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Climate change, an urgent public health problem, will increase the morbidity and mortality of older adults. The 2020 report of The Lancet Countdown highlighted that older adults are susceptible to the effects of extreme weather events, including heatwaves. Through the lens of the socio-ecological model, we identified influences on persons at risk for heat-related illnesses. We applied the Heat-related Intolerance Screening Tool (HIST) to a case that demonstrates the impact of physical, social, environmental, and societal factors on older people. The hypothetical case provides a context for ambulatory care nurses to explore innovative ways to screen for heat intolerance to mitigate the risk of heat-related illnesses, such as heat stroke. Our innovation supports the broad utility of the simple HIST by ambulatory care nurses to identify and prevent heat-related illnesses, thereby reducing emergency room visits and hospital admissions. Keywords: Socio-ecological model, heat-related illnesses, ambulatory care, older adults, extreme weather, climate change., Climate change will increase extreme heat events and lead to higher ambient temperatures. Extreme heat exposure can increase the risk of illness and death among older adults, especially people with [...]

The American Academy of Ambulatory Care Nursing (AAACN) recognizes a paradigm shift represented by the volume of health care delivery flowing from episodic acute care encounters to long-term relationships. This shift presents opportunities to further recognize and prepare nurse graduates for the complex and expanded role of the ambulatory care registered nurse (RN). This position paper discusses the current state of the RN role in ambulatory care and provides a vision for the future. The paper further identifies challenges, poses possible solutions, and highlights the AAACN position on the role of the ambulatory care RN., Ambulatory care nursing is a broad specialty that extends across diverse care settings providing care coordination and management to prevent gaps in health, avoid injury, promote disease prevention, restore health, [...]

Interprofessional teams are useful in providing complex care to patients with substance use disorder. Predictors of treatment outcomes, such as age, socioeconomic status, and social supports, have been studied in addiction treatment. Individual contributions of the office-based addiction treatment nurse in the care of patients with opioid use disorder are not well understood. Through the lens of the Nursing Role Effectiveness Model, nursing interventions related to care coordination and transition management in patients on medication-assisted treatment were examined. Documentation from interprofessional team members was reviewed and collected in REDCap. Linear regression was conducted to identify significant factors in predicting time to stabilization, defined as achieving a third opiate-free toxicology screen. Logistic regression was used to identify significant associations between patient demographics, care team members, and documented interventions. Overall, patients' time to stability on buprenorphine was decreased by approximately five months when a recovery coach was on the nurses' team (p = 0.03) and by seven months when the patient was referred for and received counseling services (p = 0.001). Our results support the role of the nurse in care coordination involves bringing together clinicians, particularly those who can provide counseling, to support recovery efforts., Primary care office-based addiction treatment (OBAT) may improve outcomes for patients with opioid use disorder (OUD) (LaBelle et al., 2016). This is accomplished by unique contributions of members of an [...]

When the pandemic first reached Boston in March 2020, Massachusetts General Hospital responded by redeploying advanced practice providers, including NPs and PAs. Jean M. Bernhardt, PhD, CNP; Melissa Chittle, MBS, [...]