Sorry to be one of those people

1. ACNP-BC (PM me for name, address, and phone number)

2. I do not consciously follow a single theoretical model or framework in my practice. I am aware of existing models that I learned in school and maybe subconsciously I am using them. If I were to give examples of them I'd have to say the AACN Synergy Model, Hans Selye's General Adaptation Syndrome, Mishel's Uncertainty in Illness Theory to name a few.

3. APN's can perform quality improvement by using measurable outcomes in care practices. For instance, one of the problems our NP group identified a few years back was that our post-op extubation times were quite longer than the national average. We did our research, collaborated with other health care professionals, and instituted measures through a new protocol for fast-track extubation and found a considerable decline in time to extubation for patients who meet our fast-track criteria. We are now meeting national standards based on the Society of Thoracic Surgery data.

4. APN's need to be constantly updated of evidenced based research practices. In our setting, many of our post-op patients are vented. The evidence suggests that high tidal volumes can have damaging effects to patients' lungs even for those who do not require prolonged ventilator dependence. It's also been found that the size of the patient's lung cavity does not change according to body habitus and that lung volumes are consistent with an individual's ideal body weight. We implement the findings of this evidence by instituting a policy where we utilize the patient's Ideal Body Weight (IBW) in calculating the ordered tidal volume on our vents by using 6-8 Liters per kg of IBW not the patient's actual body weight.

5. Research findings need to be critiqued for soundness. Just because a finding suggests following a particular management pathway does not always mean that no other pathways can be used. For instance, there is literature out there suggesting the benefits of the use of Carvedilol over Metoprolol for patients with low EF. In real life, many of our patients are insured by government-sponsored health plans and many times Cardvedilol is not in the plan's formulary. In these cases, we find that Metoprolol works just as well.

These are general examples, I can communicate with you in detail if you need more answers.

Thank you soooo much, you have no idea the phone calls I have made today to try and find an NP. I am going to try and figure out how to pm to get your personal data. :):):)

Check out the icons beside "AKA Pinoy NP."