Background and purpose: Nurse practitioners (NPs) perform diagnostic and clinical procedure skills in the acute, specialty, urgent, and primary care settings. Nurse practitioners surveyed on readiness for practice report a lack of confidence and education preparation for performing selected advanced diagnostic and skills. As NPs gain independent, full practice scope, it is imperative advanced diagnostic and procedure skills used in practice are taught in nurse practitioner curriculum. The purpose of this review is to document a systematic review of the literature, answering the following question: Among primary care NPs, does current program curriculum align with current procedures and skills in theclinical setting? Methods: PubMed, Cochrane, Scopus, CINAHL, and Embase were searched between inception and 2018 using the search terms “advanced practice nursing, clinical competence, diagnostic techniques or procedures, and primary health care.” Following the preferred reporting items for systematic reviews and meta-analysis guidelines, nine articles were included in the synthesis. Conclusion: There is scant research regarding NP educational preparation of skills and procedures. Study findings indicate that programs are not teaching all the procedures deemed important. Education should promote improved congruence between the skills and procedures taught in program curricula and those used in clinical practice. Implications for practice: It is critical to complete an education practice survey measuring skill and procedure preparation and competency at graduation. Survey results will determine whether skill and procedure guidelines are indicated for NP education. A recommendation may include minimal skills and procedure for all nurse practitioner curricula.
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This paper explores the potential public health consequences of anti-HIV microbicide adoption among women in high-risk communities, using data from an exploratory study to illustrate key points. A brief quantitative survey was administered to 71 drug-using women with primary heterosexual partners in New York City. Only 37% of women reported recent condom use with a primary male partner. Eighty-six percent expressed willingness to use a microbicide with a primary partner. Among women using condoms, 50% believed they would decrease condom use if they started using a vaginal microbicide. While overall condom use was low and intended condom migration was low among women with HIV-infected partners, universal promotion of microbicides could nonetheless lead to an increase in HIV risk among specific subgroups of women, indicating the importance of promoting continued condom use. More research is needed to inform public policy decisions prior to the availability of the first commercial microbicide. Keywords condom migration; HIV infection; sexual risk behavior; vaginal microbicide; women's healthOver the past 2 decades women have increasingly shouldered the burden of the global HIV pandemic (Joint United Nations Programme on HIV/AIDS [UNAIDS], 2004), with the majority of infected women acquiring HIV through sexual contact with a primary male partner (O'Leary, 2000). These trends are the result of multiple factors. Women may be CONFLICT OF INTEREST STATEMENT:The authors report no real or perceived vested interests that relate to this article (including relationships with pharmaceutical companies, biomedical device manufacturers, grantors, or other entities whose products or services are related to topics covered in this manuscript) that could be construed as a conflict of interest.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. biologically more susceptible to heterosexual transmission of HIV than men, especially via receptive anal intercourse (Boily et al., 2009;Mastro & Kitayaporn, 1998;Padian, Shiboski, & Jewell, 1991). In addition, gender-based social inequalities limit women's options with regard to protective sexual behavior (Higgins, Hoffman, & Dworkin, 2010;Quinn & Overbaugh, 2005;Remien, Halkitis, O'Leary, Wolitski, & Gomez, 2005 While it is anticipated that the first generation of vaginal microbicides will be less effective at preventing HIV than latex condoms, the enormous potential of this new technology lies in its enhanced acceptability and usability by women. As our experience with the female condom has demonstrated, the importance of the acceptability of an...
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