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Purpose: Numerous studies have shown that healthcare providers, including nurse practitioners (NPs) fail to provide breast cancer risk assessment (BrCRA) in primary care settings. A potential barrier to the use of BrCRA is insufficient knowledge or training of risk assessment. The purpose of this study was to analyze the outcome of a BrCRA program developed to enhance NPs' knowledge of risk assessment and use of empiric risk assessment models. Data sources: Thirty-five NPs participated in a before-after (pretest-posttest design) study evaluating the effectiveness of a BrCRA education program conducted at a national NP conference. Demographics, pre/post knowledge, and course satisfaction measures were all examined as a part of this pilot study. Conclusion: Continuing education through the implementation of a BrCRA program significantly increased NPs knowledge in assessing breast cancer risk and the use of empiric risk assessment models. Implications for practice: Many healthcare providers, including NPs, are inadequately prepared to assess a woman's risk for breast cancer. Understanding breast cancer risk assessment is essential if NPs are to provide appropriate counseling, management, and referral strategies needed to reduce a woman's risk for developing the disease. Continuing education provides one means to enhance NP's knowledge of BrCRA. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to describe nurse practitioners' (NPs') knowledge, use, and perceived comfort level in providing breast cancer risk assessment to women in clinical settings. Data sources: This descriptive study was part of a needs assessment to determine if education and training programs on breast cancer risk assessment are warranted for NPs. A convenience sample of 147 NPs completed surveys to assess their knowledge of breast cancer risk assessment and use of empiric breast cancer risk assessment tools, and to evaluate their perceived comfort level in assessing women's risk for developing breast cancer. Conclusions: Assessing women's risk for the development of breast cancer is important in providing primary and secondary preventive strategies such as chemoprevention, lifestyle changes, and enhanced surveillance thatmayreduce a woman's risk for developing the disease. Although 51.4% of NPs reported providing breast cancer risk assessment, few (37%) reported use of family history or the Gail model (6%) to determine their patients' breast cancer risk. NPs' knowledge of breast cancer risk assessment and use of empiric risk assessment models were low. The majority (71%) of NPs felt uncomfortable or a low level of comfort in conducting breast cancer risk assessment. Implications for practice: Excluding skin cancer, breast cancer is the leading cause of cancer and second leading cause of cancer death among women in the United States. Breast cancer risk assessment is important in identifying women who may be at high risk for developing the disease. At the front line in health care, NPs can play a vital role in assessing women's risk for breast cancer. These findings suggest that education and training may be warranted to enhance knowledge and use of empiric risk models to increase the comfort level of NPs in conducting breast cancer risk assessment to their patients. [ABSTRACT FROM AUTHOR]

PurposeTo define and discuss five genetic disorders--Tay-Sachs, sickle cell anemia, Canavan's disease, thalassemia, and cystic fibrosis (CF)--and to explain the importance of the nurse practitioner's (NP's) assessment of clients' ethnicity during preconception counseling, which should address these genetic conditions.Data SourcesReview of literature from professional journals, professional organizations' Web sites, guide-lines from the American College of Obstetricians and Gynecologists, the National Institute of Health Consensus Statement, and the authors' professional clinical experience.ConclusionsThe goal of preconception counseling is to identify potential or actual medical, psycho-logical, or social conditions that may affect the mother or fetus. NPs are often the health care providers that initiate preconception counseling to women in varied primary care settings. NPs must be familiar with ethnicity-related inheritable conditions in order to provide appropriate client information and education and to implement testing and, when needed,. referral for genetic counseling to individuals and families at risk for genetic disorders such as Tay-Sachs, Canavan's disease, CF, sickle cell anemia, and thalassemia.Implications for PracticeNPs providing health care to women of child-bearing age should assess the client's use of contraception and intent for future pregnancy, Preconception counseling when indicated should be initiated to all women to increase [ABSTRACT FROM AUTHOR]

Purpose: This study was part of an educational program conducted to describe nurse practitioners' (NPs') knowledge and perceived comfort level regarding the identification of hereditary colorectal cancer (CRC), specifically Lynch syndrome, also referred to as hereditary nonpolyposis CRC., Data Sources: A 3-h workshop was developed that included a pretest to evaluate NPs' knowledge of hereditary CRC syndromes, educational program focusing on Lynch syndrome, and a posttest knowledge evaluation. Knowledge of hereditary CRC syndromes was assessed via a nine-item multiple choice self-report survey. Forty-two NPs participated in the study., Conclusion: Few NPs (39%) reported "comfortable" in identifying red flags "suspect" for Lynch syndrome. Percentage of NPs who responded correctly on each of the pretest items ranged from 17.0% to 57.1% (M = 26.2%; SD = 13.5%; 95% confidence intervals [CI] 14.9%, -37.5%). NPs who responded correctly to the same items after the educational program (posttest) ranged from 53.8% to 95% (M = 80.5%; SD = 15.3%; 95% CI 67.8%, -93.4%)., Implications for Practice: Genetic testing is widely available for Lynch syndrome. It is important that NPs are cognizant of the syndrome and identify patients at risk for hereditary cancer syndromes so appropriate referral and management can be instituted., (©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.)

Purpose: To provide a practical approach to managing overweight and obese adult patients based on data from research and recommendations from established guidelines., Data Sources: Comprehensive review articles and original research articles identified through Medline and the Cumulative Index to Nursing and Allied Health Literature (CINAHL)., Conclusions: There is a great deal of research being conducted on new ways to treat obesity; however, despite all this new information, many primary care providers continue to report that they do not address weight or weight control strategies with their patients. Reasons include too little time, not enough training, lack of financial incentive, and failure to believe that patients can be successful., Implications for Practice: Weight management essentially comes down to one key concept: negative energy balance (fewer calories in and/or more calories out). Patients can be taught how to achieve a negative energy balance by using a food/exercise diary to track their daily caloric goal to achieve a 1-2 pound weight loss per week. Nurse practitioners (NPs) can implement safe and effective weight management plans for their patients by teaching them how to self-monitor, eat healthy, and exercise. This method is similar to what NPs commonly use for patients with diabetes mellitus.

Purpose: To describe the current medical genetic knowledge and perceptions of graduate advanced practice nursing (advanced practice nurse [APN]/nurse practitioner and nurse anesthetist) students using survey data for future integration of genetic topics, principles, and healthcare issues into curriculum., Data Sources: Survey data of APNs' perceived knowledge of genetics and a review of the literature from past research studies of students and current articles from professional journals and organizations. Web sites were those of the National Coalition of Health Professions for Education in Genetics and National Institutes of Health, Human Genome Research Institute; professional organizations; and the authors' professional, clinical, and educational experiences., Conclusions: Most APN students perceived they had minimum knowledge and prior training regarding medical genetics. There is a need to integrate genetic concepts, principles, and medical conditions into advanced practice nursing curriculum and to provide clinical experiences in genetic conditions across the life span and throughout the health and illness spectrum. APN students have positive attitudes toward integrating genetics into graduate curricula. Potential methods for program integration include readings, small group discussion, standardized patients, and role-play as measures to increase information., Implications for Practice: The National Coalition for Health Profession Education in Genetics, the American Nursing Association, and the American College of Nursing Education have recommended integration of genetics knowledge and skills into routine health care to provide effective interventions for individuals and families. However, previous research and data from this study have revealed that many nurses have minimal training in genetics. Advanced practice nurses must be knowledgeable on genetic principles, topics, and the ethical, legal, and social implications related to medical genetics to increase the ability to diagnose, prevent, and treat diseases and to provide effective care for individuals and families.