Dnpn

The role of Advanced Practice Nursing (APN) has changed dramatically in recent years. Currently, the Unite States (U.S.) health care is focusing on delivering a cost -effective health care to all patients. In the last decades, there were many efforts to control health care over spending in the U.S. One of such efforts is to focus on applying proven principles of evidence-based practice and cost-effectiveness to find the least expensive way to produce a specific clinical service of acceptable quality (Bauer, 2010). The vast changes in health care system, such as cost, need for high productivity, limitation on reimbursement, and the inadequacy on access have made APNs to think in a way where they most fit to provide independent care for

The role that nurse practitioner (NP) plays within the increasing complex health care system is a constant changing role with the Consensus Model and the introduction of the Affordable Care Act in 2010. The scope of the nurse practitioner (NP) includes the care of the young, the old, the sick and the well. The educational needs of a nurse practitioner vary greatly from that of a Registered Nurse (RN), in the amount of education as well as the focus of the education. NPs provide coordinated primary care with the use of comprehensive health histories and physical examinations, diagnosing and treating acute and chronic illnesses, the management of medications and therapies, ordering and interpreting tests results, and educating and

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

These impose severe constrictions on the ability of the nurse to move forward or advance into the areas of practice where traditional nursing practices were not allowed {Institute of Medicine, 2010}. However with the increase in the number of nurses graduating with advance degrees in nursing; the situation is changing. These well educated nurses are leading the charge to confront the complex issues that the rapidly changing health care situation presents. Regulatory barriers must be lifted so that nurses can practice within their scope in order to be reimbursed by private insurance for the services they provide. These changes can be done through the federal and state legislators as well as supervisory agencies and bodies such as congress and licensing regulatory boards. The IOM also recommends that nurses will expand their scope of practice and increase their responsibility through teaching and counseling of patients. {Institute of Medicine,2010}. The use of Advance Practice Registered Nurses and Physician Assistant in providing primary care services will decrease wait time and increase patient satisfaction. The high turnover of nurses transitioning from school to practice also affects the quality of care. These nurses do not have enough experience to make decisions in patient care.{Institute of Medicine,2010}.The IOM and JCAHO{2012} report supports the recommendations for the introduction of nursing residency

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

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

Advance practice registered nurses (APRNs) play a critical and prominent role in the management of patients’ health and wellness in the United States. Historically, there have been no clear definitions of APRN roles, varied legal recognition of APRNs across states, and a lack of standardization in education of APRNs. Further, even with our ever-growing presence, there remains a knowledge deficit of the APRN role amongst the public and even healthcare professionals. In order to address these concerns, improve patient safety, and support and encourage APRN practice to the maximum extent of their degrees, the NCSBN APRN Advisory Committee and the APRN Consensus Work Group was formed. In 2008, they published the consensus model

The role of the Nurse Practitioner (NP) in the U.S. is one that has undergone numerous changes over past years. When the first NP program was developed in 1965 at the University of Colorado by a pediatrician by the name of Henry Silver and a master’s prepared public health nurse by the name of Loretta Ford, the role was primarily meant to train nurses to provide care to poor, rural, children in Colorado. (Joel, 2013) By the 1970’s, it was clear that the NP could fill the country’s need for healthcare providers and the number of programs providing NP education rose to 178 by 1977. (Joel, 2013) At this point in time there were no clear guidelines in regard to curriculum and evaluation standards, that is until the American Academy of Nurse Practitioners was developed in 1985, bringing with it an abundance of political support for the NP role. (Joel, 2013)

An Advanced Nurse Practitioner (APRN) promotes a comprehensive angle to health care, making them a health care provider of choice for millions of Americans who need healthcare. APRNs offer an attractive mélange of clinical expertise combined with an eminence on health management and disease prevention. Nurses from all spectrums of training utilize evidence-based research that helps them guide their care/practice and helps improve patient outcomes. This same evidence based research allows an overview of the quality that the APRN partakes in; it is in this review of the literature that divulges why so many people are happy with the quality of care that APRNs provide. The American Medical Association may

Advanced practice nurses (APN) improve access to rural and urban primary care (Hunter, Murphy, Babb, & Vallee, 2016). It is difficult as a nurse practitioner (NP) to move between the states and practice due to the differences in laws and regulations within each state. The role of an APN is not fully understood by many people, and continuous education on a NPs scope of practice (SOP) needs to occur. NPs can help the shortage of physicians by providing primary care to those with less complex medical conditions. This gives the physician more time to focus on the complex cases and increase patient satisfaction overall (Bareil, et al., 2015). The APN SOP will be further explored in the following sections as well as a personal assessment,

Advanced practice nursing (APN) has always been a thought-provoking notion for the nursing profession and there continues to be confusion in the terminology surrounding the roles. Nursing continues to struggle with the conceptualization of advanced practice as evident by the unceasing ambiguous use of this term in healthcare and the lack of understanding of this distinct and much needed discipline. The term advanced practice nursing first appeared in the nursing literature in the 1980’s, as it represents the future frontier for nursing practice (Ruel & Motyka, 2009). The numerous systemic health care changes occurring because of The Patient Protection & Affordable Care Act (ACA) make this an ideal time for the full use of advanced practice nursing. With the new adoption of the ACA, the focus of client healthcare is shifting away from hospital-based care toward community-based care that will be lead primarily by APN’s. Physicians are not predicted to lead this change due to the current critical shortage of public health and primary care physicians (Cowen & Maisano, 2013). Also, health care now is faced with the challenge of the new influx of patients suddenly insured by the ACA who never sought treatment before, but are now seeking primary care physicians. Encouraging nurses to gain new independent roles seems to be the government’s response in delivering a more cost effective and efficient way of dealing with this health care crisis we face. With the advanced

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

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).

Nursing is a profession that is always changing to benefit the patient and the community. In the complexity of nursing, and to give uniformity an APRN (Advanced Practice Registered Nurse) Consensus Model was established. The Consensus Model promotes uniformity to the four roles of APRN’s which are as follows: Clinical Nurse Specialist (CNS), Certified Nurse Practitioner (CNP), Certified Registered Nurse Anesthetist (CRNA), and a Certified Nurse Midwives (CNM). A “CNS is n APRN with a focus on macrosystems with three spheres of influence: patient, nursing, and healthcare system. The CNS follows Core Competencies as outlined by the National Association of Clinical Nurse Specialist.” (Stuesse, 2014)

Public health nursing introduced me to the importance of social justice in every community. As a PHN, we look at the bigger picture of having the best outcomes for the whole population and not just what would benefit an individual. It made me re-examine my values, beliefs, and biases, and realized