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Advancing nursing practice: the role of the nurse practitioner in an acute stroke program.

Both patient and staff satisfaction with the SNP role has been high as it relates to quality of care delivery and accessibility of care and service. In particular, patients express satisfaction with the continuity of care experienced throughout the stroke care continuum, from acute in-hospital care to postdischarge follow-up. Improvements have been realized in systems and processes of care with the implementation of the SNP role. These include reductions in door-to-needle times in the administration of tPA (from 90 minutes to 60 minutes), rapid assessment and diagnostic interventions through coordination of are activities (e.g., door-to-CT scan times reduced from 60 minutes to 30 minutes), and faster consultation responses within the organization. Instituting the nurse practitioner role early in the development of the Calgary Stroke Program enhanced patient care while advancing the nursing discipline. The SNP has created a role that extends beyond that of physician helper to an autonomous nursing practice that has been beneficial to both patients with stroke and the regional healthcare delivery system. With the ability to practice autonomously, the nurse practitioner can aid in the expedient delivery of complex, comprehensive stroke care, as has been the case in the Calgary Stroke Program.

Alberta↗

Block nursing. Practicing autonomous professional nursing in the community.

One of the most interesting settings for nursing is on the block where you live. Jamieson describes a thriving program of block nursing that is reminiscent of earlier eras when a nurse was involved with a total community and all its citizens. Cost-effective, this community program provides nursing in a humanistic way that enables many people to remain in their own homes and in their own community.

Activities of Daily Living↗