Studies have shown that adherence to prehospital treatment guidelines, for patients with non-traumatic chest pain is incomplete and that there is a gender difference in treatment provided.
The aim of this study was to examine adherence to guidelines in a nurse-led ambulance system in southern Sweden.
Retrospective cohort study, including 862 medical records was reviewed. Data relevant to treatment guidelines was obtained e.g. the provision of oxygen, acetylsalicylic acid, glycerin trinitrate, electrocardiogram recorded, pain assessment, patient gender and time of day. Results were presented using descriptive statistics and adherence to present guidelines was described as poor (= 20%), fair (21-40%), moderate (41-60%), good (61-80%) and very good (81-100%).
The medical records included 401 women and 461 men. Twenty-three percent of the patients received = 10L/min of oxygen (men vs. women, P
This paper is a report of a study to identify the patterns of prescribing by primary health care nurse practitioners for a cohort of older adults.
The older adult population is known to receive complex pharmacotherapy. Monitoring prescribing to older adults can inform quality improvement initiatives. In comparison to other countries, research examining nurse practitioner prescribing in Canada is limited. Nurse practitioner prescribing for older adults is relatively unexplored in the international literature. Although commonly used to study physician prescribing, few studies have used claims data from drug insurance programmes to investigate nurse practitioner prescribing.
Drug claims for prescriptions written by nurse practitioners from fiscal years 2004/05 to 2006/07 for beneficiaries of the Nova Scotia Seniors' Pharmacare programme were analysed. Data were retrieved and analysed in May 2008. Prescribing was described for each drug using the World Health Organization Anatomical Therapeutic Chemical code classification system by usage and costs for each fiscal year.
Antimicrobials and non-steroidal anti-inflammatory drugs consistently represented the top ranked groups for prescription volume and cost. Over the three fiscal years, antimicrobial prescription rates declined relative to rates of other groups of medications. Prescription volume per nurse doubled and cost per prescription increased by approximately 20%.
Prescription claims data can be used to characterize the prescribing trends of nurse practitioners. Research linking patient characteristics, including diagnoses, to prescriptions is needed to assess prescribing quality. Some potential areas of improvement were identified with antimicrobial and non-steroidal antiinflammatory selection.
To review the literature to ascertain best practices in the diagnosis and treatment of adult attention-deficit/hyperactivity disorder (ADHD) and to determine the current beliefs and practices of nurse practitioners (NPs) regarding adult ADHD.
Licensed NPs (n= 260) responded to a questionnaire that inquired about numbers of patients seen with ADHD and about current diagnostic and treatment methods. Diagnostic confidence and referral patterns were also surveyed. Best practices were identified through a review of current and classic nursing, medical, and psychological literature on ADHD.
The results of the survey showed that most NPs believe that adult ADHD exists, although the majority diagnose and treat this condition infrequently. Psychiatric NPs were an exception.
NPs are diagnosing and treating adult ADHD at levels far below expected based on population prevalence data. While those NPs who suspected ADHD were using appropriate diagnostic and treatment methods, more education is warranted to increase confidence for a greater number of nonpsychiatric NPs to improve targeted diagnosis and treatment for this condition.