Advanced Nurse Practitioners Case Study

While the demand of healthcare need increasers the United States facing a physician shortage. In recent years the number of nurse practitioners (NPs) and physician assistants (PAs) has significantly increased and they are taking the part in providing healthcare cervices to the majority of patients. I believe nurse practitioners and physician assistants can practice independently from doctors and be free of oversight. Expanding the scope of NPs and PAs is essential to overcome the healthcare crisis we are facing; it will increase patient satisfaction and stabilizing the healthcare economy.

Over the last several years, the majority of graduating medical students (90%) has been focused on careers in specialized care. (Pickert, 2009) This is because they will make more money in comparison with doctors that are working in a primary care environment. As a result, a shortage has developed with many health care providers turning to Nurse Practitioners. These are nurses with some kind of advanced degree in Nursing. Their job is to diagnose / treat patients and prescribe medication. To fully understand what is happening requires looking at how this trend is having an impact on accountability, quality, costs / health promotion and risk reduction. These different

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.

With the passing of the Affordable Care Act in 2010 approximately 32 million more people will be insured throughout the United States. The need for healthcare workers and providers will be in drastic demand to provide care to these insured Americans. The 2010 IOM report details out how the advanced practice nurse can be a valuable asset in primary, chronic and transitional care and their skill set should be used to promote better healthcare across the nation (IOM, 2010). This impact of this report should help progress advanced practice nurse’s ability to practice without individual state regulation and be governed under one body to server in and outside of the hospital setting

Many Americans use Advance Practice Nurse Practitioners (APRN) for a number of their health care needs. For more than fifty years, APRN’s have provided a great amount of services in primary care and acute settings, making their presence in the health care system important. Likewise, expectations are that APRN’s will become even more crucial to the delivery of healthcare as more Americans gain access to providers through the new tax reform. With this being said, it is imperative that the APRN be able to practice to his or her full practice authority. “Full practice authority is comprised of state practice and licensure laws that allow advanced practice registered nurses to practice fully in the four domains of practice, under the exclusive licensure

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 advanced practice nurse is on the front lines of care being received or falling short within their community. By having direct asses to the success and failures of health care in the community, the advanced practice nurse (APN) can be the voice of patient to the officials having an impact on health care accessibility. The purpose of this paper is to address a current problem by evaluating multiple influencing factors and investigate a policy capable of changing and providing a more positive outcome.

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.

Texas has a rapidly growing population with complex healthcare needs, but has limited resources in terms of healthcare provider workforce. There is an expanding need for healthcare in Texas even without taking federal reform into account. Currently, more than forty percent of states have adopted full practice authority licensure and practice laws for Advanced Practice Registered Nurses (APRN). Texas is not one of them. Currently, APRN’s are regulated by both the Texas Board of Nursing and the Texas Medical Board. Passage of Senate Bill 681 would grant full practice authority to APRN’s, and therefore be regulated exclusively by the state nursing board.

Palumbo, Marth, and Rambur (2011) stipulate that over the years, advanced practice nurses have continued to avail care that is of top quality. Subsequently, they have been able to create a recognized place within the healthcare system. By 2012, it was reported that there was an approximate number of 240, 000 advanced practice nurses (Newhouse et al., 2012). The report also added to the assertion by Palumbo, Marth, and Rambur (2011) through the indication that advanced practice nurses offer their services in settings that need a heightened range of professional independence while providing healthcare. What concerns their function, LaBrocca and Angosta (2016) indicate that as a health expert, an advanced practice nurse foresees issues in healthcare

Advanced Practice Registered Nurse (APRN) has evolved tremendously since it was establish in 1965 to service vulnerable populations, however there are still barriers that must be addressed in order to free APRNs from limitation imposed by state scope of practice (SOP) laws and payers, which disrupts health care financing/costs, access, delivery, and quality patient care. Currently, only one third of the states in the U.S. permit APRNs to fully practice within their scope without limitations (Hain & Fleck, 2014; Yee, Boukus, Cross, and Samuel, 2013).

Challenges to overcome with this issue may be that physicians could feel as though the nurse practitioner (NP) is not adequately equipped as the doctor would be when dealing with patient care. According to the American Medical Association, “physicians have longer and more rigorous training than NPs, nurse practitioners are incapable of providing quality, safe care at the same level of physicians” (Hain & Fleck, 2014). This statement reflects negatively upon nurse practitioners but also coincides with the inability of a nurse practitioner to practice “to the fullest extent of their education and training” (Hain & Fleck, 2014). Only roughly “one-third of the nation has adopted full practice authority licensure and practice laws for NPs” (Hain & Fleck, 2014). This is another dilemma in and of itself within the health care setting and could be one of the reasons as to why NP are not reimbursed one-hundred percent for their

The suicide death rate has been climbing for the last ten years in Florida. According to the report by American Foundation for Suicide Prevention (2017), on average, one person dies by suicide every three hours in the state. The report also states that suicide is the second leading cause of death for people aged from 25 to 34 in Florida. Suicide has cost Florida a total of $2,841,739,000 of combined lifetime medical and work loss cost in 2010, or an average of $ 1,018,910 per suicide death. Furthermore, according to U.S. Department of Justice (2017), the homicide rate has increased 4.8% in 2016, compared to the number in 2015 (U.S. Department of Justice, 2017).

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

Almost every day an Advanced Practice Nurse (APN) will feel the impact of policy and change in the healthcare field, from the institutional, local, community, state and national levels nurses have a responsibility to contribute to the discussion focused on healthcare improvement on all levels. Let’s first look at these issues on an institutional level, Often we are faced with changes in policy in our current roles , it could be a new policy or a revision to an old policy , it can be written or a unwritten “ understood policy” that everyone follows . We had one of these policies in our clinic, Uninsured or self-pay patients were routed to main campus clinics over 35 miles away because of their uninsured or self-pay status. This