Respond to the students discusion post below: “Evidenced based advanced practice

Respond to the students discusion post below:
“Evidenced based advanced practice provider-led urology clinic
Dwindling numbers of active practicing physicians in the United States and abroad has resulted in an ongoing worldwide looming health crisis. There are 3.89 urologist per capita in the United States making genitourinary care one of the most critical subspecialty shortages (American Urological Association [AUA], 2022) . The American Urological Association endorses the employment and training of advanced practice clinicians such as nurse practitioners and physician’s assistants and in a 2018 census, 72.5% of urology practices staffed nonphysician advanced practice providers. The AUA describes a level I APP as an expert clinician capable of managing urology subspecialty clinics.
There is a growing interest worldwide in the acceptance and implementation of nurse practitioner led urology clinics. One large academic children’s hospital in Boston initiated nurse practitioner newborn circumcision clinic in 2016 with high rates of family satisfaction, few adverse events and substantial cost savings compared to OR circumcision (Williams et al., 2020). In Ireland, during the initial COVID quarantine, nurse practitioners established a men’s health/LUTS (lower urinary tract) triage clinic with success, showing only 3.5% of cases requiring ongoing office visits (Casey et al., 2021). Through education, lifestyle change and medication therapy, patients avoided invasive and risky surgical intervention. For patients with bladder cancer, surveillance cystoscopy is standard of care and requisite every three to six months. Although necessary, maintaining a high number of routine cystoscopy appointments can be fraught with scheduling issues for an average urology practice. The literature points to a successful endeavor of advanced practice clinician led bladder cancer surveillance clinics by four nurse practitioners in Denmark, performing over 1024 endoscopic procedures without any occurrences for misdiagnoses or procedural complications (Quallich et al., 2019).
Evidence-based practice guidelines are essential to providing clinically sound and standardized care. The development of clinical guidelines should incorporate four key constructs: summary and quality of literature, distinct association between evidence and recommendations, patient preferences, and management of any potential conflicts (Violette et al., 2021). Grading of recommendations, assessment, development, and evaluation (GRADE) is a systematic approach to the appraisal and ranking of evidence for protocol elaboration including endorsements for or counsel against treatment modalities including diagnostic tests (Gonzalez-Padilla & Dahm, 2021). Clinical guidelines are significant for the promotion of suitable, scientifically firm, cost-effective and resource sensible care.
The American Urological Association is the official organization for board-certified urologists with an extensive inventory of clinical practice guidelines for the screening and management of GU oncologic conditions and non-oncologic conditions including interstitial cystitis, BPH, overactive bladder, and recurrent UTI. The AUA nonsurgical management of kidney stone disease is a 27-step document informing the urology provider on recommendations for screening, risk stratification, dietary and pharmacotherapeutic interventions for the care of patients with both initial stone presentation and/or recurrent stone formation (American Urological Association [AUA], 2014) . The AUA evidence-based stone management pathway can be applied to clinical practice and trialed as the directive in a nurse practitioner led nephrolithiasis clinic. Given the science supports both favorable outcomes in AP led management of multiple urologic disorders and the accessibility and utility of evidence-based practice guidelines, a future quality improvement project integrating kidney stone guideline directed advanced practice provider care may be feasible and even advantageous.”

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“Evidenced based advanced practice appeared first on blitzarchive.com.