An Advanced Practice Registered Nurse

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.

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

The four that I will address are the Nurse Anesthetist, the Clinical Nurse Specialist, the Nurse Practitioner and the Nurse Mid-wife.

Among older adults aged 65 years and older are found to have difficulty in reading and to comprehend discharge instructions. This has been found to be a concern regarding continuing care and re-admission concerns throughout urban and rural hospitals. Does the integration of Advanced Practice Nurse (APN) guiding discharge education, along with a follow-up contact with the patient after discharge effect compliance and readmission rates, more than not having an APN guiding discharge teaching to help decrease readmission rates?

Advance Practice Registered Nurse (APRN) is a broad term that is used to define the masters prepared nurse that participates directly in patient care. This definition includes four different facets of nursing: certified nurse-midwives, nurse anesthetists, clinical nurse specialists and nurse practitioners (Joel, 2009). Of these four professions that are included in the APRN definition, Western Carolina University offers two: nurse anesthetist and nurse practitioner. Nurse educator and nurse leader, which are also offered at Western Carolina University, are not currently included in this definition.

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.

Due to the massive popularity and use of the P value in scientific research studies Advanced Practice Registered Nurse (APRN) in primary care settings must administer care based on the best available scientific evidence. In healthcare where frequency and volume of scientific studies overwhelm APRN’s and health care professionals, they are having to implement and rely on many statistical metrics to make crucial decisions. APRN’s in their daily practice will have to think critically through the research process and review the statistical data in such a manner that they can determine and decide on the best available evidence.

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

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).

One future opportunity for a DNP prepared nurse is to be involved in translational research. Translational research is a science that helps in closing the gap between research and practice to change healthcare and achieve meaningful outcomes.

In medicine today it is becoming essential to remain on the journey to best possible practice, which “involves implementing available evidence into practice” (Dogherty, et al., 2013, p. 129). Dogherty, et al. (2013) researched the facilitation of evidence based practice by selecting 20 nurses “to attend an interactive knowledge translation symposium to examine what has worked and what has not in implementing evidence in practice.” Results from the study showed both many positive and negative facilitation experiences. “Successful implementation (of evidence based practice) is associated with focus on a priority issue, relevant and easy to use evidence, development of strategic partnerships and a multidisciplinary project team including

As the nursing field grows, evidence-based practice is becoming more pragmatic. This is because people want to know the when, why, and how of diseases processes. Increasing knowledge on evidence-based practice has shown to improve health outcomes. Research translation models are utilized heavily in nursing to help transform findings into practice (Polit & Beck, 2012). Some models are more clinician oriented, while others are institution oriented. There are various models that are utilized by different entities. For the purpose of this paper, the Stetler Model of Research Utilization will be researched and discussed.

Reverse Translation is an essential component of the Clinical and Translational Science research model. As we see the need to translate our scientific findings into everyday care of patients and into lives of general population; we must also translate the concerns of the general population into scientific inquiry. Over the past decades we have learnt the importance of bringing clinicians into the research arena due to unique perspective of the clinicians hold about health care. Just as