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Our objective was to determine whether the addition of a broad-scope nurse practitioner (NP) would improve emergency department (ED) wait times, ED lengths of stay (LOS) and left-without-treatment (LWOT) rates. We hypothesized that the addition of a broad-scope NP during weekday ED shifts would result in shorter patient wait times, reduced LOS and fewer patients leaving the ED without treatment. This prospective observational study was conducted in a busy urban free-standing community ED. Intervention shifts, with NP coverage, were compared with control shifts (similar shifts with emergency physicians [EPs] working independently). Primary outcomes included patient wait times, ED LOS and LWOT rates. Patient demographics, triage category, the provider seen, the time to provider and ED LOS were captured using an electronic database. The addition of an NP was associated with a 12% increase in patient volume per shift and a 7-minute reduction in mean wait times for low-acuity patients. However, overall patient wait times and ED LOS did not differ between intervention and control shifts. During intervention shifts, EPs saw a smaller proportion of low-acuity patients and there was a trend toward a lower proportion of LWOT patients (11.9% v. 13.7%, p = 0.10). Adding a broad-scope NP to the ED staff may lower the proportion of patients who leave without treatment, reduce the proportion of low-acuity patients seen by EPs and expedite throughput for a subgroup of less urgent patients. However, it did not reduce overall wait times or ED LOS in this setting.

Portable computers, including handheld computers and laptop computers, are being implemented in home care as a means to deliver high quality, cost effective care. However, limited evidence exists to support assertions regarding the impact of portable computers on health system outcomes. The purpose of this retrospective chart review was to assess the impact of portable computers on the use of evidence based practice, client outcomes, and on the cost of care when use by home care nurses to manage clients with lower leg venous ulcers. A comparison of paper based documentation collected at Location 1(paper) with electronic documentation collected at Location 2(EMR) indicated that use of the technology may improve the use of evidence based practice and may reduce the cost of care. The use of a conceptual framework proposed by Powell-Cope, Nelson and Patterson (2008) to guide the implementation of portable technology in a health care setting is recommended.

The framework for graduate NP education in Alberta is built on the Health Professions Act (2000),2 CARNA's core competencies for NP practice,3 and Brenner's model of novice to expert4 master's education programs in Alberta support the assumption that graduate NPs are prepared as novice and progress to expert through continued exposure to the clinical practice environment.

Our objective was to determine whether the addition of a broad-scope nurse practitioner (NP) would improve emergency department (ED) wait times, ED lengths of stay (LOS) and left-without-treatment (LWOT) rates. We hypothesized that the addition of a broad-scope NP during weekday ED shifts would result in shorter patient wait times, reduced LOS and fewer patients leaving the ED without treatment. This prospective observational study was conducted in a busy urban free-standing community ED. Intervention shifts, with NP coverage, were compared with control shifts (similar shifts with emergency physicians [EPs] working independently). Primary outcomes included patient wait times, ED LOS and LWOT rates. Patient demographics, triage category, the provider seen, the time to provider and ED LOS were captured using an electronic database. The addition of an NP was associated with a 12% increase in patient volume per shift and a 7-minute reduction in mean wait times for low-acuity patients. However, overall patient wait times and ED LOS did not differ between intervention and control shifts. During intervention shifts, EPs saw a smaller proportion of low-acuity patients and there was a trend toward a lower proportion of LWOT patients (11.9% v. 13.7%, p = 0.10). Adding a broad-scope NP to the ED staff may lower the proportion of patients who leave without treatment, reduce the proportion of low-acuity patients seen by EPs and expedite throughput for a subgroup of less urgent patients. However, it did not reduce overall wait times or ED LOS in this setting.

The Nurse Practitioner Association of Alberta (NPAA) advocates for over 400 nurse practitioners working across the province. Our mandate is to assist NPs in improving patient access to health promotion, illness and injury prevention and disease management services.

As the PC government continues to debate the merits of expanding access to expert Nurse Practitioner care, the cost of chronic disease management continues to rise. A recent report published by the Alberta Auditor General concluded that chronic disease costs Alberta taxpayers billions of dollars.

When you crave nicotine your body can quite often be confused. It knows it wants something, so if you can't have nicotine, your body might tell you you're hungry. But again your body's often not able to decide if you're hungry or thirsty. Quite often, increasing your fluid intake, substituting water for food, can also decrease your caloric intake, so try fluids first. It's extremely important when you're quitting smoking to look at it as a lifestyle change. Smoking really affects your entire life: who you associate with, the habits that you have, what you eat, when you eat -- if affects everything. So when you choose to quit, it's important to have a strong social support network, as well as access to a primary health- care provider such as a nurse practitioner, to help you foresee the issues that you may have to deal with such as gaining weight, and develop a method to circumvent that before you get there.