These ANP-BC test prep are very well updated

killexams.com always suggest you to download ANP-BC exam PDF Questions for trial, go through the questions and answers before you apply for full version. Killexams.com allows you 3 months free updates of ANP-BC ANCC Adult Nurse Practitioner exam questions. Our certification group is consistently working at back end and update the ANP-BC PDF Questions as and when need.

Exam Code: ANP-BC Practice exam 2022 by Killexams.com team
ANP-BC ANCC Adult Nurse Practitioner

Category Content Domain Number of Questions Percentage
I Assessment 31 21%
II Diagnosis 39 26%
III Clinical Management 65 43%
IV Professional Role 15 10%
TOTAL 150 100%

Body Systems Drug Agents Age Group
1. Cardiovascular 1. Analgesic 1. Infant
2. Endocrine 2. Anti-Infective 2. Preschool
3. Gastrointestinal 3. Cardiovascular 3. School-Age
4. Genitourinary and Renal 4. Endocrine 4. Adolescent
5. Head, Eyes, Ears, Nose, and Throat 5. Eye, Ear, Nose and Skin 5. Young Adult (including late adolescent and emancipated minors)
6. Hematopoietic* 6. Gastrointestinal 6. Adult
7. Immune* 7. Genitourologic 7. Older Adult
8. Integumentary 8. Musculoskeletal 8. Frail Elderly
9. Musculoskeletal 9. Neurological
10. Neurological 10. Psychiatric
11. Psychiatric 11. Reproductive
12. Reproductive 12. Respiratory
13. Respiratory

Assessment
A. Knowledge
1. Evidence-based population health promotion and screening
B. Skill
1. Comprehensive history and physical assessment
2. Focused history and physical assessment
3. Risk assessment (e.g., genetic, behavioral, lifestyle)
4. Functional assessment (e.g., cognitive, developmental, physical capacity)
II Diagnosis
A. Knowledge
1. Pathogenesis and clinical manifestations of disease states
B. Skill
1. Differentiating between normal and abnormal physiologic or psychiatric changes
2. Diagnostic test selection and evaluation
III Clinical Management
A. Knowledge
1. Pharmacotherapeutics, pharmacokinetics, pharmacodynamics, and pharmacogenetics
2. Anticipatory guidance (e.g., developmental, behavioral, disease progression, crisis management, end-of-life care)
3. Age-appropriate primary, secondary, and tertiary prevention interventions
B. Skill
1. Pharmacotherapeutic intervention selection (e.g., interactions, contraindications)
2. Pharmacotherapeutic intervention evaluation (e.g., monitoring, side/adverse effects, patient outcomes)
3. Non-pharmacologic intervention selection and evaluation
4. Therapeutic communication (e.g., motivational interviewing, shared decision making)
5. Culturally congruent practice
6. Resource management (e.g., accessibility, coordination, cost effectiveness)
IV Professional Role
A. Knowledge
1. Legal and ethical considerations for health care informatics and technology (e.g., confidentiality, accessibility)
2. Scope and standards for advanced practice registered nurses
3. Regulatory guidelines (e.g., reportable diseases, abuse reporting)
4. Evidence-based clinical guidelines and standards of care
5. Ethical and legal principles and issues for patients, populations, and systems (e.g., justice, consent, guardianship, bioethics)
B. Skill
1. Research appraisal (e.g., design, results, clinical applicability)

The ANCC Family Nurse Practitioner board certification examination is a competency based examination that provides a valid and reliable assessment of the entry-level clinical knowledge and skills of nurse practitioners. This certification aligns with the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification and Education. Once you complete eligibility requirements to take the certification examination and successfully pass the exam, you are awarded the credential: Family Nurse Practitioner-Board Certified (FNP-BC). This credential is valid for 5 years. You can continue to use this credential by maintaining your license to practice and meeting the renewal requirements in place at the time of your certification renewal. The Accreditation Board for Specialty Nursing Certification accredits this ANCC certification.

The ANCC certification examinations are developed consistent with the technical guidelines recommended by the American Educational Research Association, the American Psychological Association, and the National Council on Measurement in Education (AERA, APA, NCME; 1999). Additionally, the ANCC certification examinations meet accreditation standards of the Accreditation Board for Specialty Nursing Certification(ABSNC) and the National Commission for Certifying Agencies (NCCA). Each examination is developed by ANCC in cooperation with a Content Expert Panel (CEP) composed ofcarefully selected experts in the field. CEPs analyze the professional skills and abilities from role delineationstudies, which provide the evidence for the test content outline (also called the test blueprint).

Test questions or “items” are written by certified nurses and interprofessional content experts in their discipline who have received training by ANCC staff in writing items. The items are then reviewed by the CEP with the ANCC staff and pilot-tested to ensure validity and psychometric quality before being used as scored items on the genuine examinations. ANCC adheres to a variety of guidelines during the development of items to ensure that the items are appropriate for the specialty and certification level (e.g., APRN vs. RN). This includes editing and coding items, referencing items to the approved test content outlines and reference books, and screening items for bias and stereotypes. Items for the examinations are selected that reflect the test content outline and item distributions. The validity and reliability of the exams are monitored by ANCC staff. Certification examinations are updated approximately every three to five years.

ANCC reports its examinees test score results as pass or fail. If an examinee fails, the score report includes diagnostic feedback for each of the major content areas covered on the examination.
ANCC examinations are criterion-referenced tests, which means that an examinees performance on the examination is not compared to that of other examinees in determining the examinees pass/fail status.
In a criterion-referenced test, an examinee must achieve a score equal to or greater than the minimum passing score for the examination. The minimum passing score represents the absolute minimum standards that the examinee must achieve to demonstrate the ability to practice the profession safely and competently. With the guidance of a measurement expert (e.g., a psychometrician), a panel of subject matter experts in the nursing specialty sets the minimum passing score for each ANCC examination. In setting the minimum passing score, ANCC uses the Modified Angoff Method, which is well-recognized within the measurement field.
Each exam contains between 150 to 175 scored test items plus 25 pilot test items that do not count towards the final score. For specific information on the number of items each exam contains, please refer to the test content outline associated with that exam.
Scores on ANCC examinations are reported on a scale with a maximum possible score of 500. To pass the ANCC examination, an examinee must achieve a scale score of 350 or higher. Prior to conversion of an examinees score to this scale, the examinees raw score on the examination is determined, which is simplythe number of test items that the examinee answered correctly (e.g., 105 out of 150). The raw score is then converted to a scale score, using a conversion formula.
For examinees who do not achieve a scale score of at least 350, the score report will show the scale score achieved, “fail” status, and diagnostic feedback for each of the content areas covered by the examination

ANCC Adult Nurse Practitioner
Medical Practitioner outline
Killexams : Medical Practitioner outline - BingNews https://killexams.com/pass4sure/exam-detail/ANP-BC Search results Killexams : Medical Practitioner outline - BingNews https://killexams.com/pass4sure/exam-detail/ANP-BC https://killexams.com/exam_list/Medical Killexams : Medics, participate in ongoing healthcare conventions
Health & Fitness

Medics prepare for surgery at Hola Referral Hospital during a free surgical camp. PHOTO | WACHIRA MWANGI | NMG

As part of our suffrage cycle, we are in an electioneering period with the General Election slated just over a month away. Consequently, various political outfits have been planning and undertaking healthcare conventions to outline their manifestos for the healthcare sector.

These dialogues are occurring at both national and regional levels of government. It is paramount that medical practitioners actively participate in these conventions.

Given their daily encounters with the intricate permutations of our healthcare services; at community, patient and system-wide levels, medics would best provide an accurate understanding of the current situation as well as possible solutions.

Often, half-baked policies are fronted in the healthcare sector because of a lack of involvement of medical practitioners in their conceptualisation and are dead on arrival once their implementation phases begin.

Therefore, the various professional associations representing the medical workers such as the Kenya Medical Association, Kenya Medical Practitioners and Dentists Union, Clinical Officers Council, Kenya Union of Clinical Officers, Nursing Council of Kenya, Kenya National Union of Nurses and others must undertake active participation in these ongoing health conventions.

Their involvement would provide a better practical understanding of the current challenges to ameliorate the same. As this occurs, it would be prudent to utilise an eco-system approach. In this approach, the high interconnectedness of the different players in the healthcare sector can be compared to a community of living organisms constantly adapting and evolving to survive.

This provides for opportunities for competing as well as collaborating on available resources, co-evolving, and jointly adapting to internal and external disruptions; all with an overarching goal of improving healthcare workers’ welfare and patient outcomes.

The current disruptions in healthcare traverse across public, private as well as non–governmental sectors and border on how well we can achieve universal health coverage in a Kenyan context.

Tue, 28 Jun 2022 17:25:00 -0500 en text/html https://www.businessdailyafrica.com/bd/lifestyle/health-fitness/medics-participate-in-ongoing-healthcare-conventions-3862844
Killexams : The toughest challenges facing the spine industry

From an increasingly demanding spine patient population to payers too often dictating care and a potential overreliance on enabling technologies, five spine leaders outline some of the biggest challenges facing the specialty.

Note: Responses were lightly edited for length and clarity.

Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: A discussion I frequently have with both my reps and those who train residents is there is a genuine concern of the overreliance on tech. Surgeons of a certain vintage who trained on anatomic techniques were slow to adopt them. The next generation seemed more comfortable but were also trained in the backup plan of mapping hardware placement using landmarks and aided by fluoroscopy "just in case." The following generation I hope can still do this. 

My concern is that instead of verifying and then proceeding, some will just charge ahead, assuming the navigation or technology is spot on. It's more concerning when you think about who exactly is liable when the technology is "off." I hope the next set of surgeons can see its shortcomings and that the need for anatomical knowledge is paramount.

Colin Haines, MD. Virginia Spine Institute (Reston): Spine surgeons today are faced with a huge challenge to maintain the ability to care for their patients as they see fit. Too often, payers dictate care based on either archaic literature or cost-cutting measures. I am concerned that the biggest threat to our patients is that, as spine surgeons, we lose ground in appropriately treating our patients. While evidence-based medicine is a cornerstone by which we all practice, large-scale population-based medical systems often leave the patient in the dust. In ideal medical care, each of my patients needs an individualized diagnosis and treatment plan. This level of customization is lost if we plug everyone into the same treatment algorithm. Big data and unilateral decisions by payers risk further loss of control over appropriately treating our patients.

Hooman Melamed, MD. The Spine Pro (Marina Del Rey, Calif.): Major hospitals and healthcare corporations are acquiring more and more physician practices, especially primary care, which not only is driving the cost of healthcare up but also decreases the referral to the community orthopedic surgeons, and now instead, those primary care practices have to refer to the hospital or that healthcare corporate system.

Insurance companies are further reducing payment and bundling payments together which is putting some practices on a financial strain since average overhead is going up every year. For example, as staff salaries increase every year, yet reimbursement is getting less.

This forces many orthopedic surgeons to work more and increase the volume which causes higher rate of burnouts, dissatisfaction with the job and increased patient care mistakes.

Maurice Goins, MD. Resurgens Orthopaedics (Atlanta): I believe there are many challenges, [including] providing care to an increasingly skeptical and demanding patient population that is continuing to grow in size that ultimately is outpacing the growth of practitioners. Compared to five to 10 years ago, there was a shift in patient care where it became a combined approach involving more of the patient-physician relationship to make a quality decision for patient care going forward. Over the past five years, in particular during the pandemic, our patient population has become ever more knowledgeable and even more demanding of the care provided, which makes it more challenging to meet their expectations. The shift in care is now the patient, who is a consumer along with the insurer, the physician and the internet.

Nick Jain, MD. DISC Sports & Spine Center (Newport Beach, Calif.): While prior authorization for ACDF is an obvious target due to the increased authorization process burden and delay in care, I think the decreasing CMS fee will prove to be the most detrimental latest change to patient care. As reimbursement costs decrease while staffing costs and inflation soar to all-time highs, physicians will be forced to spend less time with patients to make ends meet, resulting in shorter face-to-face visits with an increasingly sicker and older patient population who require our full attention and dedication. This will only lead to the further degradation of the physician-patient relationship and, for that reason, I would eliminate the latest cuts to the CMS fee schedule.

Wed, 13 Jul 2022 08:31:00 -0500 en-gb text/html https://www.beckersspine.com/spine/item/54712-the-toughest-challenges-facing-the-spine-industry.html
Killexams : What to know about acupuncture for arthritis

Arthritis is a common condition that causes pain and inflammation in the joints. There are many alternative and complementary treatments for arthritis, and acupuncture is one of the most popular to help relieve symptoms and pain.

Acupuncture is a technique within traditional Chinese medicine (TCM) that involves inserting very fine needles into the skin or muscle on specific body parts. Some evidence suggests it may help ease arthritis symptoms and Excellerate the quality of life for people with the condition.

This article describes what acupuncture is, how it works, and how it may affect arthritis. We then outline some of the practice’s benefits, side effects, and risks and discuss other treatment options. Finally, we answer some frequently asked questions about acupuncture for arthritis.

Acupuncture involves inserting very fine stainless steel needles into the skin or muscle on specific body parts. The underlying theory is that essential life energy known as “qi” (pronounced “chee”) flows around the body through channels called “meridians.”

Experts believe a blockage in the flow of qi results in pain or illness. With acupuncture, a practitioner stimulates a combination of over 2,000 acupuncture points, restoring the flow of qi to alleviate symptoms.

Practitioners have used acupuncture for thousands of years to treat a wide range of complaints, including:

While Eastern medicine recognizes concepts of bodily energy, such as qi and meridians, Western culture has its own hypotheses for how acupuncture may work.

One of the most popular explanations is that inserting needles beneath the skin may signal the brain to release pain-relieving neurotransmitters called endorphins and enkephalins. It may also provide the following benefits:

  • stimulating the production of the hormone cortisol, which helps control inflammation
  • regulating the immune system
  • stimulating blood flow
  • relaxing muscle tone

The exact mechanisms of acupuncture are still unclear. However, some healthcare professionals suggest that if an individual feels better following treatment, the treatment was a success, regardless of whether doctors understand the process or not.

Acupuncturists should tailor acupuncture treatment according to a person’s individual needs. For this reason, conducting reliable and controlled clinical trials can be challenging.

A 2018 systematic review of 43 studies concluded that acupuncture alone or in combination with other treatments is beneficial for managing rheumatoid arthritis (RA) and can help Excellerate function and quality of life.

A more latest 2022 systematic review and meta-analysis investigated the effectiveness of acupuncture and acupuncture-related treatments (ACNRT) as a complementary therapy in managing RA. In this study, ACNRT involved one of the following:

  • Traditional acupuncture: Involves inserting fine needles into the skin or muscle at key acupuncture sites.
  • Electro-acupuncture: This involves stimulating the acupuncture needles with an electric current to enhance the effects of the procedure.
  • Moxibustion: A practitioner burns mugwort leaves close to the skin’s surface at key acupuncture sites.

The meta-analysis included 12 randomized controlled trials (RCTs) in which participants received Western medicine alone or in combination with ACNRT.

People who received Western medicine in combination with ACNRT showed significant reductions in the following:

  • inflammatory markers in the blood
  • disease activity
  • swollen and tender joints
  • self-reported pain

The study authors concluded that Western medicine with ACNRT can reduce RA disease markers and significantly Excellerate clinical symptoms. However, they note that further long-term, high quality RCTs with larger demo sizes are necessary to confirm the findings.

Many people who undergo acupuncture to treat arthritis report improvements in their quality of life. According to the Arthritis Foundation, acupuncture aids pain relief as there is the stimulation of endorphins and oxytocin.

A 2019 study investigated the effectiveness of acupuncture on pain, disability, and quality of life in people with RA of the hand.

Each participant received one of the following treatments:

  • acupuncture using the TCM method
  • sham acupuncture, which involved acupuncture at random sites on the body
  • no treatment until after the study

The participants receiving treatment using the TCM approach reported the following benefits:

  • less pain
  • improved hand and arm strength
  • better overall health
  • improved quality of life

The above findings suggest that traditional acupuncture may be a beneficial treatment option for RA of the hands.

Supporters of acupuncture claim that the technique is a gentle way to heal the body. They state that a person who receives acupuncture from a qualified practitioner can expect to feel little to no pain during the procedure.

In rare cases, someone may experience mild, short-term side effects, such as:

  • bleeding, bruising, or pain where the needles puncture the skin
  • drowsiness
  • nausea
  • feeling dizzy or faint
  • worsening of preexisting symptoms

When symptoms change or worsen following acupuncture, practitioners believe the procedure may have unearthed blockages in the flow of qi that were initially not apparent. In these cases, a person would need subsequent treatments to address any new symptoms.

Individuals should only ever receive acupuncture from a highly trained professional.

Incorrectly performing acupuncture increases the risk of serious adverse effects. These may include:

However, there are few instances of people reporting the above side effects. Most experts consider acupuncture a generally safe procedure when an experienced, well-trained practitioner performs it.

There are many different types of arthritis, with RA and osteoarthritis (OA) being the most common. The different types of arthritis have different causes, contributing factors, and disease courses and therefore require different treatments.

Treatments for osteoarthritis

OA, or “wear and tear” arthritis, involves degeneration of the cartilage and bones, typically due to aging.

A person can sometimes manage mild OA symptoms by:

  • performing regular exercise
  • maintaining a moderate weight
  • wearing supportive footwear
  • using devices or techniques that reduce strain on the joints during everyday activities

In more severe cases, individuals may need to take painkillers.

Read more about treating OA naturally.

Treatments for rheumatoid arthritis

RA is an autoimmune condition where the immune system mistakenly attacks healthy body cells and tissues, causing pain and inflammation. Most cases primarily affect the joints.

Most people with RA take medications to help slow the progression of the disease and alleviate the symptoms.

Prescription treatments fall into two main types: disease-modifying antirheumatic drugs (DMARDs) and biologics.

Read on for the differences between the two types of treatments.

DMARDs

DMARDs slow the progression of RA and ease the symptoms of the disease. They work by suppressing the immune system response that attacks and damages the joints. Without treatment, this process could cause further damage to nearby bones, tendons, ligaments, and cartilage.

Biological therapies

People usually take biologics alongside DMARDs if the DMARD has been ineffective on its own. Biologics work by stopping particular chemicals in the blood from triggering the immune system to attack the joints.

Newer medications

A doctor may prescribe a new type of medication called janus kinase inhibitors for adults with severe RA. These drugs block chemical messengers called “cytokines” from triggering an immune response.

Below are some FAQs about acupuncture.

How long do the effects of acupuncture last?

While acupuncture may help alleviate RA pain and inflammation in some people, the treatment may not be effective for everyone.

For those who experience symptom relief, it is not possible to say how long the effects will last. A person can talk with their acupuncture practitioner about the likely treatment outcomes and whether there is anything that may help prolong the effects.

If acupuncture treatment is not having desirable effects, the practitioner may adjust the treatment plan accordingly.

How often should I get acupuncture?

A course of acupuncture treatment typically involves several separate sessions of around 20 minutes or more.

However, a person should talk with their acupuncture practitioner regarding the number and frequency of acupuncture treatments necessary to manage their condition.

How much does acupuncture cost?

The cost of acupuncture ranges from around $75 to $200 per session.

While some health insurance companies will cover all or some of the cost, others will not provide any cover. A person can check their insurance policy before considering acupuncture treatment.

Arthritis presents a unique set of symptoms for each individual. As such, people typically manage the disease using a combination of treatments.

Scientific evidence suggests acupuncture may offer some symptom relief and Excellerate the quality of life for those with arthritis. Although scientists have not identified the exact mechanism behind these effects, some suggest that acupuncture may trigger the release of pain-relieving and anti-inflammatory chemicals within the body.

While scientists may never be able to explain exactly how acupuncture works, individuals with arthritis may consider this complementary therapy worth trying.

Mon, 27 Jun 2022 12:01:00 -0500 en text/html https://www.medicalnewstoday.com/articles/acupuncture-for-arthritis
Killexams : Certificate in Health Informatics

This hands-on course examines the technologies and infrastructure required to support digital innovation.  The course examines the major components of the information technology infrastructure, such as networks, databases and data warehouses, electronic payment, security, and human-computer interfaces.  The course covers key web concepts and skills for designing, creating and maintaining websites, such as Grid Theory, HTML5, CSS, JavaScript, AJAX theory, PHP, SQL and NoSQL databases.  Other principles such as Web Accessibility, Usability and User eXperience, as well as best security practices, are explored in detail through a combination of lectures, in-class examples, individual lab work and assignments, and a final group project.

Tue, 31 May 2022 13:33:00 -0500 en text/html https://www.dal.ca/academics/programs/graduate/digital-innovation/program-details/health-informatics.html
Killexams : New recommendations for prenatal care delivery

The American College of Obstetricians and Gynecologists partnered with the University of Michigan to convene a panel of maternity care experts to determine new prenatal care delivery recommendations. Based on emerging evidence and experience, including significant changes in prenatal care delivery during the COVID-19 pandemic, these recommendations are published in the Journal of Women's Health.

The recommendations were developed by a diverse panel of maternity care, , pediatrics, and equity experts, in addition to two patient representatives from across the country to review delivery for medically average-risk patients.

Alex Friedman Peahl, MD, from the University of Michigan, and coauthors, state that "These flexible recommendations can be enacted through any care delivery model: traditional individual visits, group prenatal care, or pregnancy medical homes; any maternity care provider: physicians, midwives, , or physician assistants; and any practice setting: those with high or low resources." The new model of prenatal care delivery "represents a in prenatal care delivery, replacing a one-size-fits-none model that has been associated with overutilization of low-value care and under-utilization of high-value services."

"Peahl et al. present an outline of the new Michigan Plan for Appropriate Tailored Healthcare in pregnancy (MiPATH), and they provide practical guidance on how to implement these new recommendations in routine practice," says Journal of Women's Health Editor-in-Chief Susan G. Kornstein, MD, Executive Director of the Virginia Commonwealth University Institute for Women's Health, Richmond, VA.



More information: Alex Friedman Peahl et al, Michigan Plan for Appropriate Tailored Healthcare in Pregnancy Prenatal Care Recommendations: A Practical Guide for Maternity Care Clinicians, Journal of Women's Health (2022). DOI: 10.1089/jwh.2021.0589

Citation: New recommendations for prenatal care delivery (2022, June 23) retrieved 18 July 2022 from https://medicalxpress.com/news/2022-06-prenatal-delivery.html

This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

Wed, 22 Jun 2022 12:00:00 -0500 en text/html https://medicalxpress.com/news/2022-06-prenatal-delivery.html
Killexams : Democratic attorney general candidates outline plan for Roe v. Wade fallout

In the wake of overturning Roe v. Wade, both candidates seeking the Democratic Party's nomination for attorney general have said they'll take steps to protect Vermonters' access to abortions.

Charity Clark, who served under former attorney general T.J. Donovan as assistant attorney general and chief of staff, announced Monday that if elected she'll:

— Protect Vermont medical providers from out-of-state prosecution when they act within their Vermont license.

— Protect the data privacy of those seeking abortions in Vermont.

— Identify or certify pharmacies for those seeking abortion medicine.

— Develop a "no-tolerance" policy towards deception and misinformation about abortion medication and providers.

— Advocate that Vermont extradition laws be changed to protect its abortion providers.

— Change policy or pass legislation allowing local law enforcement to not cooperate with out-of-state investigations related to providing abortions.

— Support Vermont's medical boards and in-state malpractice insurance companies in abstaining from taking adverse action against treatment providers treating out-of-state patients.

— Eliminate the ability of people from other states compelling anyone in Vermont to testify in a civil action against abortion seekers or providers.

"I'm a problem-solver, so whenever a problem presents itself that's where my brain goes, and in this case these are the items I have considered and am thinking about to try to project Vermonters — and health care providers — seeking an abortion," said Clark on Tuesday.

Clark said she believes the Legislature would be supportive of these measures where legislation is needed.

"For me the biggest concern is for health care providers in-state because I think that's the issue that's going to come up the most," she said. "So, dealing with those issues, to me, looking at this issue through the eyes of those practitioners would be my priority because I think that's going to come up the most."

Clark said that data privacy has been a big concern of hers for years, even when not related to abortion access, and she plans to incorporate the two concerns if elected attorney general.

"Ultimately, what our mindset should be is that this is a profound moment in history," she said. "Very little can compare."

Besides abortion access and data privacy, Clark said her focus as attorney general would be to protect small businesses, as well as criminal justice reform. She said the administration and Legislature have not been seeing eye to eye on criminal record expungement, and she believes she can help them reach a compromise.

Running against her is Washington County State's Attorney Rory Thibault.

During the weekend, he also released a list of things he'd do, or support doing, in order to protect those seeking abortions and other reproductive health care services in Vermont. Among them were:

— Advocating for the passing of the Reproductive Liberty Amendment in November.

— Be proactive in protecting those traveling to Vermont for an abortion, including passing safe-harbor laws for patients and providers.

— Prohibit lawsuits from out-of-state against abortion providers serving those from other states.

— Secure the ability to produce within Vermont the pharmaceuticals needed for Plan-B.

— Bolster in-state health care capacity and insurance laws for non-Vermonters seeking reproductive services in Vermont.

— Work on how to assist Vermonters who are out-of-state for travel, school or work who need reproductive health care services in states that are hostile to them.

"The challenge is going to be making sure whatever the laws and protections that are implemented in Vermont are ones we can feel confident that we can defend both in state court and, ultimately, in federal court," Thibault said.

He said he believes the state as a whole needs to take the long view and not assume that the president come 2024 will be pro abortion access. It may come to pass that other elements of the federal government, besides the Supreme Court, become hostile to reproductive rights.

The first thing a federal government seeking to limit or eliminate abortion access would do is hamper access to abortion-related drugs, he said.

Vermont should also be wary of other Supreme Court decisions that may target access to contraception, and marriage equality, he said.

Both candidates said New York and surrounding New England states have been pro-abortion access, opening opportunities for Vermont to either lead or work with its neighbors' initiatives.

keith.whitcomb @rutlandherald.com

Wed, 29 Jun 2022 00:16:00 -0500 en-US text/html https://insurancenewsnet.com/oarticle/democratic-attorney-general-candidates-outline-plan-for-roe-v-wade-fallout
Killexams : New guidance for cancer pain and opioid use disorder or opioid misuse

Opioids are a cornerstone of cancer pain management, but there is a lack of consensus on how to treat pain in cancer patients who also have struggled with opioid use disorder or prescription opioid misuse. In a study published today in JAMA Oncology, researchers outline guidance for treating such patients and highlight obstacles and opportunities for better integration of addiction treatment in cancer care.

"There is no standard of care for treating and managing opioids in people who come into their with a history of substance use, or who are at increased risk for adverse events due to prescription opioid misuse behaviors, such as taking more opioids than prescribed," said first author Katie Fitzgerald Jones, M.S.N., a palliative and addiction nurse practitioner at VA Boston Healthcare System and Ph.D. candidate at Boston College. "As a first step towards improving care of these patients, our study surveyed clinicians to understand how they treat patients with opioid complexity."

The study was led by Jones and study principal investigator and senior author Jessica Merlin, M.D., Ph.D., associate professor of general internal medicine at the University of Pittsburgh School of Medicine and co-director of the Palliative Recovery Engagement Program at UPMC, a clinic that serves patients with serious illnesses, like , who also struggle with opioid use disorder or prescription opioid misuse. In collaboration with colleagues at RAND, the investigators used an online Delphi study platform to explore consensus among 120 and addiction experts about how they would approach treatment of a hypothetical 50-year-old patient with advanced cancer who has cancer-related and either a history of opioid use disorder or prescription opioid misuse.

Participants were asked to rate and comment on various management strategies, such as prescribing methadone and buprenorphine. Experts indicated that both of these medications are an appropriate approach to treating cancer pain in a patient with a history of an opioid use disorder.

Prescribing methadone and buprenorphine for pain requires clinicians to hold only a Drug Enforcement Administration (DEA) license, but there are additional barriers to prescribing the very same drugs for opioid use disorder. Methadone can be legally used to treat opioid use disorder only in licensed methadone treatment programs. Additionally, clinicians must have what's known as a DEA X-waiver to prescribe buprenorphine for opioid use disorder. According to Jones and Merlin, only a small fraction of oncologists and palliative care clinicians hold an X-waiver, a hurdle for who could benefit from this medication.

"Because of the way that methadone and buprenorphine are regulated—one way for pain, another way for addiction—addiction treatment is isolated from mainstream medical care, including ," said Merlin. "It's othering, and it adds to the stigma of opioid use disorder."

Study participants agreed that it is inappropriate to refer a patient with advanced cancer to a methadone treatment program because of the burden of frequent, sometimes daily, visits alongside cancer treatments.

"Interestingly, experts in the study suggested that it was appropriate to prescribe methadone outside of the context of a licensed methadone treatment program for pain in cancer patients with a history of opioid use disorder—even though this is murky legal territory," said Merlin. "This finding highlights the need to Excellerate access to this drug."

According to Jones, methadone is dosed differently for pain and opioid use disorder, and more research is needed to understand the best approach for treating cancer pain and opioid use disorder concurrently.

In scenarios where the hypothetical cancer patient did not have a history of opioid use disorder but was misusing opioids—taking higher doses than prescribed or taking a benzodiazepine that wasn't prescribed—experts recommended continuing their opioid regime but increasing monitoring through more visits or shorter prescriptions. According to Merlin, this was an interesting finding because these scenarios pose increased risk for overdose and opioid-related harms. Despite these risks, experts were reluctant to transition to buprenorphine, a safer opioid with less overdose potential.

"Drawing from our other research, we think there are many reasons that clinicians were hesitant to use buprenorphine, including knowledge gaps, lack of guidelines for management of opioid misuse, regulation of buprenorphine and stigma," said Jones.

The researchers say that better education around buprenorphine and cancer pain management in the context of an opioid use disorder or opioid misuse is needed.

"There is a tendency to ignore treatment of opioid use disorder in advanced cancer patients because people think, 'Oh, this person has bigger fish to fry,' but that's not a very patient-centric way of looking at things," said Merlin. "We know that opioid use disorder is a really important factor in quality of life, so addressing opioid addiction and in people with advanced cancer is really critical."

Merlin and Jones are working to educate palliative care clinicians around the country about using buprenorphine to treat , including encouraging them to get X-waivers to treat addiction alongside pain.

"If we are going to prescribe opioids for pain, it is our moral obligation to also treat an important consequence of that opioid prescribing— addiction—if and when it occurs in our patients," said Jones.



More information: Consensus-based guidance on opioid management in individuals with advanced cancer-related pain and opioid misuse or use disorder, JAMA Oncology (2022). DOI: 10.1001/jamaoncol.2022.2191

Citation: New guidance for cancer pain and opioid use disorder or opioid misuse (2022, June 30) retrieved 18 July 2022 from https://medicalxpress.com/news/2022-06-guidance-cancer-pain-opioid-disorder.html

This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.

Wed, 29 Jun 2022 12:00:00 -0500 en text/html https://medicalxpress.com/news/2022-06-guidance-cancer-pain-opioid-disorder.html
Killexams : Prevent: the role of mental health nurses in counter-terrorism programmes

This article discusses the vital role of forensic mental health nurses within the counter-terrorism Prevent programme

Abstract

In this article, we discuss the role of forensic mental health nurses in the Prevent counter-terrorism programme. We briefly outline the UK counter-terrorism strategy and describe the role of the mental health teams that operate alongside counter-terrorism police. Mental health nursing in this setting requires a specialist skillset, drawing on knowledge developed in inpatient and community forensic services. A case study is used to explain the activities, challenges and outcomes of those involved in this work.

Citation: Carrington T et al (2022) Prevent: the role of mental health nurses in counter-terrorism programmes. Nursing Times [online]; 118: 7.

Authors: Toni Carrington and Hayley Cushing are clinical nurse specialists, Central Counter Terrorism Vulnerability Support Hub; Sarah Sanderson is specialist forensic nurse practitioner and nurse manager, North Counter Terrorism Vulnerability Support Hub; Luc Taperell is forensic nurse specialist and team lead, South Counter Terrorism Vulnerability Support Hub.

  • This article has been double-blind peer reviewed
  • Scroll down to read the article or download a print-friendly PDF here (if the PDF fails to fully download please try again using a different browser)

Introduction

Terrorism – defined as the unlawful use of violence and intimidation, especially against civilians, in the pursuit of political aims (HM Government, 2018a) – not only causes great physical harm, but also has a significant impact on the safety of communities and society at large (HM Government, 2018a).

CONTEST is the UK’s counter-terrorism strategy that was first developed by the Home Office in 2003, with the aim of reducing the risk to the UK and its interests overseas from terrorism. It has four strands:

  • Prevent – to stop people becoming terrorists or supporting terrorism;
  • Pursue – to stop terrorist attacks;
  • Protect – to strengthen the UK’s protection against a terrorist attack;
  • Prepare – to mitigate the impact of a terrorist attack (HM Government, 2018a).

This article is focused on Prevent, which is about safeguarding and should be considered in the same context as support provided to people at risk of involvement with drugs, gangs or other forms of harm. Prevent is concerned with all forms of extremism and addresses vulnerabilities to radicalisation, a process that can lead some people to adopt and act on a violent extremist view, break the law and, in some cases, commit acts of terrorism (Corner and Gill, 2015). Guidance on Prevent is outlined in Box 1.

Box 1. Why should nurses refer to Prevent?

  • Prevent statutory guidance is issued under section 29 of the Counter-Terrorism and Security Act 2015
  • The health sector is well placed to contribute to the Prevent strategy to identify individuals who may be drawn into terrorist activity – Prevent is safeguarding
  • The NHS has a statutory safeguarding duty to uphold the Prevent agenda
  • Anyone can refer to Prevent – including nurses, NHS staff, education staff, social services or the general public – if they have a safeguarding concern that relates to any form of extremist vulnerability
  • It is important to be aware of workplace policy in relation to Prevent and to attend the statutory Prevent training
  • NHS staff should refer to their individual workplace policy in relation to making a referral to Prevent. For other services, including staff working in education, refer through the Prevent leads or designated safeguarding leads via the anti-terrorist hotline (telephone number: 0800 789 321) or the police (telephone number: 101)

Nurses and other health professionals have a responsibility to make or consider a referral to the Prevent counter-terrorism programme under the NHS England Prevent duty guidance from the Home Office (2021), which states that “healthcare professionals will meet and treat people who may be vulnerable to being drawn into terrorism”. The health sector needs to ensure that healthcare workers can identify early signs of an individual being drawn into radicalisation. Staff must be able to recognise key signs of radicalisation and be confident in referring individuals to their organisational safeguarding lead or the police, thus enabling them to receive the support and intervention they require.

Box 2 gives more details about what might trigger a referral to Prevent. On acceptance of a referral, the case is allocated to a counter-terrorism case officer, referred to as a CTCO or a Prevent officer. The Prevent referral is also sent to a vulnerability support hub (VSH) if there are indications of mental health and/or multiple and complex needs. The VSH involves a multidisciplinary team of experienced psychiatrists, psychologists, nurses and police with administrative support.

Box 2. What would trigger a Prevent referral?

We have a responsibility to make or consider a referral to Prevent under NHS England’s Prevent duty (Home Office, 2021). The National Police Chiefs’ Council (nd) suggests potential key signs as:

  • Having a need to find an identity, belonging, status or excitement
  • Being in a transitional phase of life
  • Being susceptible to being influenced or controlled – or wanting to dominate others
  • Feeling a sense of grievance, injustice or being under threat
  • Having an emotional desire for political or moral change
  • Having mental health-related issues
  • Being secretive about social networking contacts

Other things to look out for include:

  • Evidence of a change in behaviour/engagement/motivation/escalation/verbal threats
  • Making comments in relation to terrorism or holding strong political views, such as those that are racist or right wing
  • Signs that a person is being exploited or is vulnerable
  • Monetary donations being made to concerning causes
  • Change in religion and expression of beliefs (note a change in religion is not a reason to refer to Prevent but, along with other concerns outlined above, a referral could be beneficial)
  • Exposure to racism/criminality/conflict
  • Expressing ideological beliefs, especially if out of the ordinary for that person
  • Signs/symbols/posters/flags/books in the home that may raise concern
  • Recent critical events, such as trauma/loss

Our service users can be affected by what is in the news (for example, a terror attack, a school shooting, religious or political unrest and wars/riots), which may cause them to be concerned and/or increase their interest in current issues.

It is important to note that you can make a referral if you are concerned about an establishment or provider, not just a person. It is better to be on the side of caution so, if there are any concerns, a referral should be made for Prevent to review. Discuss the concern with a line manager and the team, and always discuss with the Prevent lead/coordinator or the safeguarding lead in the organisation. Ensure the evidence, discussion and decision is documented and, if at all possible, discuss with the service user if it is felt to be appropriate.

Research has shown that:

  • Those at risk of radicalisation often have a range of complex mental health difficulties;
  • Many people referred to Prevent have multiple and complex needs – including those relating to mental health, housing, substance misuse – and are at risk of criminal activity, including reoffending (Birmingham and Solihull Mental Health NHS Foundation Trust, 2017);
  • A high proportion of individuals referred to Prevent are unknown to, or are not engaging with, mental health services;
  • People with multiple and complex needs require lots of different types of support, but often have ineffective contact with – and fall though the gaps in – services (Home Office, 2021).

A rationale was developed for setting up forensic mental health teams to work with counter-terrorism police (Birmingham and Solihull Mental Health NHS Foundation Trust, 2016), which led to the creation of the VSH in the West Midlands in 2016, followed by two pilot sites in Manchester/Leeds (classed as North VSH) and London. The three hubs cover the geographical area of the whole of England and Wales.

The CTCO will also discuss the case with the local Channel Panel (Home Office, nd). Individuals referred to Prevent can consent to work with the Channel Panel, which meets once a month and takes a multidisciplinary intervention approach to support individuals who are at risk of radicalisation. The Channel Panel is arranged by the local authority and attended by a wide range of agencies including health, mental health, education and social services. There may also be involvement from intervention providers, who are specialist mentors employed by the Home Office to work with individuals in a one-to-one therapeutic relationship.

Box 3 outlines some other key facts about the Prevent programme.

Box 3. Key facts about the Prevent programme

  • Between April 2017 and March 2018, there were 7,318 referrals to the Prevent programme
  • Of these, 1,314 were discussed at a Channel Panel – 662 for Islamist concerns, 427 for far-right concerns, and 225 for other concerns
  • More than 780 individuals have left the Channel Panel process since April 2015 with no further terrorism-related concerns

Source: Home Office (nd)

Vulnerability support hubs

The VSH works with a CTCO to try to:

  • Reduce the risk of people being radicalised and vulnerable people being drawn into extremism;
  • Understand and address individuals’ vulnerabilities, thereby mitigating risk;
  • Identify unmet mental health needs;
  • Improve health and criminal justice outcomes for individuals;
  • Reduce costs through efficient partnership working, shorter durations of untreated mental illness and fewer investigations.

Each hub has an embedded multidisciplinary mental health team that works collaboratively with the police and health providers. The purpose of a VSH is to safeguard vulnerable individuals who have mental health and/or complex needs issues and are at risk from radicalisation, by supporting healthcare providers to offer care and treatment. The focus is on working in partnership to discourage stigma, help individuals to access the care they need, and work collaboratively with health providers to ensure those referred have timely access to appropriate services and treatment.

The nurses in the VSHs always adhere to the principles of Nursing and Midwifery Council (NMC) legislation and guidance as set out in the NMC’s (2018) code of conduct.

Evolving community teams

Community mental health and learning disability nurses working alongside counter-terrorism police is a new and innovative role. In general, these teams have changed significantly over the years, reflecting the varied requirements and different support packages needed. One type of service definitely does not fit all.

Historically, community mental health and learning disability nursing has involved supporting a smooth transition from hospital back to community settings, providing mental health reviews, medication management and practical signposting, as required. They also traditionally involved support to prevent unnecessary admissions to hospital by providing a similar package of care based in the home. Since the 1990s, however, the roles have become increasingly diverse and also provide mental health support in court, prison and police custody settings.

It is accepted and understood that many service users in maximum- and medium-security settings can be rehabilitated back to the community. However, to do so, a service needs to show:

  • How mental health links to risk;
  • Whether that risk links to harm to others;
  • How risk will be mitigated.

Evidence-based risk assessments have been developed to help people leaving a highly managed setting, and this prompted the evolution of community forensic mental health nursing. Practitioners working in community forensic mental health deal with ongoing risk assessment and support (NICE, 2017). Identifying risk and early warning signs for such behaviour allows forensic nursing teams to mitigate concerns with appropriate actions, which may include medication reviews, additional support measures, engagement with additional services or readmission to hospital (Woods, 2020).

Risk assessments can be done in various settings, from secure hospitals to prisons and court or custody settings, where risk formulation and recommendations are essential. This requires an understanding of legal processes, laws, roles and responsibilities in the criminal justice system, and how mental health and complex needs interact with risk during a person’s recovery (Royal College of Psychiatrists, 2016).

The knowledge and experience staff develop in community and forensic settings allows risk assessment skills to be transferred to work in the context of the Prevent strategy. As well as being able to identify risk, staff need to know the range of options available to eliminate or mitigate the risk. Prevent is not just concerned with mental health, but also complex needs, and whether a person’s risk factors are present and relevant to the situation. If the presenting problem or concern is identified promptly, and with knowledge of behaviours that contribute to risk, suitable management and interventions can be identified.

Nursing in the VSH

It is important to note that the VSHs are staffed with mental health and learning disability nurses from different trusts. Despite varying titles, they are all band 6-8 nurses, who have significant experience in areas such as forensics, liaison and diversion, prison and learning disability. Their role is diverse, unique and involves independent working, with experience and knowledge in all aspects of mental health.

The specialist mental health practitioner’s role is an integral part of pioneering work that helps change the way vulnerabilities are identified and addressed in relation to Prevent and the wider CONTEST strategy. The role has been developed to provide an additional level of safeguarding and health input for referred individuals who may have mental health problems and/or complex needs, and who are at risk of radicalisation.

A key part of the role is risk identification and the production of multidisciplinary formulations, which are used to help inform agencies involved directly in the care of the people referred to the team, so that appropriate interventions and safeguarding measures can be put in place.

It is a nursing role that requires close working with police colleagues on a daily basis, advising on cases and liaising with professionals working with people in a variety of settings. It is not typically a face-to-face clinical role and the screening process is done using the information provided to the team by the police and any other professional working with the individual. The team also provides training on mental health to police and healthcare colleagues.

The nurse draws on past experiences and training in risk assessment and management, and a foundation in evidence-based practice, to identify areas of risk and concern quickly and effectively. The goal is to ensure the best outcome for the vulnerable individual and, where possible, divert them away from criminality and ensure they are appropriately safeguarded. As part of this process, the nurses work closely alongside NHS colleagues to help ensure appropriate mental health safeguarding; risk to others and self is a key concern when reviewing a case.

“Community mental health and learning disability nurses working alongside counter-terrorism police is a new and innovative role”

Case study

A referral was made to Prevent from a university Prevent lead in relation to a young person who had been posting extreme right-wing material on an open social-media platform that advocated violent acts. This person had been arrested a number of times over the previous few years for minor offences, and disclosed to police a belief that something was “wrong” with their mental health but declined to see mental health liaison and diversion services. Due to mental health concerns, the case was referred by the CTCO to the VSH; the CTCO and their police sergeant supervisor decided to visit the person.

During the visit, there were concerns because the young person did not make any eye contact with the officer and said they had joined an online group that made them feel accepted and they were enjoying learning about Nazi history. They made odd statements about the government spying on them and conspiring against them. There were many drawings on the wall of extreme right-wing signs and symbols, the room seemed untidy and chaotic, and the person was unkempt and distracted, giving cause for concern that they were struggling with poor mental health. They did not seem to understand the vulnerable position they were putting themselves in online and how they may be taken advantage of by people with more extreme views.

The CTCO contacted the VSH, expressing concerns about the young person’s apparent poor mental health and said they may need further support due to a vulnerability of being drawn into extremism. Both the CTCO and nurse felt action was needed to safeguard the person and the public. The nurse contacted the mental health services in the areas the person had lived in previously (Leeds, Cornwall and Herefordshire) to see if they were known to services, but they were not.

The nurse supported a referral to mental health services via the GP and the mental health trust Prevent lead was also notified. The referral was accepted and an assessment by the community mental health team suggested possible emerging psychosis. The early intervention in psychosis service provided medication, treatment and support.

The nurse from the VSH helped the early intervention service and CTCO with a risk management plan, with a trigger plan for a rereferral to Prevent if there were concerns in the future. The CTCO helped the early intervention service and the person to understand the risks and vulnerabilities in relation to being drawn into extremism. In addition, the Channel Panel offered an intervention provider to work though the young person’s extreme right-wing views and emerging ideology.

When the referred individual was mentally stable, the CTCO reassessed the counter-terrorism risk and found it had been negated due to the person’s mental health stabilising. They also worked with the university in relation to universities being targeted by extreme right-wing groups and offered to talk to students about online safety.

With the support of the early intervention service, the CTCO and university support services, the young person is now recovering well after a gap year from university and will continue with their studies.

Sharing concerns

Vulnerabilities can only be appropriately safeguarded if they are known, and mental health services may be unlikely to know information related to an individual’s involvement with other services or police. Nurses working in the VSH can add additional value by sharing concerns about vulnerable individuals to make sure they are kept safe, while adhering to legislation relating to information sharing (Box 4).

Box 4. Information governance

The HM Government’s (2018b) guide for information sharing outlines:

  • Is there a legal basis to share patient information?

All information sharing for Prevent purposes must comply with the relevant legislation (Data Protection Act 2018, Human Rights Act 1998 and the common law duty of confidentiality), and meet the same rigour required for sharing information as for any other safeguarding concern

  • Do I need patient consent to share their information for Prevent purposes?

The General Data Protection Regulation (GDPR), which underpins UK data protection legislation, has strengthened the need to show that consent is given freely. GDPR has also strengthened the need to have a clarity of purpose for sharing or processing data. However, the legislation does allow for safeguarding professionals, criminal justice agencies and others to: continue to use and share personal data to prevent and investigate crime; bring offenders to justice; or safeguard vulnerable individuals or people at risk, and keep communities safe from harm

If we have noted that an individual needs mental health intervention, we will make sure this is shared with the relevant service. This is a key area, given that vulnerable people often find themselves in the hands of criminal justice services. It is our unique placing that allows us to fill a gap that was missing; the development of this vital role is comparable to the established need for liaison and diversion nurses in custody.

It is important to remember that, as nurses, we are not the only people involved in an individual’s care, so we must work together with other agencies for the benefit of the patient. This keeps people safe by sharing potential risk. Busy and specialist services can find themselves working solo, but multiple services working together is the best way to effectively safeguard people. We are often told that multiagency working is the gold standard.

Conclusion

Although the ‘Prevent duty’ was controversial when it was introduced, it has brought awareness about vulnerability – and the risk of being drawn towards extremism – into the safeguarding arena. This has, in turn, saved many people from becoming involved in violence, and protected vulnerable people and the wider public from harm.

After six years of working as a successful pilot, the three VSH hubs are negotiating agreements to become an embedded service, as a collaborative partnership between the NHS and counter-terrorism policing.

Key points

  • Mental health nurses are an important and integral part of reviewing referrals to Prevent
  • Anyone can refer to Prevent and each trust has guidance and training of which all nurses should be aware
  • Mental ill health and complex needs are key features of most Prevent referrals
  • The aim is to safeguard people and reduce their risk to themselves and others
  • The teams collaborate with the police and other agencies, adhering to information governance guidelines
References

Birmingham and Solihull Mental Health NHS Foundation Trust (2017) PREVENT In-Place. Intensive Psychological Liaison Assessment and Community Engagement. BSMHFT.

Birmingham and Solihull Mental Health NHS Foundation Trust (2016) Complex Mental Health, Psychological and Behavioural Difficulties and Problematic Social Backgrounds in Channel Referrals in England and Wales: Summary of Methodology. BSMHFT.

Corner E, Gill P (2015) A false dichotomy? Mental illness and lone-actor terrorism. Law and Human Behaviour; 39: 1, 23-34.

HM Government (2018a) CONTEST: The United Kingdom’s Strategy for Countering Terrorism. HM Government.

HM Government (2018b) Information Sharing: Advice for Practitioners Providing Safeguarding Services to Children, Young people, Parents and Carers. HM Government.

Home Office (nd) Counter-terrorism and Border Security Act 2019: Prevent and channel panel measures fact sheet. gov.uk (accessed 31 May 2022).

Home Office (2021) Revised Prevent duty guidance: for England and Wales. gov.uk, 1 April (accessed 7 June 2022).

National Institute for Health and Care Excellence (2017) Mental Health of Adults in Contact with the Criminal Justice System. NICE.

National Police Chiefs’ Council (nd) The warning signs. npcc.police.uk (accessed 14 June 2022).

Nursing and Midwifery Council (2018) The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates. NMC.

Royal College of Psychiatrists (2016) Rethinking Risk to Others in Mental Health Services. RCPsych.

Woods L (2020) What is a forensic mental health nurse? nurses.co.uk, 10 February (accessed 14 June 2022).

 

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Sun, 26 Jun 2022 12:00:00 -0500 NT Contributor en-GB text/html https://www.nursingtimes.net/roles/mental-health-nurses/prevent-the-role-of-mental-health-nurses-in-counter-terrorism-programmes-27-06-2022/
Killexams : How digital front doors can lead to affordable and accessible healthcare for all

Digital front doors present an opportunity to engage patients and optimize how they access care

Around the world, thousands of people struggle to gain access to quality healthcare. While significant structural change is needed to address these problems in the long term, there are solutions that can begin to address this problem immediately. Telehealth, for example, has significantly increased patient access to healthcare by enabling patients to meet with a doctor from their homes. 

But there is a step that goes beyond telehealth that can lead to even greater change in accessibility: digital front doors. A digital front door is an entry point where patients have a chance to seek help first through validated information and then from healthcare providers. It’s a strategy designed to engage patients at specific touchpoints of their journey.

Digital front doors present an opportunity to engage patients and optimize how they access healthcare services. In this article, I will outline three ways symptom checkers can contribute to healthcare accessibility for patients around the world.  

Enhancing patient experience 

The COVID-19 pandemic has led to many shifts in the healthcare industry. One of those shifts was in how patients interact with their own healthcare experience. Patients increasingly want more and more agency and choice in their healthcare journey. It is imperative that providers create options for patients and allow them to choose how they want to receive healthcare. 

One way they can do that is through digital front doors, which facilitate access to healthcare at any time or place, 24/7 (as long as the patient has an internet connection). They can be used on a variety of technologies like smartphones, tablets, and laptops. Digital front doors enhance the patient experience in a range of ways, some of which I will touch on below. 

Firstly, the triage capabilities within digital front doors provide options for audio, video, or text teleconsultation. This broadens a patient’s choice in the way they can receive care. Further, digital front doors also allow patients to select their preferred physicians and communicate with them through flexible communication channels. 

Digital front doors have also been shown to reduce burnout caused by much administrative work. Burnout has, in some cases, been shown to reduce the quality of patient care. Implementing digital front doors could therefore lead to improved quality in patient care. 

Reducing time spent in doctors’ offices

Digital front doors contribute to time savings for patients. Someone in an urban setting may live right down the street from their doctor, but those who live in rural settings may have to drive more than an hour to get there. While it is crucial that we expand healthcare offerings in rural areas, that process can take quite a bit of time. There needs to be an immediate solution in the meantime. 

Digital front doors are a great option to help address this urgent need by providing virtual opportunities for care. Using symptom analysis and triage capabilities, digital front doors can assess a patient's true needs and recommend the appropriate solution – whether that is in person or through virtual care. If the patient does need an in-person appointment, the technology can suggest the type of doctor to see, and to the closest one. Digital front doors ensure that patients’ time is well spent with the proper provider.  

Even when a patient does choose to go into the office, digital front doors have options that can reduce the time the patient spends in the office. First, patients can conduct a symptom check or fill out their medical history prior to the appointment. They can even do this while sitting in the waiting room. This saves the providers from having to go through all of these questions with them and, as such, allows the patient and medical practitioner to have meaningful conversations and achieve outcomes from the allocated visit time. 

Healthcare managers can also use symptom checker data to actively manage incoming patients by proposing shorter waiting times for those with higher triage levels. They can even recommend telemedicine services for those with mild symptoms. Digital front doors can also offer patients shorter times-to-visit and, in some cases, instant consultations. This technology increases accessibility by getting patients to the proper care in the quickest way possible. 

Cost savings 

Finally, digital front doors can also significantly reduce costs for patients – which ultimately increases accessibility. In the U.S., those without health insurance can spend anywhere from $100 to $250 just for a visit to a general practitioner or a specialist. For more complicated visits, like seeing an ENT for ear infection, it could cost them anywhere from $100 to $350. Not to mention, there can be added costs depending on where a person lives, including travel or taking time off of work. The high costs of seeking medical care in the U.S. can cause many people to delay care, or not seek it at all. This leads to worse health outcomes, and contributes to health disparities all across the country.  

Health technology is a proven cost-effective solution to address this problem. For example, digital front doors can direct patients to teleconsultation visits instead of in-person visits (when appropriate), which can reduce several explicit and implicit costs. As mentioned earlier, digital front doors can also direct patients to the appropriate care, ensuring that they don’t spend money on the wrong appointment. In fact, one study found that $4.1 billion could be saved with effective patient prescreening. With savings this large on the line, it is crucial that symptom checkers and digital front doors be utilized more widely.  

Conclusion

Having symptom-checking, self-service tools for patients as their first touchpoint to a digital healthcare service improves access and reduces inequities in healthcare. These tools can guide patient navigation and narrow down the services from a vast array of options.

This improved navigation translates to higher patient satisfaction and streamlines healthcare as a whole. Organizations using symptom checkers can reduce the number of low-acuity patients in EDs, increase adoption rates of telemedicine, save patients’ time, and drive cost optimizations.

Digital front doors are an excellent solution to many healthcare accessibility issues facing the world today – and should be implemented by health systems around the world.

(Image source: futurecdn.net)

Sun, 26 Jun 2022 12:00:00 -0500 text/html https://vator.tv/news/2022-06-27-how-digital-front-doors-can-lead-to-affordable-and-accessible-healthcare-for-all
Killexams : Democratic attorney general candidates outline plan for Roe v. Wade fallout

In the wake of overturning Roe v. Wade, both candidates seeking the Democratic Party’s nomination for attorney general have said they’ll take steps to protect Vermonters’ access to abortions.

Charity Clark, who served under former attorney general T.J. Donovan as assistant attorney general and chief of staff, announced Monday that if elected she’ll:

— Protect Vermont medical providers from out-of-state prosecution when they act within their Vermont license.

— Protect the data privacy of those seeking abortions in Vermont.

— Identify or certify pharmacies for those seeking abortion medicine.

— Develop a “no-tolerance” policy towards deception and misinformation about abortion medication and providers.

— Advocate that Vermont extradition laws be changed to protect its abortion providers.

— Change policy or pass legislation allowing local law enforcement to not cooperate with out-of-state investigations related to providing abortions.

— Support Vermont’s medical boards and in-state malpractice insurance companies in abstaining from taking adverse action against treatment providers treating out-of-state patients.

— Eliminate the ability of people from other states compelling anyone in Vermont to testify in a civil action against abortion seekers or providers.

“I’m a problem-solver, so whenever a problem presents itself that’s where my brain goes, and in this case these are the items I have considered and am thinking about to try to project Vermonters — and health care providers — seeking an abortion,” said Clark on Tuesday.

Clark said she believes the Legislature would be supportive of these measures where legislation is needed.

“For me the biggest concern is for health care providers in-state because I think that’s the issue that’s going to come up the most,” she said. “So, dealing with those issues, to me, looking at this issue through the eyes of those practitioners would be my priority because I think that’s going to come up the most.”

Clark said that data privacy has been a big concern of hers for years, even when not related to abortion access, and she plans to incorporate the two concerns if elected attorney general.

“Ultimately, what our mindset should be is that this is a profound moment in history,” she said. “Very little can compare.”

Besides abortion access and data privacy, Clark said her focus as attorney general would be to protect small businesses, as well as criminal justice reform. She said the administration and Legislature have not been seeing eye to eye on criminal record expungement, and she believes she can help them reach a compromise.

Running against her is Washington County State’s Attorney Rory Thibault.

During the weekend, he also released a list of things he’d do, or support doing, in order to protect those seeking abortions and other reproductive health care services in Vermont. Among them were:

— Advocating for the passing of the Reproductive Liberty Amendment in November.

— Be proactive in protecting those traveling to Vermont for an abortion, including passing safe-harbor laws for patients and providers.

— Prohibit lawsuits from out-of-state against abortion providers serving those from other states.

— Secure the ability to produce within Vermont the pharmaceuticals needed for Plan-B.

— Bolster in-state health care capacity and insurance laws for non-Vermonters seeking reproductive services in Vermont.

— Work on how to assist Vermonters who are out-of-state for travel, school or work who need reproductive health care services in states that are hostile to them.

“The challenge is going to be making sure whatever the laws and protections that are implemented in Vermont are ones we can feel confident that we can defend both in state court and, ultimately, in federal court,” Thibault said.

He said he believes the state as a whole needs to take the long view and not assume that the president come 2024 will be pro abortion access. It may come to pass that other elements of the federal government, besides the Supreme Court, become hostile to reproductive rights.

The first thing a federal government seeking to limit or eliminate abortion access would do is hamper access to abortion-related drugs, he said.

Vermont should also be wary of other Supreme Court decisions that may target access to contraception, and marriage equality, he said.

Both candidates said New York and surrounding New England states have been pro-abortion access, opening opportunities for Vermont to either lead or work with its neighbors’ initiatives.

keith.whitcomb @rutlandherald.com

Tue, 28 Jun 2022 09:17:00 -0500 en text/html https://www.rutlandherald.com/news/democratic-attorney-general-candidates-outline-plan-for-roe-v-wade-fallout/article_34856024-f46c-58ce-90e8-5320acd68309.html
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