Nurse Practitioners : Potential Standard For Advanced Practice Registered Nurses

Healthcare systems and the way safe, quality health care is delivered are continually changing to better serve patients and communities. Professional nursing practice is a large component in the healthcare system today. Back in the 1960s, professional nursing leaders tried to adopt the bachelor degree programs as the only educational track to become a registered nurse (Creasia & Friberg, 2011). Due to nursing shortages and demands this motive did not hold fast. Individuals entering the nursing profession today must first decide which educational pathway to take to become a Registered Nurse (RN).

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)

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 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,

In the traditional health care model, formal learning is not complete when a physician receives their medical degree and white coat at the end of their academic program. Medical school graduates are required to complete an accredited hospital residency program to become licensed to practice medicine, (Jolly, Erikson, & Garrison, 2013). However, acute care nurse practitioners (ACNPs) are not afforded, nor expected to complete, the same educational requirements. The current expectation that a new graduate ACNP learn their advanced nursing role “on-the-job” is unacceptable and leads to decreased job satisfaction and preparedness. In the every-changing climate of health care, the development of required residency programs for ACNPs should be maintained as a priority.

As popular as the ADN is today, there is a huge momentum to encourage nurses to receive their BSN instead of an ADN. Nurses that are already entering the workforce at the BSN level are not only more skilled at following and understanding evidenced based practice, but they are also more prepared to go on to school to complete their masters or doctorate degrees. In the changing face of healthcare, more nurses with advanced degrees will be needed to provide primary care as in the role of nurse practitioners. APRNs are going to be in higher demand in community care, public health nursing, evidence based practice, research, and leadership. Shortages of nurses in these positions create a “barrier to advancing the profession and improving the delivery of care to patients” (IOM, 2010, p. 170). Shortages of APRNs and the increasing need for nurse practitioners to provide primary care is why the IOM is recommending to increase the amount of BSN educated nurses entering the workforce to 80% and to double the number of doctorate nurses by 2020 (IOM, 2010, p. 173) The goal to increase the nursing workforce to 80% BSN educated nurses and double the amount of nurses with doctorate degrees is a formidable goal, but increasingly necessary. Patients are becoming more complex inside and outside of the hospital setting with chronic multiple comorbidities. BSN educated nurses are not only better prepared to care for these

The success of NPs depends on practicing evidence-based care with competency in assessment, diagnosing, managing patients, and maintaining a caring practice. The nursing component of the NP role continues to be challenged from within nursing, as well as by large national physician organizations. NPs are extensions of nursing practice who are guided by nursing theory. The transformation from nurse to the advanced practice role of NP involves development of advanced knowledge and skills for listening, knowing, being with patients, connecting patients to their communities, promoting health,

Three issues or trends I see that are important with regard to credentialing are reimbursement, malpractice and education. Within each issue are opportunities for the advance practice nurse (APN) to grow in knowledge and participate in change. It is important to understand why each one effects credentialing for the APN.

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

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).

The primary care nurse practitioner (NP) encompasses six different specialties: the Family NP, Adult NP, Pediatric NP, Gerontological NP, Adult-Gerontology Primary Care NP, and the Women’s Health NP. Each of these fields is unique, and each has a diverse subset of knowledge. The primary care NP can practice in a variety of locations including long-term care, acute care, private practices, and community-centered offices. The Family NP is considered to be the broadest of the primary NP specialties, as it is comprised of adults, geriatrics, pediatrics, and women’s health. Based on graduation statistics gathered in 2012 from the American Association of Colleges of Nursing (AACN), 82% of NPs elected primary care fields as their education focus (Hamric, Hanson, Tracy, & O’Grady, 2014).

The educational requirement for advanced nursing practice is a master’s level education in a program or track leading to APN licensure, including graduate degree-granting and post-graduate certificate programs with established educational standards and attainment of the APN core, role core and population core competencies (National Council of State Boards, 2012). APN’s acquire increased knowledge in the sciences of anatomy, physiology, microbiology, chemistry, pathophysiology, and pharmacology. The core curriculum for the advanced practice role includes priorities in

As I began my doctoral education, I will defend my choice of pursuing my doctorate of nurse practitioner (DNP) degree by explaining the characteristics and traits a DNP must possess as well as the need for this profession within the community. There is a need for doctorarlly prepared nurses not only in the clinical setting but also within education as it is estimated that between 200-300 doctorarlly prepared nurses will retire annually therefore there is a demand for DNP nurses (Postal, 2013). Additionally the DNP program will help with the shortage of doctorial prepared nurses and will also help with the increasing complexity of healthcare and the need for more knowledge (White & Zaccagnini, 2017).

Although there is some personal satisfaction and financial gain to motivate nurses to pursue a higher level of education, the stressors of healthcare imposed by our society has pushed for the demand of higher educated nurse professionals (Bradley University, 2016). Increased costs of healthcare, increased complexity of disease treatment, decrease of physicians in primary care and the integration of new technology in providing care are essential factors that play a key role in how society is impacted and has ultimately affected the development of the NP role (Short, 2017). With such an increased need of NPs that has already taken precendence and as the societal factors only increase in demand, the need for NPs will be even greater in the future. According to the Bureau of Labor Statistics (2015), the need for advanced practice nurses (APN) will increase by 31 percent between 2014 and 2024, which is significantly faster than the average for other

Utilizing the medical model and philosophies of nursing allow the DNP graduate to contribute to the discipline of nursing through a more holistic approach. Carper stated that the profession should “define itself separate from the medical model” (Zander, 2018). Another viewpoint is that advanced practice nurses learn to acquire knowledge from many sources and the medical model is a small part of that learning (Zander). If you examine the two professions closely it has been stated that the advanced practice nurse begins with the human being and not the specific disease (Zaccagnini & White, 2017).) As leaders DNP graduates are prepared to effectively combine these methods to provide expert nursing care. As part of the holistic approach using