Nurse Practitioners' Education, Awareness, and Therapeutic Approaches for the Management of Fibromyalgia.

BACKGROUND: In the United States, fibromyalgia affects 2%-5% of the adult population, rendering it the most common chronic, widespread pain condition. The American College of Rheumatology has published diagnostic criteria for fibromyalgia, with the latest version in 2010. PURPOSE: The purpose of this study was to evaluate nurse practitioners' education and awareness of fibromyalgia and to evaluate nurse practitioners' practices for the management of fibromyalgia. METHODS: Sixty-six nurse practitioners voluntarily completed an online survey regarding their education, diagnosis, and treatment options for patients with fibromyalgia. RESULTS: The majority of participants reported that they always or occasionally had difficulty diagnosing fibromyalgia and worried about labeling their patients as having fibromyalgia. The most commonly used agents were nonsteroidal anti-inflammatory drugs (70%), serotonin norepinephrine reuptake inhibitors (61%), selective serotonin reuptake inhibitors (51%), and muscle relaxants (44%). Nondrug therapies included exercise (88%), cognitive behavior therapy (58%), and nutrition (56%). CONCLUSION: Further education is needed for nurse practitioners to increase confidence in diagnosing and managing fibromyalgia.

Comparing new BSN RN self skills assessment to actual skills demonstration.

The purpose of the study was to compare the self-skills assessment with the skill competence during an actual skills demonstration of newly hired bachelor of science in nursing (BSN) registered nurse graduates. This retrospective study included 32 randomly selected BSN registered nurse graduates from January 2010 to December 31, 2010. The participants were already hired into a midwest health system. Because this was a retrospective study, no demographic data were collected, and no consent from participants was needed. This study included a clinical skills check list where the participants rated themselves on specific skills utilizing a Likert scale ranging from 1 (no knowledge) to 4 (able to perform independently). The same clinical check list was utilized by an expert registered nurse when the skill was demonstrated. This study compared the difference between the subject's self-rating of skills and the clinical demonstration of the skills. We used t tests in the analysis to demonstrate the differences between the participant's self-rating of skills and the expert evaluation of the clinical demonstration of the skills. The data were inserted into the Statistical Package for the Social Sciences 19 software program to assist in the analysis process. The study demonstrated 17 significant differences in the skills ratings between the participant and competency demonstration of new BSN graduates. These significant results (2 tailed) ranged from .000 to .048.The 17 out of 46 specific skills where differences were noted included the following: staple removal, nasal pharyngeal suctioning, urinary catheter specimen collection, site care dressing change, urinary catheter irrigation, Juzo application and measurement, 5-lead telemetry, oral airway insertion, hemovac/Jackson Pratt, oral pharyngeal suctioning, urinary catheter insertion, dry suction chest drainage, bed to cart/slider board, urinary catheter removal, antiembolism stockings, measurement and application, removal of iv and sit-and-stand alarm. Overall, the participants rated their skill levels lower in 15 out of 17 significant skills when compared with their competency assessment (t test: -3.284, df = 31, P = .003). In two skill ratings (urinary catheter specimen collection and oral pharyngeal suction), the participants rated themselves higher than the competency demonstration. Two skills that had a mean participant and expert score between 1 (no knowledge) and 2 (able to perform with 1-to-1 coaching) were oral airway insertion and dry suction chest drainage. Some possible reasons why the participants rated themselves lower could be the use of different or unfamiliar terms or uncertainty of the procedure at a different health institution. Some newly graduated BSN nurses may have not performed the skills on a regular basis or only in simulation.