Bill Would Let Nurses Prescribe Medicine On Their Own, Without Consulting Physicians

Measure could help ease shortage of primary care doctors, limit impact of federal healthcare reform.

S-2354 is a bill that is currently working its way through the New Jersey state legislature that would allow Nurse Practitioners to prescribe medicine on their own without the joint protocol from a physician. Because of this, the bill makes it easier for NPs to establish their own private practice.

As of recent NPs have taken a much larger role in primary care and are assumed to have their role grown as a result of the Affordable Care Act. This is because more people are now available with medical coverage through Medicaid and at the same time a high volume of doctors do not see patients on Medicaid.

The objection holding back this bill is that physicians believe that NPs establishing their own health care practices will affect the quality of patient care even though NPs have the proper training and school to give proper healthcare.

Historically NPs are more conservative towards writing prescriptions. As such they help to lower malpractice rates. Studies have been conducted through New Jersey that state that the level of care that NPs provide is equal if not better than the care given by physicians across the state. In addition, the cost of providing care is 20 to 35 percent cheaper than a physician.

As the bill currently stands NPs with less than 24 months or 2,400 hours of practice will still need to have joint protocol with a physician.

The bill is not a perfect solution for the NP and physician paradigm but it is on the right track for giving NPs equal privilege to physicians in New Jersey.

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Written by Brandon Kassof

More nurse practitioners visit home care patients

More and more Nurse Practitioners are providing home care for elderly or other patients with limited care access. Over time this type of care has shifted from physicians to NPs. As the population ages there is an increased need to care and NPs are now in a position to fill that role at the convenience of the patient.

Hospitals are even involving themselves in home care by sending out their NPs to local residences like the ones near Maimonides Medical Center, Brooklyn, New York.

The benefit of home care is understanding and analyzing the home environment of the patient and make corrections to better ensure that their sustainability and recovery are done in an environment that is indicative of a situation where health is at the forefront and proper care can be implemented in the most direct way.

NPs are the proper agents for this type of care because of their predisposition for warmth and understanding towards their patients. By being in the patients home an NP can custom tailor their treatment to fit the exact needs and surroundings that the patient lives in and thus engineer the perfect health care paradigm for the patient.

All of this allows anyone to receive the proper care they deserve even if they were in a situation where they normally would not be able to reside in a hospital or long term care facility.

There are still flaws in the system currently. While NPs can write prescriptions for patients  they cannot sign home care certifications, as this must be done by a physician. Other problems exist in the communication between home care and hospitals in terms of Medicare reimbursement, but as time goes on and more home care is needed NPs are positive that the needed change will occur.

For more information and the full article follow the link provided.

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Written by Brandon Kassof

Nurse Practitioners See Rise in Full-time Salary Rates

Since the beginning of the decade nurse practitioners have earned an increased salary every year. Experts say that the reasoning for this is that people are recognizing the value of nurse practitioners. Depending on their location and their skill NPs can earn as much reimbursement as a physician. Employers are understanding the value of nurse practitioners and are thus willing to pay them more. 

An online survey found out that NPs were earning $90,770 compared to $89,579 from two years ago. Nurse practitioners working in emergency situations made the most at $104,549. Nurse Practitioners working in cardiology earned the biggest change in income, 11.9 percent increase, from $90,195 to $100,881. Interestingly male NPs earned 12.8 percent more than females. 

In 2011 Indeed.com listed the average income of NPs at $90,000 and trending upwards.

Marsha Siegel, former president of the American College of Nurse Practitioners says that even though there is a significant pay increase, the responsibilities and requirements are much more advanced than an RN. She notes that the life of a NP is not for everyone but at the same time it is very rewarding.

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Written by Brandon Kassof

Hospital Readmissions

Readmission rates have been dropping steadily, but links between rates and demographics could make it tough to make big strides

Two out of every ten New Jersey Medicare patients return to the hospital within a month of being discharged. This number is a significant reduction from over the past four years. Studies show that even though the number of readmissions is dropping, a significant change seems hard to achieve because of correlation between readmission rates and demographics.

Healthcare Quality Strategies Inc. released data that showed a drop in the rate of patients readmitted to hospitals in the state of New Jersey. The data was broken down by county and showed that 20 percent of patients return to the hospital within 30 days.

Last year nearly every hospital in New Jersey was penalized by Medicare for having too high readmissions.

Hunterdon County, which has the highest median income and the second largest non-hispanic white population in New Jersey has the lowest readmission rate, below 17 percent. On the other hand, Hudson County which is much more diverse and economically challenged is the county with the highest readmission at 24 percent.

The data shows a trend where better communication is implemented in the hospital and post-acute care facilities with the patients, even the counties with the higher readmission rates can lower their numbers.

After digesting the data the New Jersey Hospital Association knows that it still has a long way to go to ensure that every county has lower readmission rates regardless of diversity or economic situation.

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Written by Brandon Kassof

NP Associates Youtube Video Introduction

We recently created a video on YouTube explaining NP Associates and how we work. The NP featured in this video is Courtney Leach. The script writer is Shaina Sarna. The videographer and editor is Brandon Kassof. NP Associates will be creating more videos in the future. Please subscribe to our Youtube channel for future updates.

YouTube

MRSA Testing: Newer, Faster, Better

In Fight to Detect MRSA, New Tests and Techniques Challenge Labs

Methicillin is an antibiotic that was introduced to combat certain penicillin resistant bacteria such as Staphylococcus aureus. Shortly afterwards a methicillin resistant strain of Staphylococcus aureus developed named MRSA. This is normally found in a hospital environment where people with lowered immune systems can pick up different strains of bacteria. In addition in the 1990's a strain of MRSA developed in people who were not associated with hospitals at all. This strain is called community acquired MRSA or CA-MRSA. 

MRSA Facts: 

• 95,000 cases of invasive MRSA infections occur annually in the U.S.

• MRSA causes 19,000 deaths each year

• 86 percent of MRSA infections are healthcare associated

• 14 percent of MRSA infections are due to community-acquired MRSA

• In 2012 it cost $3.2 billion to $4.2 billion to treat hospitalized MRSA patients

All this information is what laboratorians and researchers use to answer questions as to how to treat MRSA and how to stop its growth.


Setting up a System: One of the difficulties of MRSA is determining how to detect it. Some hospitals check every single patient they admit while others only check patients who are the most likely to acquire MRSA. In addition, different hospitals treat MRSA differently as well. The problem is that there is no surefire way to detect or treat MRSA so no one way is more correct that any other. New forms of detection are being implemented every day.

Detection: Last year, a British hospital utilized whole genome sequencing to halt a MRSA outbreak. This is the first time that DNA sequencing has been used in such a capacity. As technology advances these kind of practices can become more cost effective. There are many different tests that are conducted across the country to combat MRSA, each which provide answers in a couple of hours. Speed is your friend when working with MRSA because as soon as you can come back with a MRSA negative result you can start working on the actual problem that is facing your patient. Experts say that with continued developments on combating MRSA, a future strategy could involve a vaccine.

For more information and the full article follow the link provided.

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Written by Brandon Kassof

Integrating Care for Populations and Communities

Helping Patients Plan Their Healthcare Future

Depending on the patient there are a variety of different ways to approach the appropriate care for them. Palliative care works at managing your patients pain and suffering while also managing their condition. Hospice care covers patients with a life expectancy of 6 or less months. It is covered by Medicare and does not manage their condition. The goal is to ease the patients remaining time and also cares for the patients loved ones that are left behind. Understanding which type of health care they wish to receive goes a long way to giving your patient the proper care and making their time in your health care facilities as comfortable as possible. An asset that patients can use to ease their time at your health care facility is the advance directive. An advance directive is a living will that states the desires of the patient in regards to their healthcare at the end of their life. Having an advance directive created is a great way to reduce stress for the patient and their loved ones. Another way to plan for end of life care is through the use of Practitioner Orders for Life-Sustaining Treatment or POLST. POLST treats your patients end of life desire as a medical order so that the proper care is maintained until death. Whatever type of end of life care your patient and their loved ones decide on, the important idea is to plan for this inevitable life conclusion and to not be caught surprised by it. By taking these steps with your patient and their loved ones you can ensure a more comfortable end of life care facilitation.

For more information follow the links provided

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Written by Brandon Kassof