Advanced Nursing Practice Paper

“Nurses are more than caregivers in today’s healthcare settings. They are teachers, advocates and pioneers in improving healthcare. They are stepping out of the old model and taking ownership for changes in healthcare. Nurses are developing their own scientific research programs to improve patient care. They are playing a pivotal role in healthcare reform. Nurses are becoming leaders, not followers in healthcare reform.”

The health care industry is experiencing a surge in the number of baby-boomers needing health care and increased demands on the physicians providing the care. This trend has made the role of Advanced practice providers more important (cite). It is imperative to understand the differences and similarities in the advanced practice provider roles as it pertains to healthcare. This paper will identify specialty nursing roles including advanced practice registered nurses (APRN). It will further compare and contrast the advanced practice nurse (APN) and physician assistant (PA) roles in practice.

The Institute of Medicine’s 2010 report on The Future of Nursing: Leading Change, Advancing Health acknowledges the changing healthcare sector in the US and describes future vision of healthcare and the role of nurses to fulfill that vision. The United States always strives to provide affordable and quality healthcare to the entire population of the country. In order to achieve this goal an overall restructuring of the healthcare system was necessitated. Nurses are considered to be the central part of the healthcare system to provide high quality and safe patient care. Nursing in the US is the single largest segment of the healthcare workforce with almost 3 million nurses working in different areas across the county. The changing

Over the past few decades, many drastic changes occurred in U.S health care delivery.   Our current healthcare trends demand nurses to take more active role in the health care decisions in hospital setting, long term care setting and in community healthcare setting. Since “nursing is based upon a body of knowledge that is always changing with new discoveries and innovation” Potter and Perry (2005), nursing profession is compelled to grow from being just a traditional bedside nurse. IOM’s future of nursing report which is released in 2010 calls nurses to be “more highly educated, diverse nursing workforce”.

“A Council on Graduate Medical Education document anticipated that there had, “been 242,500 PCPs within the United States in 2010, and nearly 25% (55,000) of them aged ≥56 years. The common reimbursement for PCPs is approximately only 55% that of other scientific specialties, main to a cumulative lifetime internet income gap of about $ 3.5 million per primary care physician” (Collins, 2012). This makes being a primary care physician less desirable since the incentive is so low. A similar associated issue is the very low percent of medical institution students who are choosing to become primary care physicians. Another issue is that about 59 million Americans live in regions with health professional shortages. Shortages in a number of other primary care healthcare specialists exist, especially with nurses. “In 2014, US schools turned away almost 70,000 qualified nursing applicants because they didn’t have the capacity for them. In fact, almost two-thirds of surveyed nursing schools cited faculty shortages as the reason for not accepting all qualified applicants into nursing baccalaureate programs” (Erickson, 2016). This greatly contributes to the shortage of nurses if they cannot receive proper education and training to join the workforce. Many healthcare service professionals shortages are in regions within

One common theme that has resurfaced throughout the entire Obama administration and has created a great deal of focus and debate is health care reform. The Patient Protection and Affordable Care Act (PPACA) which was introduced by Obama in 2010 creates a new structure of health care. It transforms health care from “late-stage, high intensity, illness focused, tertiary, interventional health service to a much stronger value driven focus on achieving the highest levels of health” (Porter-O’Grady, 2014, p. 65). Through this act, legislation has been created that regulates the way hospitals and physicians are reimbursed, which is built on evidenced-based, quality health care outcomes that are cost effective without infringing upon patient satisfaction. At the heart of this debate is the impact on nursing care, for nursing is the largest health care professional as well as the largest component of health care costs. Any change in the health care reimbursement will greatly affect the nursing practice (Buerhaus, 2010). In order to fully understand the impact of this health care reform, one must understand that health care reform is not a new concept. Health care reform has been transforming since the 1800s.

The report shows that the part of nursing must be expanded so that nurses are able to practice to the fullest degree of their education and training. Currently, advanced practice nurses (APRNs) work according to the scope of practice guidelines set forth by their individual state, meaning these highly educated nurses may not be working to the extent of their training but to the individual state laws. The report offers recommendations to streamline these idiosyncrasies and get rid of the red tape so that nurses can work in their appropriate manner and deliver safe quality care to some 32 million Americans who will before long gain access to health care services (American Association of Colleges of Nursing [AACN], 2012). The report correspondingly finds that nurses need to attain advanced levels of education and training through an enhanced education structure which encourages a cohesive academic progression as to safeguard the delivery of quality health care services. Patients are becoming progressively more complex and nurses need to attain the proper skills to care for these persons. Nursing education must embrace the continuous move towards a streamline approach to higher degree programs (Institute of Medicine [IOM], 2010, p. 2). Nurse residency programs

The American Association of Colleges of Nursing has identified nine essentials that are incorporated into master’s nursing programs to help direct the practice of advanced practice nurses (APN’s). Essential II outlines how an APN can utilize organizational and systems leadership to promote safer and more cost effective care. By incorporating effective leadership skills, APN’s can help transform healthcare and make quality improvements for the patient, the institution, and the community. According to the American Association of College of Nursing (2011), an effective leader assumes and applies “the skills of communication, collaboration, negotiation, delegation, and coordination” (p. 11). APN’s must be able to establish and maintain a healthy

Mission: One church, one heart one purpose advancing health awareness and providing people with tools to take responsibility for their health through early detection and prevention. The project is a public health intervention event with interactive and educational information with screenings and basic preventive medicine for the community.

"In 2008, the Robert Wood Johnson Foundation (RWJF) and the Institute of Medicine (IOM) began a two-year study initiative to respond, the need to assess and transform the nursing profession."("The-Future-of-Nursing-Leading-Change-Advancing-Health," 2010).An interdisciplinary committee was put together to report the nations issues impacting health care. Recommendations were set forth by the IOM in a way to improve and restructure the nursing profession to fit the future of the medical field. ("The-Future-of-Nursing-Leading-Change-Advancing-Health," 2010) The recommendation from the committee starts with an action-oriented blueprint for the future of nursing also to identify matters of medical care, research, education. (AJN, American Journal of Nursing: 2010). The Affordable Healthcare ACT (ACA) of 2010 introduced new changes to United States healthcare system. These changes were the improvement of research and evidence-based practice, health awareness, prevention screenings, and community-based wellness promotion and applied. (Affordable Care Act, 2010) Before the IOM’s action-oriented blueprint nurses came up against barriers that prevented them from being able to the start to make those transformations. Today nurses have the potential to overcome obstacles by leading innovative strategies to transform nursing education, practice, and leadership. ("The-Future-of-Nursing-Leading-Change-Advancing-Health," 2010)

Compare and contrast the two definitions of advanced practice nursing as defined by the American Association of Colleges of Nursing (AACN) DNP Essentials, the APRN consensus model, and as defined in the textbook reference below. a)Explain the two factors you think are the most important in your textbook’s definition of advanced practice nursing. b)Chapter 3 will be attached to instructions. Definition of APN on this Chapter c) APA style and use citations and references (3) immediate attachment: Please, review this discussion sample to write my paper (Same topic)

The profession of nursing includes: promoting health, preventing illness, as well as providing care. NUR 102 teaches student nurses, like myself, a wide range of information and knowledge needed in order to become a successful nurse and also aids in the preparation for clinical placement. Nonetheless, this course teaches essay writing, critical thinking, nursing theories, as well as the roles and responsibilities that I will have as a nurse.

Health care in the United States (US) is constantly evolving however, when the 2010 Patient Protection and Affordable Care Act (PPACA) was signed into US legislation the need for evolution increased at an exponential rate (Institute of Medicine [IOM], 2010a). The PPACA’s primary goals were to provide safe, quality, and affordable health care to every US citizen as well as to minimize the number Americans without insurance (Cherry & Jacob, 2016). According to the IOM (2010a) nurses played a fundamental role in developing the goals of the PPACA and are an essential component in meeting the requirements of the new act. Despite making up the largest sector of the health care workforce, the nursing profession faces multiple hurdles trying to effectively respond to the rapid metamorphosis of health care (IOM, 2010a). The recommendations proposed by the IOM to overcome these hurdles were released in their report on The Future of Nursing: Leading Change, Advancing Health (IOM, 2010b)

Nursing research is important and vital to creating changes that positively affect the outcomes of patients. Guidelines, rules, and regulations set into action by the United States Department of Health and Human Services (USHHS) have provided participants in research studies insurances that their rights and welfare will be well served and protected. The Common Rule was adopted by USHHS in 1991 and since that time clinical research has grown considerably to include multiple collaborative sites that use sophisticated data collection methods (Hoffman, Fortenberry, & Ravel, 2013). The changing scenario within the medical and technology communities since the adoption of the Common Rule provides a solid argument that rules and regulations should

According to the Arslanian, Hicks, Whall and Algase (2005) nursing theories have unique views. Advanced Practice Nurses (APN) not only focus on diagnosis and medical intervention but also considers family, environment and patient responses in their plan of care. This makes them different from other health care providers like physicians and physicians assistants (Arslanian et al., 2005). I agree that it is important for us as an APN to use theories to guide our own advanced practice because theory gives identification to nurses, and distinguishes nurses from other profession by its unique contribution to the clinical practice. Nursing is an autonomous profession (Kenny, 2013). Nursing theory provides various information to understand the patient