to guide healthcare workforce forethought, academic planning, and policy initiatives. METHOD: This secondary data analysis investigated nurse practitioner (NP) program enrollment trends from 2013 to 2022, including sub-analyses of master's versus doctoral enrollment, clinical tracks (acute care, primary care, psychiatric mental health), and enrollment status (part-time vs. full-time). An autoregressive integrated moving average (ARIMA) projection modeling is used to forecast enrollment for four years, 2023-2026. RESULTS: CONCLUSION: Increased enrollments in doctoral NP programs, visible in DNP NP program and enrollment growth, may offer advantages for the healthcare workforce. Part-time enrollment prevalence requires attention in workforce planning due to the potential for extended graduation timelines. These findings hopefully will lead to an effective healthcare response to meet the demand for high-quality care in a changing landscape.

BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia worldwide and the majority of AF patients are treated in primary care. In order to minimize hospitalizations and visits to emergency departments, nurse-led care was introduced in secondary care and primary health care (PHC). However, even though nurse-led care was initiated in PHC almost a decade ago, and ESC guidelines recommended patient-centered integrated care including PHC for patients, there seems to be a lack of scientific evidence regarding the effects. AIM: To review the scientific literature regarding the effects of nurse-led AF clinics in PHC. METHODS: A systematic review of scientific literature in Medline/Cinahl. Two reviewers independently assessed the retrieved articles. RESULTS: Only one study was found that investigated the effectiveness of nurse-led structured AF management in PHC. The results from the study indicated positive effects; 45% reduction in all-cause mortality compared to usual care and significantly lower number of all-cause hospitalizations with nurse-led care. Several studies were found analyzing the effects of nurse-led AF-care in secondary care facilities, but only one in PHC setting. The results mainly showed that nurse-led care in AF-clinics in secondary care reduces mortality, hospitalizations and visits in emergency departments. CONCLUSIONS: Even though only one study focused on PHC, the review indicated positive effects of nurse-led care for AF patients. However, the results are only based on studies performed in inpatient care. Hence, no firm conclusion can be drawn about nurse-led AF-clinics in PHC, and more research is clearly needed in this area.

BackgroundThe understanding, appreciation, and application of integrated healthcare by health professional students can shape future health promotion and intervention strategies. This involves blending nutrition, lifestyle, and conventional medical approaches from educational curricula to the professional practice arena.AimsTo assess targeted healthcare students from three institutions for associations between demographics and survey parameters of knowledge, attitudes, and practices regarding nutrition and integrated healthcare approaches, and to evaluate students' prospects for integrating lifestyle-based and conventional healthcare approaches, within the context of the Knowledge-Attitude-Practice (KAP) model.MethodsSurvey questions and responses based on a previously validated electronic questionnaire were used to evaluate university-level healthcare students enrolled in the nutrition (n = 92) and nursing (n = 195) disciplines. Demographic data were analyzed alongside scored items assessing knowledge, attitudes, and practices. Descriptive statistics, chi-square tests, Kruskal-Wallis tests, Dunn-Bonferroni tests, Spearman's rho, and partial correlations were conducted.ResultsMost students demonstrated high overall knowledge (74%), attitude (93%), and practice (84%) scores. However, significant differences (p < 0.05) in the knowledge scores were observed across institutions, academic levels, and disciplines. Although relatively weak, knowledge had a significant and positive relationship with attitude (rho = 0.263, < 0.001), but not with practice. The strength of relationships was moderated by controlling for socio-demographic factors such as specific degree/discipline, institutional and environmental context, race, religion, and age.ConclusionThe findings of this study highlight the benefits of using KAP-based learning outcomes for healthcare training programs and demonstrate its relevance in informing tailored educational strategies and clinical interventions and policy initiatives that support integrated healthcare approaches.