Twenty-eight years of experience measuring autonomy using the Dempster Practice Behavior Scale.

BACKGROUND: Autonomy in practice is an important attribute of all professions and a cornerstone of advanced nursing practice. The Dempster Practice Behavior Scale was conceptualized, constructed, and psychometrically tested to make available a generalizable, empirically sound, and useful tool capable of measuring previously unrecognized dimensions of autonomy in practice. Nurse practitioner (NP) practice continues to evolve as new models of care emerge, requiring more autonomy in the NP role. PURPOSE: The purpose was to describe the development and psychometric testing of the Dempster Practice Behavior Scale (DPBS), review the extant research on its use in research on nursing and other professions, and determine where future research is needed on the concept of autonomy in professional practice with a focus on advanced practice registered nurses (APRNs). METHODS: Research articles, theses, dissertations using the DPBS as an instrument to measure practice autonomy were reviewed. RESULTS: Twenty-one unique publications were examined for reports of psychometric properties in various populations. For the APRN population (total N = 1,669 in 10 studies), psychometrics for the DPBS support the reliability of the instrument for research. The remaining 11 studies included 2,285 participants who were not APRNs. IMPLICATIONS FOR PRACTICE: Questions remain about the relationships between autonomy and external factors such as regulatory environment, practice setting, models of care, years of experience, and practice mix.

Professional organization membership: Advancing the nurse practitioner role.

With a paucity of literature on professional organization membership by nurse practitioners (NPs), the authors base the discussion of the personal benefits associated with membership on literature focusing on clinicians other than NPs and their personal experiences as members of multiple organizations. Membership is described as related to NP socialization, engagement, networking, mentorship, advocacy, policy, leadership development, research dissemination, professional development, and volunteerism. In addition to encouraging active participation in one or more professional organizations, the need for research into factors influencing the degree to which NPs participate in organizations and the associated benefits is identified.

Effective professional networking.

The reasons for nurse practitioners to develop a professional network are boundless and are likely to change over time. Networking opens doors and creates relationships that support new opportunities, personal development, collaborative research, policy activism, evidence-based practice, and more. Successful professional networking involves shared, mutually beneficial interactions between individuals and/or individuals and groups, regardless of whether it occurs face to face or electronically. This article combines nuggets from the literature with guidance based on the authors' combined experience in networking activities at the local, national, and international levels.

Nurse Practitioner Research Agenda Roundtable, October 2015.

This is a report of the 2015 nurse practitioner (NP) Research Agenda Roundtable hosted by the Fellows of the American Association of Nurse Practitioners. A consensus was reached on four major categories where the need for research is greatest: 1) policy and regulation, 2) practice models, 3) education, and 4) workforce. Specific gaps in the existing body of research on NPs as essential elements of the broader health care environment were identified.

American Academy of Nurse Practitioners National Nurse Practitioner sample survey: focus on acute care.

National survey data on the practice of nurse practitioners (NPs) provides valuable information on role components, practice patterns, and specialty practice descriptions. The American Academy of Nurse Practitioners (AANP) has been conducting NP surveys since 1988. The most recent AANP Sample Survey was conducted in 2009-2010 with responses from over 13,000 NPs, 962 of who were acute care NPs (ACNPs). This article reports on the findings of the 2009-2010 AANP National NP Sample Survey related to ACNP practice.

Acute cough: a diagnostic and therapeutic challenge.

BACKGROUND: Acute cough is one of the most common complaints prompting patient visits to healthcare professionals. Despite the broad repercussions of acute cough on patient quality of life, school and work productivity, and public health resources, research on this condition is minimal, as are the available treatment options. Many patients use over-the-counter medicines, which are often ineffective for symptom relief. Some therapies may achieve antitussive activity, but at the expense of unpleasant or intolerable side effects. UNMET NEEDS: When considering the treatments currently available for the management of acute cough, the multiple limitations of such treatments are quite apparent. Most of these treatments lack clinically proven efficacy and reliability to support their use. This reinforces the need for the generation of quality scientific data from well-performed clinical trials. Hopefully, the result will be the development of safer, more effective and more reliable therapeutic options in the management of acute cough. COUGH ASSESSMENT AND MANAGEMENT: Acute cough can be due to a variety of causes, and it is worthwhile to consider these pathogenic factors in some detail. It is also important to be familiar with the effects that acute cough has on patients' quality of life, work productivity, and the healthcare system; proper awareness of these effects may contribute to better understanding of the social impact of cough. In reference to the available treatments for the management of acute cough, adequate knowledge of the type of over-the-counter and prescription products in the market, as well as their mode of action and advantages/disadvantages, may provide expanded pharmacotherapeutic opportunities and facilitate better clinical decisions. However, due to the drawbacks of current treatment options, ideas for future cough management and newer products need to be considered and tested. CONCLUSION: In view of the socio-economic impact of acute cough and the limitations of available treatments, a renewed interest in the management of acute cough needs to be encouraged. The current strategies for acute cough management need to be reassessed, with a focus on developing new, reliable products and formulations with proven efficacy and safety.

The clinical nurse leader: promoting patient-centered outcomes.

In 2004, a 551-bed nonprofit hospital launched a pilot of the unit-based clinical nurse leader (CNL) role to support staff nurses and their patients. Thus far, the role has demonstrated great promise in promoting individual patient-centered outcomes, although the pilot has identified potential adaptations to enhance aggregate outcomes. These include decreasing the patient-to-CNL ratio, increasing CNL availability to 7 days a week, and reconsidering whether to fill CNL positions with nurses who were prepared as nurse practitioners.