Advanced Practice Nursing Case Study

The roles of advanced practice nurses have been an ongoing debate in many states. In a globalized world, advance nurse leaders are regarded as forefront leaders that provide first-rate healthcare to the public. However, the role of new advanced practice nurses is known to be complex. Advance practice nurses use countless different strategies and nursing theories to improve the wellbeing of their patient. To improve the well being of all patients, there is a growing demand for advance practice nurses worldwide. The advanced practice roles of CNM, CNP, CNS, and CRNA require a toolbox of skills, understanding, and integrative abilities that synthesize advanced practice nursing knowledge" (Buppert, 2011). With the rapid development of the advance practice nurse leader, the national organization of Nurse Practitioners are eager to help ensure the competencies of the diverse roles of APN.

While reflecting back on the previous weeks, I have to say that this was the foundational class for the FNP students. Before this class, I used to think how I am going to fulfill the role of a Nurse Practitioner (NP). This class helped me to better understand my role and gave me the confidence that I can fulfill the role of an NP. Today, when I look at myself, I know I am in the stage of advanced beginner in Patricia Benner’s Novice to expert theory. The case studies in the discussion threads really put me in the real world of practical nursing as an NP fulfilling the role of a provider. Thorough the case studies, I have learned how to make a best differential diagnosis based on the patients presenting symptoms. The interaction and sharing

The aim of this study is to provide a detailed account of the nursing care for a patient who is experiencing a breakdown in health. One aspect of their care will be discussed in relation to the nursing process. The model used to provide an individualised programme of care will be discussed and critically analysed.

In the Texas, state law prohibits Advanced Practice Registered Nurses (APRNs) including nurse practitioners (NPs) from practicing to the full extent of their education and clinical ability. Currently, Texas law requires than an APRN receive approval from an individual physician prior to engaging in the practice of advanced nursing. This type of complex regulatory scheme is outdated and restricts patients’ access to care, creates geographic disparities in services, and unnecessarily increases health care costs. For example, current law requires APRNs to meet periodically face-to-face with a supervising physician; with few physicians choosing to practice in rural areas, many APRNs who are willing to work in rural areas are essentially forbidden from delivering care to these underserved areas.

This paper explores the perception of clinical practitioners to the change in policy related to the advanced practice registered nurse (APRN) full practice authority. The author conducts a one-on-one, open-ended interview of 5 nurse practitioners and 5 physicians licensed to practice in Maryland on their perceptions of the recent passage of the Advanced Practice Registered Nurse Full Practice Authority. A literature review was conducted in a policy report by the professional nursing organization, and discussion within the peer-reviewed article supported an overview, regulatory differences among 50 states, including the District of Columbia. Their policy implication for enhancing APRNs role nationally. The author discusses a critical component

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).

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

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

Defining the scope of practice for an advanced practice nurse (APRN) can be a difficult task. Currently, in the United States, each state has its own policies regarding APRN scope of practice. State policies/laws vary from restrictive to independent. States under a restrictive policy of APRN scope of practice may have strict physician collaboration regulations. For example Missouri requires the collaborating physician to review a percentage of charts and be within so many miles of the APRN’s work place. Restrictive scope of practice can also limit prescriptive authority and decrease reimbursement of services (Hain & Fleck, 2014). States with more independent scope of

The role of Advanced Practice Nursing continues to change and develop. In the past few years, state legislatures authorized Nurse Practitioners to receive direct payment and write prescriptions. These changes have increased the Nurse Practitioner 's independence. This has resulted in Nurse Practitioners establishing independent practices that provide the same health care of primary care physicians, or they can also work in practices where the Nurse Practitioner and the doctor care for patients together (Spitzer 1974). "Many states are increasing the level of authority and reimbursement for Nurse Practitioners. Most private insurance companies and health maintenance organizations cover the services of Nurse Practitioners (Pearson 1993). Some blame the nursing shortage partly on Advanced Practice Fields. Registered Nurses are obtaining their master 's degree in order to earn more money and have more opportunities.

Expanding the scope of practice for APRN remains a controversial issue in Missouri, where I currently reside. Expanding the scope of practice also remains an issue for the health care field nationwide. Stakeholders that I can identify include The American Association of Colleges of Nursing (AACN), The National Organization of Nurse Practitioner Faculties (NONPF), APRN Consensus Work Group, National Council State Boards of Nursing (NCSBN), APRN Advisory Committee, along with other health care organizations, health care educators, and health care providers nationwide (IOM Report., n.d., p. 133). Focusing in on Missouri, the stakeholders for this endeavor include health care

As resistant as some states’ legislative and regulatory bodies are to grant APNs autonomy of practice, the damage being done by over-regulation is clear (Safriet, 1992). Physicians are forced into a position to either supervise the APN’s practice or be constantly consulted for approval of their practice decisions. Safriet (1992) described that in and of itself, this constant supervision may appear to patients that the APN is not competent to provide adequate or care equivalent to that of a physician. If the role of the APN is to bridge gaps in health care by relieving the medical establishment of some of the patient load by performing the same function as a physician in a primary care setting, it seems wholly unnecessary to restrain their scope of practice in those areas. This type of restrictions affect cost and patient care accessibility (Safriet, 1992). This was a problem stated in the article, however 25 years later, populations of patients remain unseen or cared for and APNs continue to be underutilized (Safriet, 1992). Rigolosi and Salmond (2014) cite the American Association of Nurse Practitioners (AANP) when they state that not utilizing nurse practitioners due to practice restrictions costs $9 billion annually in the US (p. 649).

In recent years, there have been increased efforts to improve the state of healthcare in the United States. Despite spending much more than any other high-income countries on healthcare each year, the United States is behind many other countries when it comes to overall health status (Squires & Anderson, 2015). There have been several new policies set forth to improve patient outcomes while also cutting costs. In addition to excess spending, there are also concerns regarding the increased demand for healthcare as the baby boomers continue to age (Song & Ferris, 2018). To address these challenges, officials are working toward utilizing advanced practice nurse practitioners (APRNs) to act as healthcare providers for the growing population of

As the young and rapidly-aging population continues to increase, the demands of primary, acute and chronic disease management will also increase. As a result, more health care professionals who provide primary care will be needed to meet these demands. Thus, the emergence of Advanced Practice Registered Nurse (APRN) evolve. APRN is a nurse who has completed a graduate degree and has acquired advanced knowledge and skills. APRNs are grounded with theory, concepts and principles that enable them to assess, diagnose, treat and manage their patients. APRNs can work in conjunction with other health care professionals or independently. APRNs improve access to health care by providing care in the rural and underserved areas. APRNs also reduce the cost to health care (Joel, 2013).

As the healthcare system in America is overhauled, advanced practice nurses are going to increasingly assume the role of primary care providers. Many states have kept up with the evolving expansion of