The focus of the evidence in this literature review is to explore the need for and the development of APP preceptors to aid in new hire transition to practice, with a focus on CRNA preceptors. The review will begin broadly by presenting the evidence that supports the need for preceptor program development due to the common themes identified by novice APPs. Then, the need for preceptor development will be discussed. Finally, the review will conclude with current evidence that preceptor development is not only needed, but is effective in bridging the practice gap for novice APPs. Significant Studies A review of the literature was performed and yielded 26 articles relevant to precepting programs for novice nurses and advanced practice providers (APPs). For the sake of brevity, only the literature regarding novice APPs will be evaluated in this paper: six studies. Two had a date range exceeding 10 years, and were included in an attempt to fully explore the applicable literature. All of the articles reviewed can be found in Appendix A. The Johns Hopkins Evidenced-Based Practice Evidence Rating Scale was used to evaluate the literature (Newhouse, Dearholt, Poe, Pugh, & White, 2007). Of importance, in a review of over 300 articles, Billay and Myrick (2007) concluded that the preceptors’ greatest assets were their knowledge and experience. The authors also identified that for a preceptor model to succeed, a well-developed program was essential. As a literature review, this was
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)
Providing current Option care nurses opportunities to increase their skills in clinical teaching and become preceptors for residency nurses
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.
Advanced practice nurses have core competencies that are similar or are specific to each specialization defined as an advanced practice. The profession of nursing presents favorable circumstances for nurses to specialize in roles with distinct responsibilities and opportunities to contribute to the function of a health care industry with growing demands and complexity. The profession of nursing continues to debate to whom the title advanced practice nurse applies to. Examination of the core concept frame works described by nurse leaders and professional organizations tend to either support or refute the argument related to the use of the term, advanced practice nurse for nursing administrators and educators. For the purpose of this paper the author will explore the core competency similarities and differences of a nurse practitioner and a nurse educator. Nurse educators and nurse practitioners are registered nurses that possess advanced education, skills, and experience. Each specialty nurse has defined scopes of practice with distinct sets of responsibilities, requirements, and skills. Each role represents distinct educational requirements and activities that contribute to the complex and diverse health care industry.
The purpose of this assignment is that I will be reflecting on my own engagement in professional relationships and establish key skills that underpin lifelong learning. I will also be looking into how to perform evidence-based practice and reflect on my capabilities and weaknesses identified in my SWOT analysis (see appendix 1) and personal development plan (see appendix 2).
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,
Historically, the American Medical Association (AMA) has continuously contended the progression of nursing practice, in particular advanced nursing practice (Keeling & Bigbee, 2005). They have done so by opposing the advances of nursing practice claiming the broader and more specialized roles of advanced practice nurses (APNs), which includes diagnosing and prescribing, encroaches on physician practice and claim nurses are not educationally sufficiently prepared to take on these roles (Summers & Summers, 2007). The medical profession posits APNs should be supervised by physicians in their advance practice roles. Examples of such opposition are evident in for example AMA’s posting of a recent speech given by Nancy Nielsen (2009) stating
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
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).
Advanced Beginner is the next stage in Patricia Benner’s model. Nurses considered to be in this stage have had enough real life experiences to note different aspects of a situation. They base their assessments of patients on previous experiences similar to the current patient they are providing care for (Benner, 1984). Nurses performing at this
The role of the Advanced Practice Nurse (APN) is expanding internationally throughout the healthcare system. Since the initiation of the Patient Protection and Affordable Care Act in 2010, there has been an increased need for APNs due to the growing demand for primary care services and increased population that have gained healthcare coverage (Lanthrop & Hodnicki, 2014). The purpose of this paper is to explore the role of APN and develop a professional development plan for my future career.
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
In this report I will demonstrate my understanding of what is required to be an effective and
Clearly defining practitioner roles and responsibilities will enhance the positive elements and reduce ambiguity and misunderstandings (Paquette-Warren et al., 2004).
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