Changes in healthcare environmental factors resulted in the introduction of the acute care nurse practitioner (ACNP) role in Ontario. The purpose of the study was to identify success indicators, barriers, and recommendations for role implementation to assist healthcare providers to develop strategies for integrating ACNPs into teams. Acute care nurse practitioners (n = 14), physicians (n = 14), administrators (n = 12), and staff nurses (n = 48) from four tertiary care hospitals completed a researcher-developed, self-administered questionnaire with fixed and open-ended questions. Specialty practice areas (cardiac/critical care, geriatrics, and nephrology) were matched within the four sites. Acute care nurse practitioners (n = 14), physicians (n = 12), administrators (n = 8), and staff nurses (n = 34) responded. The major indicator by all groups for successful role implementation was level of preparation. Barriers included lack of mentorship and knowledge of the role, and perceived lack of support from administration and physicians. Themes reflecting impact on patient care were improved communication and attention to patient care issues. Respondents accepted the role, concluding that enhanced continuity of care was a result. Role clarity before and during implementation would assist team members in understanding the purpose and value of the role, thus easing the integration of the ACNP into the healthcare team.
Behavior changes can significantly improve outcomes for patients in the cardiac rehabilitation population. The authors examined the influence of time perspectives on health-promoting behaviors of patients for whom the future might be perceived as limited, although goal-directed behavior changes are crucial. Measures included the Zimbardo Time Perspective Inventory and the Health-Promoting Lifestyle Profile II (HPLPII). In this study of 74 cardiac participants with a mean age of 60.2 years, the preponderant time perspective was found to be past-positive orientation. The authors discuss the effects of a life-threatening event and older age on time perspective and health-promoting behaviors and consequent implications for cardiac rehabilitation programs.
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