BACKGROUND:A nurse practitioner (NP) is defined as having comprehensive knowledge to diagnose and treat health conditions. When a registered nurse (RN) transitions to the NP role, several challenges may arise. PURPOSE:This study aimed to determine the role transition process from an RN to NP and the factors that contribute to a successful or unsuccessful transition. METHOD:This quantitative, descriptive, cross-sectional study employed census sampling of 51 nurse practitioners. Data were collected using the Novice Nurse Practitioner Role Transition (NNPRT) scale and analyzed using descriptive and inferential statistics. RESULTS:The response rate was 72.5% (37). Receiving a formal orientation, 67.6% (25) reported. More than half of the participants (64.9%; 24) reported receiving mentorship. Spearman rho coefficient test indicated a significant, moderate positive relationship between NNPRT scale scores and prior years as an RN (rs = 0.18), formal orientation (rs = 0.42), and mentorship (rs = 0.24-0.58). CONCLUSIONS:Formal orientation and specific aspects of mentorship contributed to a successful role transition. Further investigation of other variables is necessary to determine what influences successful or unsuccessful role transitions. Results also indicated that a documented transition program may exist; however, it requires improvement or the implementation of a new role transition program. IMPLICATIONS:These findings highlight the need for coordinated practice, educational, and policy initiatives to implement standardized NP transition programs with mentorship, as organizational support is central to a successful role transition.
ABSTRACT The Annie Goodrich Post-Graduate Psychiatric Nurse Practitioner (NP) Fellowship, established in 2017, supports advanced practice nurses transitioning into independent psychiatric roles by emphasizing excellence in care and education. Psychiatric Mental Health Nurse Practitioners (PMHNP-BC) often enter practice with limited experience managing complex psychopharmacologic regimens, creating a critical gap in competency. To address this need, we developed a specialized psychopharmacology curriculum designed to strengthen foundational knowledge and promote confident, evidence-informed clinical decision-making. This educational case study describes the development, implementation, and preliminary evaluation of this psychopharmacology curriculum within a postgraduate psychiatric NP fellowship program. Initial efforts to incorporate multiple disciplines into the curriculum proved challenging, prompting a shift to a focused 10-week seminar series led by interprofessional faculty using a case-based approach. Seminar topics included psychiatric emergencies, prescribing during pregnancy and postpartum, and strategies for safe medication tapering. Curriculum timing and content were refined through iterative feedback from fellows and faculty, as well as preseminar and postseminar evaluations assessing the fellows perceived changes in knowledge, confidence, and relevance to clinical practice. Key lessons learned include the importance of aligning content with NP professional identity, addressing interdisciplinary barriers, and fostering sustainable faculty collaboration. This innovative approach offers a replicable curriculum for enhancing psychopharmacology education in postgraduate psychiatric NP training. By bridging foundational knowledge with advanced clinical decision-making, the curriculum was designed to support the development of practitioners prepared to deliver safe, person-centered, and collaborative psychiatric care.
ABSTRACT Genomics is increasingly integral to nurse practitioner (NP) practice, informing risk assessment, diagnosis, treatment selection, and precision care. Despite expanded clinical responsibilities, recent evidence demonstrates that NP genomic knowledge remains only moderate, mirroring earlier findings among registered nurses. This persistent gap highlights the need to move beyond foundational education toward applied, practice-based genomic competency. In addition to strengthening workforce preparedness, NPs must advocate for equitable access to genomic services through organizational, state, and federal policy initiatives. Advancing genomic competence and advocacy is essential to improving patient outcomes, reducing disparities, and ensuring equitable implementation of precision health care.
ABSTRACT In this segment, American Association of Nurse Practitioners Region 10 Director Dr. Michelle Anderson and I discuss how regulation shapes Nurse Practitioner (NP) practice and why every NP should understand the regulatory process.
BACKGROUND:Health care systems require strong practice leadership to address increasing complexity, workforce demands, and quality outcomes. Doctor of Nursing Practice (DNP) nurses are educated to lead evidence-based practice, quality improvement, and system-level change; however, variability in role clarity and organizational support limits full utilization, and qualitative evidence describing their impact remains limited. PURPOSE:To explore the lived experiences of those who hire or work with DNP-prepared nurses. METHODOLOGY:A qualitative phenomenological design was used with a purposive sample of 21 US-based participants recruited through prior study participation and professional networks. Virtual interviews were transcribed and analyzed using a modified Giorgi method, including identification of meaning units, structural statements, and thematic synthesis until data saturation was achieved. RESULTS:Two themes emerged within each group and were synthesized into one overarching theme: DNP-prepared nurses drive value through leadership, competencies, and system-level impact when supported by organizational culture and structure. Participants described DNP nurses as influential leaders demonstrating advanced clinical reasoning and systems thinking; however, inconsistent role clarity and limited organizational support constrained full enactment of DNP-level capabilities. CONCLUSIONS:Doctor of Nursing Practice-prepared nurses are essential practice leaders capable of advancing quality outcomes and system performance. Their impact depends on organizational alignment, including clear role differentiation, leadership support, and structural investment. IMPLICATIONS:Institutions must cultivate cultures that provide protected time, clear role expectations, and leadership support to enable DNP-prepared nurses to practice at full scope. Without structural alignment, DNP competencies remain underused, reinforcing the need to treat organizational investment in DNP roles as a strategic priority.
ABSTRACT Accreditation is fundamental to nursing program quality, graduate/completer eligibility for licensure and certification, and admission to graduate study. Traditionally, faculty expectations have been organized around three pillars: teaching, scholarship, and service/practice. Although these categories remain essential, they no longer fully capture the scope of contemporary faculty responsibilities. This article proposes that accreditation activities constitute a fourth cornerstone of the faculty role, integral rather than supplementary to academic work. Nurse practitioner faculty often transition from clinical practice to academia without adequate preparation for accreditation. Yet accreditation requires active, ongoing faculty engagement across all program domains, including mission and governance, resources, curriculum, and outcomes. Faculty serve as subject-matter experts, aligning program design with accreditation standards, professional competencies, and regulatory requirements set by nursing program accreditors. When faculty engage meaningfully in accreditation, compliance becomes continuous quality improvement. Early introduction to accreditation standards and the accreditation process, guided by mentorship from experienced faculty, is an essential strategy for building this capacity among new faculty members. Integrating accreditation as an explicit faculty expectation strengthens program accountability, supports student success, and ensures alignment with evolving professional and regulatory standards. Recognizing accreditation as a core faculty responsibility reframes it as a faculty-driven commitment to excellence rather than a periodic administrative obligation.
ABSTRACT Nursing schools struggle to address the broader nursing workforce crisis, in part due to the decline in the number of qualified candidates for leadership positions. In this paper, we report interviews of four nurse practitioners (NPs) who have served as deans or directors of schools of nursing to gain an initial understanding of NPs in these roles. These interviews profile the career pathways, education, motivation, skills, plus genesis and preparation for rigorous application and interview processes of these NPs in a dean role. Together these key informant deans cited leadership as the essential skill needed for the role. One NP dean particularly stated that leadership supersedes the need for research or scholarship expertise. It will be interesting to see whether an emphasis on leadership, rather than terminal degree, will help our profession solve the problem of dean candidates in short supply.
ABSTRACT Leadership development remains a critical need for emerging nurse leaders as academic and health care environments become increasingly complex and resource constrained. Nursing faculty are frequently expected to assume leadership roles with limited formal preparation or structured support. In response, a pilot coaching-based professional development program was designed and implemented with early-career nurse faculty in a single academic setting. The Advancing Collegiate Coaching for Excellence in Leadership (ACCEL) program combined individualized coaching with structured cohort-based learning, emphasizing strengths-based reflection, goal setting, and peer dialogue within a psychologically safe environment. Program outcomes demonstrated promising early impact. Leadership self-awareness and confidence were assessed using a 20-item self-report survey administered before and after participation, with mean scores increasing from 71.0 to 87.3 across all participants. Participants also reported high satisfaction and described greater confidence in their leadership identity, increased clarity regarding leadership strengths and growth areas, and enhanced engagement in academic roles. These findings suggest that ACCEL offers an ethically grounded and adaptable model for leadership development that can be applied across academic, clinical, and administrative nursing settings to strengthen leadership capacity and support professional sustainability.
ABSTRACT As demand for health care providers continues to rise across diverse clinical settings, newly minted nurse practitioners (NPs) are entering the workforce in record numbers—yet many do so without the clinical confidence or structured support needed to succeed. This article offers a timely, real-world account of how one large health care system bridged that gap by launching a 12-month, system-wide NP residency program backed by Health Resources and Services Administration funding. More than just a policy response, this program became a lifeline for novice NPs navigating a high-stakes transition during the COVID-19 pandemic. With more than 200 applicants in 4 years, the program attracted early career NPs willing to delay full salary in exchange for mentorship, tailored learning, and hands-on clinical experience. Grounded in the Barnes Novice NP Role Transition Scale and shaped by interdisciplinary leaders, the curriculum emphasized building confidence, equity-focused care, and policy engagement. Resident reflections bring the data to life—sharing how structured support transformed fear into fluency, and uncertainty into purpose. Unlike theoretical models or small pilot efforts, this program's scale, adaptability, and strong applicant interest make it a blueprint for institutions nationwide. Readers seeking practical insight into workforce development, graduate readiness, or the future of NP training will find this article both informative and inspiring.
ABSTRACT:This commentary discusses the emerging role of nurse practitioner (NP) clinician-scientists and its implications for strengthening advanced practice within acute care health systems. Although NPs have transformed health care delivery in acute care settings, research describing their optimal deployment, system-level impact, and workforce sustainability remains limited. We argue that NP clinician-scientists, clinically active NPs with formal research training, are uniquely positioned to bridge frontline practice and rigorous scientific inquiry. Their embedded roles within Learning Health Systems enable pragmatic trials and workflow redesign that directly reflects real-world care delivery. We highlight the growth and impact of NPs in acute care settings, explain why NP clinician-scientists matter, and outline what they can uniquely contribute. Finally, we describe organizational and academic strategies to cultivate this emerging role. Intentional investment in NP clinician-scientists represents a strategic opportunity to generate actionable evidence, strengthen interdisciplinary care models, and advance quality and workforce sustainability in health systems.
BACKGROUND:An increase in syphilis cases in the United States and the global shortage of Benzathine Penicillin G (BPG) calls for evidence-based optimization. Confusing serologies and incomplete sexual history exacerbate the overprescription of BPG, especially for patients with "serofast" serologies. PURPOSE:The aim of this project was to reduce unindicated BPG administration while maintaining or improving appropriate BPG administration in people diagnosed with syphilis. METHODOLOGY:A longitudinal pre-post design was implemented where actionable education was delivered to patients who received BPG injection to treat syphilis. RESULTS:Benzathine Penicillin G was administered 187 times (69 preintervention, 118 postintervention), and inappropriate administration declined by 7.9% relatively (10.1-9.3%). There was no difference in outcomes between the newly infected and reinfected patients. CONCLUSION:This project demonstrated modest improvements in the administration of appropriate BPG, although the results did not reach statistical significance. IMPLICATIONS:Future interventions should focus on automating patient education within the electronic health record. The growing prevalence of syphilis among non-traditional risk groups emphasizes the importance of sexual health screening and educational approaches to enable patients to advocate for appropriate syphilis management, especially when they are serofast.
ABSTRACT:Psychiatric mental health nurse practitioners (PMHNPs) are an essential and growing part of the health care workforce, especially in community settings. To address PMHNPs' increasing presence in community psychiatry, a 1-year postgraduate PMHNP fellowship in community psychiatry was developed with the goals of enhancing clinical competency and employment retention in underserved public sector settings. Data on 5 cohorts and 31 fellows are presented in this article. PMHNP fellows, preceptors, didactics, and clinical sites were evaluated across several time points including baseline and 6 and 12 months. The program has graduated 100% of fellows with largely positive feedback. Fellows reported significant improvements in competency across the domains of 1) assessment and diagnosis, 2) treatment, and 3) professionalism and leadership. These items were substantiated by clinical preceptors' ratings of fellows' clinical skills from 6-month and 12-month time points. Relatedly, clinical sites, preceptors, and didactics were all rated highly by fellows. After the program, 90.3% of graduates remained working in the public sector including correctional settings, community clinics, and safety net hospitals.
ABSTRACT:Superior vena cava (SVC) syndrome is a potentially life-threatening condition caused by impaired venous return from the head, neck, and upper extremities that can present with prominent facial cyanosis. This finding may be misleading, as it does not necessarily reflect impaired arterial oxygenation. We report a 68-year-old woman with metastatic colorectal cancer receiving chemotherapy through a right internal jugular implantable venous access port who presented with acute dyspnea, weakness, and progressive facial and perioral cyanosis 2 days after completing FOLFOX (A chemotherapy regimen consisting of folinic acid (leucovorin), fluorouracil (5-FU), and oxaliplatin. It is commonly used to treat colorectal cancer) chemotherapy. Given recent chemotherapy exposure, her presentation initially raised concern for hypersensitivity or anaphylactoid reaction. Despite the patient's striking cyanotic appearance, arterial blood gas analysis demonstrated normal oxygenation, whereas venous blood gas revealed marked desaturation with elevated deoxyhemoglobin. Imaging subsequently identified extensive catheter-associated thrombosis involving the bilateral internal jugular, subclavian, and brachiocephalic veins with complete occlusion of the SVC and extension into the right atrium. The patient was treated with systemic anticoagulation and urgent endovascular thrombectomy with the removal of the indwelling port, resulting in rapid clinical improvement. This case emphasizes that in SVC obstruction, visible cyanosis may reflect localized venous congestion rather than systemic hypoxemia. Recognition of discordant arterial and venous oxygenation can help avoid misdiagnosis and facilitate timely intervention, particularly in oncology patients with central venous devices.
ABSTRACT:The 2021 American Association of Colleges of Nursing Essentials: Competencies for Professional Nursing Education, has required Colleges of Nursing to transition to implementation of competency-based education while redefining development and validation of competencies. It was essential for programs to structure assignments and activities with a focus on competency-based education assessments targeting end outcomes for practice-focused graduate nurse practitioner (NP) students. The purpose of this article is to provide a model for structuring competency-based assessments using an innovative, tiered approach for NP students in a Doctor of Nursing Practice program.
ABSTRACT:Case studies are an effective educational strategy; however, there is limited literature examining virtual case-based learning for nurse practitioner (NP) students in online education. This evaluation examined the impact of case studies on the students' learning experience, self-efficacy, engagement, and critical thinking among NP students enrolled in an online course. As an alternative to traditional recorded lectures, two written case studies and three interactive unfolding case studies were developed addressing vaccinations, pediatric asthma, type I diabetes, pediatric gastrointestinal disorders, and pediatric musculoskeletal disorders for NP students in an online Family NP Pediatric Theory course. After each case study, students completed self-evaluation surveys assessing their pre and post self-efficacy for managing the clinical scenarios. At the end of the course, students revaluated the impact of the case studies on their learning experience as well as their affective, behavioral, and cognitive engagement and critical thinking. Students reported increased self-efficacy for each case study with large effect sizes. Overall, the unfolding case studies positively influenced students' learning experience, engagement, and critical thinking. These findings support the integration of unfolding case studies in online NP education as an effective strategy to enhance students' self-efficacy, engagement, and critical thinking in online courses.
ABSTRACT:Securing grant funding is an important achievement for nurse practitioners and academic faculty, yet the postaward phase introduces complex administrative, regulatory, and scholarly responsibilities essential to project success. This article is the second in a two-part series examining the lifecycle of a grant. Building on part 1, which focused on preaward planning and proposal development, this manuscript addresses postaward activities from award acceptance through dissemination. Drawing on the authors' shared experience as principal investigators and project directors, the article provides practical guidance on grant start-up, implementation team formation, budget and personnel management, compliance and reporting requirements, sustainability planning, and award closeout. Emphasis is placed on proactive communication with institutional offices and funding agency project officers, intentional documentation, and early integration of dissemination and sustainability strategies. By outlining common challenges and actionable approaches, this article aims to strengthen nurse practitioner preparedness for postaward grant administration and support the translation of grant-funded initiatives into long-term educational, clinical, and policy impacts.
ABSTRACT Early cancer detection is the cornerstone of cancer care, as it allows for clinical intervention at a timepoint when outcomes are optimal. For this reason, there is a clear inverse relationship between cancer stage at diagnosis and 5-year relative survival, irrespective of tumor type. As such, cancer screening modalities are a formidable weapon, and timely detection is paramount. However, the current cancer screening paradigm remains suboptimal, with the majority of incident cancer diagnoses in the United States lacking a USPSTF Level A or B Screening Recommendation or an available screening test. Multicancer early detection (MCED) tests have the potential to revolutionize the paradigm, removing hurdles and bridging critical gaps; but for MCEDs to be effectively implemented into practice, patient-facing clinicians must be equipped with the requisite knowledge, competence, and confidence to embrace innovation and advance care. This educational initiative, an on-demand enduring activity accredited for 0.75 hours and hosted on the AANP CE Center from October 2024 to October 2025, was designed with these foundational goals in mind. A total of 3,442 learners completed the activity, 88% of whom were nurse practitioners (NPs), and significant improvements were observed across all outcomes levels. Consistent with the high degree of patient interface boasted by NPs, this education is expected to benefit more than 42,000 patients per week. In addition to revealing meaningful improvements in knowledge, competence, and confidence, outcomes analysis also identified important residual gaps, which should be addressed by future educational activities on this topic.
ABSTRACT Global trends have recognized the expansion of Advanced Practice Registered Nurse (APRN) models as a strategic approach to enhancing health care accessibility, equity, and patient outcomes. Brazil faces significant challenges in institutionalizing APRN roles, including the lack of approval for APRN education at the master’s level, lacking regulatory support, and a prevailing medical culture. This article evaluates the Global Exchange Program (GEP) as a collaborative platform to strengthen the development and integration of APRNs in Brazil. The GEP is a 5-day immersive educational program that provides structured exposure to APRN education, curricular frameworks, and clinical practice in the United States while fostering sustained dialogue on contextually appropriate pathways for APRN development in Brazil. The program evaluation used an online survey with open-ended questions to assess participants' experiences in the GEP and its influence on APRN development in Brazil. Data were analyzed using qualitative descriptive method and thematic analysis revealed six central themes: (1) positive experiences, (2) cultural awareness, (3) networking opportunities, (4) implementation of advanced practices, (5) educational value, and (6) supportive environments. Participants, mainly Brazilian nursing faculty and key stakeholders, indicated that the program enhanced their professional insights, highlighting the importance of cultural competency and advanced nursing strategies. The GEP promotes reciprocal learning and contextual adaptation. Using the GEP model may enable other engagement with international stakeholders, facilitate discussions on tailored APRN model implementation, and provide experiential learning that enhances understanding and advances global adoption of APRN practices.
BACKGROUND:Dual certified primary care and psychiatric mental health advanced practice registered nurses (PC/PMHNP) are well-positioned to care for high needs/high-cost patients. Although prior work suggests that PC/PMHNP care produces positive patient outcomes the existing evidence was limited and primarily based on case studies and anecdotal reports. PURPOSE:To conduct a survey of dual certified PC/PMHNPs to identify outcomes providers perceive to be associated with their practice preparation and dual role. METHODOLOGY:Primary care and psychiatric mental health advanced practice registered nurses across the state of Iowa completed an online survey exploring their perceptions of their impact on patient outcomes. RESULTS:Respondents perceived dual certification to be positively associated with patient satisfaction and associated with decreased health care utilization costs (e.g., hospitalization, ER visits). Yet, respondents felt their dual role was underrecognized by employers both in pay and time allocated for patient visits. CONCLUSIONS:This systematic effort to capture the perceived impact of dual certification confirmed past findings of the benefits to integrated practice by PC/PMHNPs. It also extends prior work by articulating ways in which PC/PMHNPs work to fulfill their dual role, including working in multiple practice settings and providing uncompensated care in their second specialty. IMPLICATIONS:Dual certified PC/PMHNPs feel uniquely empowered to improve patient care and decrease health resource utilization. This study supports the feasibility and need to conduct a nationwide survey of the PC/PMHNP role.
ABSTRACT:New graduate nurse practitioners often encounter a significant gap between theoretical classroom learning and the realities of clinical practice, with many experiencing challenges in translating didactic knowledge into hands-on patient care. This pilot project explored the effect of a standardized patient simulation-based experience on Doctor of Nursing Practice adult-gerontology primary care nurse practitioner students' self-confidence, self-efficacy, and clinical performance within a primary care setting. Eleven students completed a quasi-experimental pretest and posttest study, including focused standardized patient simulation-based experience participation and reflective review. Statistically significant improvements were seen in 14 of 23 measures on the National League for Nursing-Student Satisfaction and Self-Confidence in Learning Scale, specifically regarding geriatric patient assessment, diagnostic reasoning, physical examination, care planning, and resource awareness. Students' reflective narratives reinforced these findings, citing increased confidence in clinical skills and highlighting areas for further growth. Although some aspects, such as stress management and advocacy for care plans, did not improve, simulation provided meaningful opportunities for skill development and transition preparation. Immediate debriefing and video reflection were noted as valuable for learning and anxiety reduction. These findings suggest that focused simulation can foster self-efficacy and competence in new nurse practitioners and should be broadly considered in graduate nursing education. Further research across diverse populations and institutions is recommended to strengthen the case for widespread simulation integration in nurse practitioner programs.
