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New and Noteworthy
A forum for discussion on recent news and developments in healthcare and the NP field.
Thursday, July 31, 2014
Piggybacking on the last post, I'd like to discuss technology and its role in healthcare a bit further. It is no doubt that the majority of patients and healthcare providers use smartphones on a daily basis. That being said, there are several medical apps out there – perpetually under FDA regulatory scrutiny – that can help facilitate providing health care for clinicians and patients. Here are some of the apps I think may benefit you and/or your patients:

Medscape is one of the highest-rated free medical apps for both Apple and Android devices. The app features a drug reference, a drug interaction checker, medical calculators, formulary information, disease and condition reference, and a procedure reference. It also offers CE credits.

Prognosis: Your Diagnosis simulates real-life clinical scenarios, allowing its users to test their clinical decision-making abilities.

Med Helper Pro Pill Reminder helps patients keep track of their prescriptions and sounds an alarm when medications are to be taken, for scheduled appointments, and also helps track vital signs.

First Aid puts expert advice in the hands of its non-clinical users. Created by the American Red Cross, the app gives instant access for common first aid emergencies with videos, quizzes, and step-by-step advice in urgent situations.

AHRQ ePSS provides clinicians with decision-making support regarding appropriate screenings, counseling, and preventive services for patients based on current evidenced-based recommendations from the U.S. Preventive Services Task Force.

Here are a few non-medical apps that can be useful for clinicians and health professional students:

Noteability is a note-taking app that lets you import any type of document (Microsoft Office) and mark it up. Textbooks can also be placed in the app and highlighted/marked up. In addition, users can also import photos and record audio/video.

Quizlet is an app that allows you to make virtual, double-sided note cards, which can help users study for exams.

Dropbox/Google Drive are cloud storage services that allow users to place and/or share any type of file; the files (Word Document, PDF, etc.) are placed online and can be accessed or shared with colleagues later.

These are just a few of the many apps out there to help us in our daily routines. What apps are you using, and what apps do you recommend to your patients if any?

Tuesday, June 24, 2014
As the use of technology advances, more and more devices will undoubtedly find their way into the healthcare setting to help optimize the experience for patients and healthcare professionals alike. Google Glass, a wearable computer with an optical head-mounted display (resembling prescription glasses), displays information in a hands-free format. Although still in its infancy, the wearable device has already been adopted by many clinicians around the country.

At a basic level, Google Glass can help free up clinicians from having to perform simple yet time-consuming tasks by synching patient information with their electronic health record via pictures and videos taken directly from the device, eliminating the need to write anything. The images and recordings (with the patient's permission) can then be reviewed later or sent to other medical professionals for diagnosis and collaboration.
 
Here's an example of one of the many clinicians who have adopted Google Glass into their practice. What are your thoughts on the application of such a device in the healthcare setting?

Wednesday, April 23, 2014
A new study from the University of Michigan Health System found that 69% of Americans support insurance coverage of birth control. Michelle Moniz, M.D., an OB/GYN, and lead author of the study sent out a survey last November to respondents from all 50 states inquiring about insurance coverage for several different health services.

The data "indicates that the majority view in the United States is that coverage for contraceptives should be required," Moniz said.

The study also found that Blacks and Hispanics are much more likely to support this coverage as compared to the general population. So what are your thoughts on birth control coverage? Do you agree with the majority of the nation? Be sure to share your thoughts in the comments section.


Source

Wednesday, February 26, 2014
Medical marijuana is a controversial subject in the U.S. Since 1996 (beginning with California), 20 states and the District of Columbia have legalized medical cannabis. Colorado and Washington State have even legalized the drug for recreational purposes. Regardless, marijuana’s medical benefits and risks are still widely debated today, and healthcare professionals should be aware of both the good and bad when it comes to medical marijuana use before prescribing it to patients.

Former U.S. Surgeon General Joycelyn Elders stated in 2004 that, "The evidence is overwhelming that marijuana can relieve certain types of pain, nausea, vomiting, and other symptoms caused by such illnesses as multiple sclerosis, cancer, and AIDS -- or by the harsh drugs sometimes used to treat them. And it can do so with remarkable safety. Indeed, marijuana is less toxic than many of the drugs that physicians prescribe every day."

The British Lung Foundation, however, did not find medical cannabis to have favorable effects on patients, stating the health risks associated with smoking medical marijuana (2002): Three to four cannabis cigarettes a day are associated with the same evidence of acute and chronic bronchitis and the same degree of damage to the bronchial mucosa as 20 or more tobacco cigarettes a day. Cannabis smoking is likely to weaken the immune system. Infections of the lung are due to a combination of smoking-related damage to the cells lining the bronchial passage and impairment of the principal immune cells in the small air sacs caused by cannabis."

These are just some examples of the divergent medical perspectives regarding cannabis use. Nevertheless, marijuana has many strains and should be researched further. The plant also differs from its capsule form (dronabinol) in that the capsule only contains synthetic delta-9-tetrahydrocannabinol (THC), whereas the plant has over 400 chemicals in it.

So what are your thoughts on prescribing medical marijuana to patients? Do you support the use of marijuana for conditions in which research has demonstrated its efficacy, or do the risks outweigh the benefits? Feel free to share your thoughts in the comments section.

Thursday, October 31, 2013
How safe is it for primary care providers (PCPs) to prescribe psychotropic drugs? Patients generally visit their PCPs first in regards to mental health issues. When the issues are within the scope of the PCP's practice, medications might be prescribed, and the outcomes are favorable. However, when the mental health issue is more complex, the PCP may not have the necessary training to properly assess and address the patient's issue(s). Time constrictions may also present challenges for the PCP.

Considering how much symptom overlap exists in the world of behavioral health, an accurate diagnosis could be difficult to attain; furthermore, a wrong or delayed diagnosis could lead to adverse outcomes. Even the most skilled psychiatric provider may find it difficult to diagnose a patient depending on their symptoms. Thus, mental health issues should not be taken lightly. Consultation or referral to a mental health professional should take place when indicated so that a full, thorough assessment can be made, especially prior to taking medications.
About the Author

Jamesetta (Jamie) A. Newland
Jamesetta (Jamie) A. Newland is a Clinical Associate Professor at New York University College of Nursing where she is the director of the Doctor of Nursing Practice (DNP) program. She is also a certified Family Nurse Practitioner in the NYU Nursing Faculty Practice. Her expertise on nurse practitioner education and practice has been sought nationally and internationally. She is the current editor-in-chief of The Nurse Practitioner: The American Journal of Primary Healthcare, the inaugural journal publication for nurse practitioners.

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