Clinical Laboratory Improvement Amendments: Future Nurse Practitioner

The facility my change project has potential impact upon is a teaching hospital which is known for promoting, supporting, and encouraging clinical research and implementing latest evidence-based practice. Erlanger serves as the region's only academic teaching hospital and strives to employ healthcare professionals who are knowledgeable in the latest skill, technique, and evidence based practice (EBP) (Erlanger Health System, 2017). This serves as both a strength and opportunity for the facility. A major strength for the hospital is the support that is has for research and implementation of all change processes. In 2013 the Institute for Clinical Research (EICR), was developed to solidify unity of two objectives, providing patients’ access

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 CRNBC Standards for Acting with an Order. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Procedures Below Body Surfaces Administering Substances Putting Items into Body Openings Putting Substances into Ears Hazardous Forms of Energy Medications Allergy Testing and Treatment Section 8: Restricted Activities for Certified Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Certified Practice Categories and Education Requirements Part 4: Delegation CRNBC Standards for Delegating to Registered Nurses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Activities Approved for Delegation to Registered Nurses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Appendices 1. CRNBC Scope of Practice Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30 2. CRNBC Limits and Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 3. Model Reflecting RN Scope of Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 4. Glossary. . . . . . . . . . .

Credentialing from advanced practice registered nurses (APRNs) perspective is defined as “furnishing the documentation necessary to be authorized by a regulatory body or institution to engage in certain activities and use a certain title” (Hanson, 2014). Credentialing is also define from a local institutional process that consider specific documentations for APRN before they assume the practice role as APRN within their facility. In health care system, credentialing ensures individuals meet required standards of practice and is prepared to perform those duties implied by the credentials. National certification and education are considered as part of credentialing for APRN to acquire basic level of competence to practice. (Hanson, 2014)

In 2008 the Alliance for Advanced Practice Credentialing and the National Council of State Board of Nursing published specific masters educational, accreditation, licensure, credentialing, certification processes. The masters educational, accreditation, licensure, credentialing, certifications are based on a set of values steps to practice will ensure that NPs have the skills training to place themselves to serve an fundamental role in national health care reform (Graduate NursingEDU,

The APRN Consensus Model was released in July of 2008 to define advanced practice registered nurse, identify the titles to be used by APRNs, and define specialty area of practice. The Consensus Model also describes population foci, suggests a process for recognition of new APRN roles, and recommends requirements for implementation (American Nurses Association [ANA], 2010). The APRN regulatory model helps uniform scope of practice of APRN across the United States, which benefit individual APRN, enhance patient outcomes, and improve the quality of care. Consensus Model consists of Licensure, Accreditation, Certification, and Education. The Education criteria in LACE Consensus Model relate to all APRN programs regardless of master’s or doctoral

In 2008, the coalition of members from the Alliance for Advanced Practice Credentialing and the National Council of State Boards of Nursing (NCSBN) created the Consensus Model for Advanced Practicing Registered Nurses (APRN’s). This model creates a framework for APRN’s in licensing, accreditation, certification, and education in the United States (Alleman & Houle, 2013). The establishment of this Consensus Model has developed a bases for the ARNP’s comprehensive knowledge base, ability for clinical reasoning, cultural, and ethical competencies, establishing a model of practice for ARNPs in which to follow. These concepts will be further discussed in this paper.

There are 9 types of health care facilities that are accredited by the Joint Commission. The Ambulatory Health Care accreditation, encompassing organizations and facilities that provide outpatient services of medical/dental nature as well as diagnostic, surgical, and therapeutic services. Other types of facilities that are accredited are critical access hospitals, hospitals, laboratories, office-based surgical centers, and nursing care centers. There is also Home Care services, the Opioid Treatment Program, and the Behavioral Health Care Program. Critical Access Hospitals meet special requirements regarding patient beds and LOS. Hospitals that are accredited include general and specialty hospitals.

Consensus Model for APRN Regulation has 4 components: Licensure, Accreditation, Certification, and Education It supports goals of the ANCC APRN certification process and will align the inter-relationships among licensure, accreditation, certification, and education to create a more uniform practice across the country. Its aim is to improve consistency and clarity and take APRNs to the next level and also enhance patient care (“American Nurses Credentialing Center," 2015)

Standard 16 of the American Nurses Association (ANA) Scope and Standards Practice, directs nurse leaders to advocate not only for patients but for all members of our healthcare community. As a discharge planner, I am in a unique position to advocate not only for patients but for caregivers as well. As part of my responsibilities, I participate in daily multi-disciplinary team rounds. The meetings take place so that all disciplines can openly discuss patient care needs. They provide the perfect opportunity for anyone to bring to light problems or concerns.

Now that I remain in the CLT program, it has actually opened my eyes to a complete different world of operating in the medical laboratory field. Having that chance to be more involved with the breakdown of the process of the clinical laboratory studies is astounding. I ‘am pleased to have prepared myself to travel beyond with a little in order to succeed with wealth of

by a nurse equivalent is equivalent to care provided by a physician.. In addition, the

The ANA standards of practice affect the nurse and the manager in that it provides direction to the nurse and the manager. It’s the foundation of the decision making process in nursing. It lets the nurse and manager know what they can and cannot do in their scope of practice. Deviating from it can cause legal problems and harm to those you care for. The nurses must comply with these standards and Manager to need to make sure nurses under them are compliant. Compliance assures that the population we treat are protected and protects the nurses from liability. .

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).

Merriam-Webster (2015) defines a nurse practitioner (NP) as ?a nurse who is qualified through advanced training to assume some of the duties and responsibilities formerly assumed only by a physician.? The NP is a direct care provider that provides a plethora of services ranging from primary prevention to disease management. For example, the NP has authority to monitor and alter drug therapies and order diagnostic tests.

According to the Texas, Nurse Practitioner can be well defined as a registered nurse who has advanced education and clinical training in a specialty area. They provide as a primary healthcare provider from children to the elderly population patients. They can address both acute and chronic disease conditions in the patients. Texas is more thorough and complete than the other states according to my own individual research. Board Rule 221 requires that one identifies the advanced practice role and population focus area for which you have been licensed as an advanced practice registered nurse by the Texas Board of Nursing.