Advance Practice Nursing

There are four types of Advanced Practice Nurse roles, the nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, and certified nurse-midwife. The Family Nurse Practitioner is the advanced practice role that will be discussed. According to Hamric, Hanson, Tracy, and O 'Grady (2014) the primary care NP provides care for patients in diverse settings, including community-based settings such as private and public practices, acute, and long-term care settings across the life span (pg. 396). Family Nurse Practitioners have faced many challenges in the medical profession to be recognized as health care providers. Most of these challenges where from fellow nurses. According to Hamric, Hanson, Tracy, and O’Grady (2014) conflict and discord about the Nurse Practitioner role continued to characterize relationships between NPs and other nurses (pg. 18). Despite the resistance to NPs in nursing, physicians increasingly accepted NPs in individual health care practices (Hamric, Hanson, Tracy, and O’Grady, 2014, pg. 18). Physicians readily accepted the role of the Nurse Practitioner, working together to improve patient outcomes and safety.

The purpose of this paper is to describe the role of health care reform with regards to the evolution and development of advanced practice nursing (APN) in the United States. Foundational aspects prominent in the development of defined APN roles include the health needs in society, support for innovation in health care, governmental health policy and regulation, health workforce supply and demand, and the development of advanced education, among other factors (Ketefian et al., 2001). APNs are comprised of nurse anesthetists, nurse midwives,

There have been concerns regarding the identification and credentialing of advanced practiced registered nurses (APRNs). A APRN is a registered nurse who has successfully completed an accredited graduate-level education program, in which the individual is well prepared and successfully passed the nationwide certification examination (APRN Consensus Model, 2008). However, there are still debating issues of who would fall under the APRN category. The National Council of State Boards of Nursing (NCSBN) has identified four APRNs who are deem fit to be called ARPNs; however, only two will be named. They would be certified registered nurse anesthetists (CRNAs) and certified nurse practitioners (CNPs). Whereas, the nurse informatics and the nurse administrations are not considered to be APRNs; although, they are still license registered nurses but they do not provide direct patient care and are not required to take the national certification examination (ARPN Consensus Model, 2008).

Advanced Practice nursing (APN) is considered the usage of a broader scope of constructive, logical and research-based expertise related to the health and well-being of patients, within a varying disciplines (DeNisco & Barker, 2013). What is the future position of APNs in the progression of our healthcare system? What role will this writer assume, educator, practitioner, population health coach, or all three? The use of theory, primarily Sister Callista Roy’s Adaptation Model, and EBP give this writer a firm foundation to develop and modify her own practice framework.

Advanced practicing registered nurses (APRNs) serve essential roles in providing acute care, pediatric care, maternity care, chronic disease management, adult primary care, and mental health treatment. They are registered nurses who have additional training, education, and certification in a given field of practice. There are many potential issues which can influence their practice setting. This paper covers the legislative issues affecting advanced practice nursing formulates a possible policy change to address that matter. Legislative Issues Affecting Advanced Practice Nursing Legal issues affecting advanced practice nursing refer to the policies or laws enacted by legislatures to give guidelines in the field of advanced practice nursing.

An advanced practice registered nurse (APRN) is an umbrella term consisting of but not limited to roles such as Psychiatric Mental Health Nurse Practitioner (PMHNP); Adult Geriatric Primary Care Nurse Practitioner (AGPCNP); Certified Nurse Midwife (CNM); and Certified Registered Nurse Anesthetist (CRNA). Across the Commonwealth of Massachusetts, it is an undeniable fact that APRNs care for multitudes of patients across the entire human lifespan and across many certain from the nursing homes and home care to hospitals, pain clinics, and substance abuse centers.

Advance practice nurses (APNs) are at the forefront of today’s healthcare system. To keep up with the aging population and the demands of complex healthcare needs of this society, APNs need to perform at the highest quality to provide efficient, effective, holistic and improve patient outcome and satisfaction while reducing cost. To provide such care, APNs need to implement the six core competencies as outlined by Hamric. These six core competencies are: direct clinical practice, expert coaching and advice, consultation, research skills, clinical and professional leadership, collaboration, and ethical decision-making. This paper will explore how APNs can implement each of the six core competencies to support the effective improvement of outcomes such as patient satisfaction, readmissions, cost, health status, and complications. In addition, each of the six core competencies of the APN’s role identified by Hamric will be outlined and applied using a fictitious patient case study.

The historic article by Safriet (1992) fully lists and analyzes the major challenges facing the advanced practice nurse (APN). At the time the article was written compared to now, a few aspects are changing. In areas where change has occurred, it has been an exceedingly slow process. Change for APNs is often dependent on legislation and regulatory authorities which receives half-hearted support, at best, from the medical establishment (Safriet, 1992). Since the first day nurses were given any authority to practice outside of regular practice, physicians only objected when it began to encroach upon their perceived hierarchal status or potential for compensation (Hamric, Hanson, Tracy, & O’Grady, 2014). The concern that this

The Advance Practice Nurse has a long and interesting history. Advanced practice nursing has gone from women being trained by physicians to administer chloroform to, in some states, having their very own practice. The term of advanced practice did not begin until the 1980s, prior to that the advanced practice nurse was described as having an extended or expanded role. While the advanced practice nurse had finally gained a name for their role there are currently several definitions to define this ever changing field. There is currently no standardized definition of the Advanced Practice Nurse (APN). Three definitions of advanced practice will be described and reviewed within this text.

Advanced Practice Nursing (APN) covers four types: Certified Nurse Practitioners, Certified Nurse Midwives, Certified Registered Nurse Anesthetists, and Clinical Nurse Specialists.

The role of an Advanced Practice Nurse (APN) is evolving as the shortage of primary care providers occurs as a result of an aging population and the implementation of Affordable Care Act (ACA) (Laurant, 2014). The advancement in medical technology, increasing aging population, and the prevalence of chronic diseases increase the expectation of public in healthcare system. In order to meet those needs various nursing roles evolved, and all those fall under the umbrella of APN (Ramis, Wu, & Pearson, 2012). Evidences support the role of APN in reducing patient length of stay, subsequent hospital costs, and functions as a recruitment strategy to encourage nurses to stay within the profession (Bauer, 2010). In order to be a successful APN, a nurse needs to have the advanced knowledge and expertise in the designated area. The APN is one who has advanced knowledge and skills in meeting the needs of a population with complex and unpredictable health needs. The skills needed to be successful as an APN is critical thinking, leadership skills, and clinical judgment in addition to the mastering of core competencies required by the National Organization of Nurse Practitioner Faculty (NONPF). For the purpose of this project I interviewed Mrs. A.C, who is an APRN for the Cardiovascular Surgeon. The main focus of the interview was to analyze the NONPF core competencies possessed by Mrs.A.C. The part of this paper includes the Description of the NONPF NP core competencies, Interview

The domains of nursing practice and the core competencies of the APRN role were explored. The four domains in relation to competencies were identified as clinical practice, nursing profession, system levels, and health policy. The competencies define APRN role and distinguish it from the specialty RN practice role. Direct clinical practice was acknowledged as the most fundamental of the seven competencies for every APN. As an NP it is vital to develop the clinical expertise in order to perform competent and safe care. I plan to achieve this by completing my program and practicum as an NP student as required by South University

What are your thoughts on the role of the Advanced Practice Nurse (APN)/Nurse Practitioner? “I’ve noticed their role and responsibilities has increased over the years, with more patients using Advanced Practice Nurses as their primary care providers” (T. Smith, personal communication, July, 1, 2015).

Tennessee board of nursing offers advanced nursing registration to nurses with qualifications at graduate levels who have achieved certifications in various areas of specializations. The state board applies the title Advanced Practice Nurse (APN).The state board also recognizes the advanced practice obligations as provided in the National Council Of State Boards Of Nursing (NCSBN). The four advanced practice roles are Nurse Practitioner, Clinical Nurse Specialist, Nurse Anesthetist and Nurse Midwife. APNs in the state of Tennessee must also be licensed as registered nurses. In the event that the nurse resides in another state, RN licensing is done in the state of residence. The

The role of the Advanced Practice Nurse (APN) is expanding internationally throughout the healthcare system. Since the initiation of the Patient Protection and Affordable Care Act in 2010, there has been an increased need for APNs due to the growing demand for primary care services and increased population that have gained healthcare coverage (Lanthrop & Hodnicki, 2014). The purpose of this paper is to explore the role of APN and develop a professional development plan for my future career.