BACKGROUND:Advanced practice providers (APPs) play a critical role in neuroscience patient care and system-level leadership. Despite their growing presence, the practice of neuroscience APPs throughout the United States is underexplored. This study aims to describe the current practice for neuroscience APPs in the United States. METHODS: An online survey was developed using the 2006 American Association of Neuroscience Nurses advanced practice survey as a starting point. The peer-tested survey used snowball recruitment, with an initial email to American Association of Neuroscience Nurses members or customers who identified as APPs (n = 4950). The survey was open to any neuroscience APP. The survey collected demographic, current practice, and system-level role data. RESULTS: A total of 350 respondents completed the survey. Respondent roles were nurse practitioner (76.6%), clinical nurse specialist (20.9%), and physician assistant (2.6%). Most worked in hospital settings (83.1%) and practiced in inpatient (56.3%) or ambulatory (31.1%) settings, with the southern region of the United States (31.1%) having the highest representation. Common practice elements included patient evaluation, management, procedures (intraventricular catheters, intracranial monitoring devices), and billing and coding practices across roles. CONCLUSION: This survey highlights the diverse roles and practice contributions of neuroscience APPs. Findings underscore the need for standardized practice measures and further research to define and optimize APP integration into neuroscience care. The results provide insights into opportunities to support the development and recognition of neuroscience APPs' impact on patient outcomes and health care systems.
This chapter talks about a distinction between a crisis and an emergency. Emergencies have their own unique characteristics, including emotions, public actions, credibility and trust, that affect how risk communication is put into practice. The chapter explains some of these characteristics in detail. Planning involves understanding the needs and desires of the community and organizational jurisdictions in an emergency situation, creating and getting approval for a written plan, training staff, educating the public, getting the resources required in the plan, and making sure that the infrastructure is in place to carry it out. The chapter provides guidance on making sure that your organization is ready, teaming with other organizations, working with communities in advance, determining appropriate communication methods, and developing an emergency communication plan. It also provides additional advice on communicating during an emergency and after an emergency.
The Letter uncovers an issue which is increasingly relevant in Community Hospital practice. The authors have highlighted the following points with an interesting case and adequate referencing, but the points are relatively well reported and not novel. There has been a clearly documented increase in the number of reported cases of loperamide abuse and toxicity in the literature in recent years. There is a relatively clear established link between loperamide use and cardiotoxicity. The cardiotoxic effects more commonly reported include QTc prolongation and QRS interval prolongation with concomitant ventricular arrythmias. There has also been an increase in popular awareness regarding the abuse potential of loperamide which has entered the public domain. The increased abuse of loperamide may be related to the general trend of restricting prescriptions of controlled substances A few additional points that may be brought to the authors attention:
