Advanced Nurse Practitioners (ANP)

The role that nurse practitioner (NP) plays within the increasing complex health care system is a constant changing role with the Consensus Model and the introduction of the Affordable Care Act in 2010. The scope of the nurse practitioner (NP) includes the care of the young, the old, the sick and the well. The educational needs of a nurse practitioner vary greatly from that of a Registered Nurse (RN), in the amount of education as well as the focus of the education. NPs provide coordinated primary care with the use of comprehensive health histories and physical examinations, diagnosing and treating acute and chronic illnesses, the management of medications and therapies, ordering and interpreting tests results, and educating and

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

According to the American Association of Colleges of Nursing (2015) the traditional roles of the advanced practice nurses include nurse practitioners, clinical nurse specialists, nurse midwives and nurse anesthetists. Therefore, the impact of the research on the practice of the preparation of DNP nurse educator requires education in evidence-based practice, quality improvement, leadership, policy advocacy, informatics, and systems theory. Furthermore, transitioning to the DNP as a nurse educator does not change the current scope of practice of the Advance Practice Registered Nurses (APRNs) for their current roles. The transition of the DNP better prepares APRNs by utilizing new models of the care delivery system and growing complexity of health

In the article written by Ford, (2009), the doctorate of nursing practice (DNP) has an important role to play in the current health care system which is constantly changing. As healthcare around the world is transforming, the Institute of Medicine (IOM) 2011 report mentioned that in the United States, Advanced practice nurses play a vital role in the rapid complex changes based on the full extent of their education and training. This article describes some of the positive role of the advance practice Nurse as a facilitator in the regulatory and policy developments. The Advance practice nurse participates and provide cost-effective care models that will improve the access and quality of care of the population. Another positive area for the APN in this current healthcare system is health promotion, health maintenance, and prevention. In this evolving health care system, it gives the Advance practice nurse the opportunity to set up acute and primary care settings that will positively impact health care delivery as they meet the needs of an expanding, aging, and chronically ill population. All over the world, the NP’s role has developed and is beneficial to health care systems and health care consumers. As Advance practice nurses we must use this great opportunity to advance our role and work with others to improve and transform health care globally. DNP graduate 's role is include leadership, research, practice, education, and

Since the inception of the Nurse Practitioner (NP) role in the 1960s, NPs have thrived in the delivery of primary healthcare and nurse case management. Despite patient satisfaction with NPs ' style of care, nurses have been critical of NPs, while physicians have been threatened by NP encroachment on MD practice. Balancing assessment, diagnosis, and treatment with caring defines NPs ' success as primary care providers. Understand the role and Scope of Practice of NPs is sometimes difficult for some to understand. The purpose of this paper is to define the role and history of NP, compare and contrast licensure versus certifications, understand NP Scope Of Practice and Standards of Care, discuss how the State Practice Acts regulate FNP practice, discuss credentialing and privileging, and differentiate between legislative and regulatory processes.

These impose severe constrictions on the ability of the nurse to move forward or advance into the areas of practice where traditional nursing practices were not allowed {Institute of Medicine, 2010}. However with the increase in the number of nurses graduating with advance degrees in nursing; the situation is changing. These well educated nurses are leading the charge to confront the complex issues that the rapidly changing health care situation presents. Regulatory barriers must be lifted so that nurses can practice within their scope in order to be reimbursed by private insurance for the services they provide. These changes can be done through the federal and state legislators as well as supervisory agencies and bodies such as congress and licensing regulatory boards. The IOM also recommends that nurses will expand their scope of practice and increase their responsibility through teaching and counseling of patients. {Institute of Medicine,2010}. The use of Advance Practice Registered Nurses and Physician Assistant in providing primary care services will decrease wait time and increase patient satisfaction. The high turnover of nurses transitioning from school to practice also affects the quality of care. These nurses do not have enough experience to make decisions in patient care.{Institute of Medicine,2010}.The IOM and JCAHO{2012} report supports the recommendations for the introduction of nursing residency

The role of the nurse practitioner began in the 1960’s, with the development of an advanced nursing role in pediatrics in Colorado, to meet the need of treating children of low-income families. Since the inception of the advanced nursing role, there has been controversy in educational standards, educational requirements, knowledge base needed, and state imposed restrictions on practice. It is through the rapid development of ARNP programs and inconsistencies in educational standards that have created obstacles in the advancement of these roles, licensure differences, and restrictions that have minimized the role of the ARNP (Stanley, 2011).

Advanced practice nursing is an evolving field that is integral to the healthcare delivery system. The role of a nurse practitioner is to provide patient and family-centered care by practicing health promotion, disease prevention, and health education. With a shortage of primary care physicians nationally in the United States, there is a high demand for certified nurse practitioners to help meet the needs of patients across all age populations. According to the Consensus model, Advanced Practice Registered Nurses (APRNs) “are prepared educationally to begin practicing with responsibility and accountability to diagnose, treat and manage health problems including pharmacological or diagnostic interventions” (Stewart & Denisco, 2015). With a

While uncertainty about the role of an Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP) persists, what research has found about the role is that AG-ACNP’s provide advanced nursing care to those who are acutely, critically or chronically ill in both traditional and nontraditional healthcare settings (Kleinpell et al., 2012). Standard of scope differs between all types of scopes and nurse practitioners alike. The scope of practice (SOP) for an Acute Care Nurse Practitioner (ACNP) is not based on practice setting, but rather what type of care the patient will need, for example, someone who needs ventilator management in either the home or hospital environment (Kleinpell et al., 2012).

The relationship of the advanced practice nurse and the patient, with the patient being a single individual or a family unit, is participative with the focus being on meaning as the nurse practitioner assists the patient to select one of the multitudinous possibilities in a given health situation. The nurse practitioner does not prescribe a patient to a set of interventions alone, but instead the FNP intervenes with active presence and listening to help the patient to identify their own desires for change. Instead of finding what is wrong with the patient, the nurse practitioner asks what the patient wishes to discuss during an encounter. Then, the FNP supports the patient and helps improve the patient’s quality of life through perspective, pattern recognition, and change if the patient desires. Together, the FNP and patient collaborate to achieve patient-chosen health goals.

The role of the Nurse Practitioner (NP) can be described as diverse and challenging; while at the same time, rewarding and the mainstay for future healthcare. Like many early nursing pioneers, breaking misperceptions by focusing on national recognition and public awareness of the role continues to be an emphasis of today’s NP. Both similarities and distinct differences can be seen between nurse practitioners, registered nurses, and physicians. The nursing model, whether as a registered nurse (RN) or NP, has holistic care at the core of patient care.

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 Registered Nurses (APRNs) continue to play a vital role in providing patient centered healthcare in different environments and settings. There are several types of healthcare personnel categorized as APRNs including mid-wives, nurse anesthetists, clinical nurse specialists, and family nurse practitioners among others (Newhouse, 2011). One major issue of concern is to identify whether a nursing role is clinical or no clinical. Family Nurse Practitioners (FNP) comprise of registered nurses working autonomously or collaborating with other healthcare professionals to deliver healthcare in family-centered settings. They offer a broad range of healthcare services revolving around the concept of the family unit.

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.

A Certified Nurse Practitioner (CNP) must possess a current active registered nurse licensure. A CNP must finish a graduate nursing program that is accredited by