The Impact Of Nurse Practitioners

Critically ill patients that require mechanical ventilation are at risk of developing secondary infections that may increase length of stay and possibly even morbidity. This fragile patient population requires special attention and meticulous adherence to established nursing standards of care. These standards of care are founded on evidenced based practices. It is important that nurses receive education about why these standards are in place and what consequences can result due to not following the established care protocols.

It is no secret that communication is key when providing direct patient care in a skilled nursing facility. However, there is a noticeable lapse in the communication between the care team when providing care to the individual or groups of individuals. Two main parts of any care team are the registered nurse and the certified nursing assistant, as these are the two people whom have the most direct and impactful roles with residents in a skilled facility. The Registered Nurse and the Certified Nursing Assistant play similar roles in providing patient care, but have different roles in its entirety. The role of the Registered Nurse (RN) is defined as having the competency and skill to provide direct and indirect health care to individuals, their families, and communities around them. Services are also provided designed to give out medications, to promote comfort or healing, promote healing, and to also provide the dignity of their patients and patient’s families (American College of Rheumatology, 2015).

For the most part, hospitals are places where one comes for healing and it is place where our clients should feel safe and away from harm. Nurses have an important role as a patient advocate and are to provide all clients with safe, compassionate, and quality care at all times. Nonetheless, the hospital can also be a dangerous place for inpatients. It is a foreign environment to clients and there may be alterations in their medical condition in regards to their physical and/or mental status. With this said, there is a need to improve upon how we care for our clients, especially those who are at most risk for various incidents.

Healthcare workers in the United States work together to provide the best possible care for patients that come into their facility. Patients go through different waves of health care professionals before seeing an actual physician. Healthcare systems use a nurse practitioner, which is a registered nurse with more education and specialization, to help treat a patient in a timely manner. According to the American Academy of Nurse Practitioners, NPs have been providing care to patients for over 45 years. The year 2011 has seen 140,000 practicing nurse practitioners in the United States alone, with 9,000 more expected to enter the work force (American Academy of Nurse Practitioners a, 2010). With statistics demonstrating great expectations of

Budzi, Lurie, Singh, and Hooker (2010) state, “Nurse Practitioners’ (NP) interpersonal skills in patient teaching, counseling, and patient centered care contribute to positive health outcomes and patient satisfaction.” According to their research they encourage healthcare systems in the U.S. to hire more NPs to allow for better access affordable, and quality care (Denisco & Barker, 2016). With the demand for primary care providers, The NP role aids in delivering a solution to some of the healthcare issues that exist today. Organizations like the Institute of Medicine (IOM) and Centers for Medicare and Medicaid (CMS) all agree to allow nurses to practice to their full abilities to make healthcare more accessible and affordable, especially for the aging baby boomers and less accessible rural neighborhoods, and densely populated urban areas. Research has proven that NPs that provide primary care have similar health outcomes to primary care physicians (DeNisco et. al., 2016). NPs particularly take pride in their holistic approach, forming therapeutic relationships between other providers of the healthcare team, patients, and their families, aiding the informed decision making process, use of the evidence based practice approach in health management (Brown, 2005). Some of the other actions or qualities that

Fairley (2005) gives a consultant nurse’ perspective of a clinical role in critical care unit that has evolved as a central feature of all surgical high dependency units (SDHU) in large teaching hospital trusts. Advanced nursing practice is perceived not as the acquisition and application of technical procedures which are usually undertaken by doctors, but also an integration of medicine and nursing where holistic nursing assessment and symptom focused physical examination go hand in hand. Fairley presents a reflective account of practical problems encountered relating to role integration, professional autonomy, legal and consent issues, non-medical prescribing, and role evaluation (Fairley, 2005). The paper successfully describes a model of nursing applied to high dependency units integrating the role of the advanced nurse practitioner within the medical and clinical team an reflective practice plays an important role by being the main method of evaluation of a consultant nurse’ perspective. In a

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,

Healthcare delivery and management especially hospital care has changed dramatically over the years. In the past, the scope of Healthcare included physicians who diagnosed and treated disease. This scope left nurses and other providers out of place while they struggle to define their roles. This in fact, raises many questions. Is nursing dependent on what physicians wanted? Also, does nursing require other specialized knowledge and skill that is different from other healthcare providers? (Manson, Iscaacs, & Colby, 2011). These questions became difficult to answer especially when nursing is define without embracing the physical, emotional, psychological, and social needs which are critical to delivering supportive care.

Critically ill patients are at increased risk for pressure ulcers. Hospital -acquired Pressure ulcers are serious clinical complications and that can lead to increased length of stay, pain, infection and potentially death. Nurses have the primary role in the pressure ulcer prevention. The study assessed nurses’ perceptions of the usefulness and impact of a pressure ulcer prevention care bundle intervention on clinical practice. So it is imperative to understanding nurses’ assessments of interventions when interpreting results and translating evidence into practice.

The healthcare environment in America is rapidly changing as a result of improved scientific research, healthcare reform, and an enhanced focus on Evidence Based Practice (EBP) care. This has given rise to the need for a highly educated and expertly trained nursing workforce. Clinical nurse specialists (CNS), trained as advanced practice nurses, fulfill a vital need in nursing by providing expert clinical expertise to patients, families, and staff. CNSs are also committed to improving staff, patient, and hospital-wide outcomes.

Critical care nursing can be traced back to the battlefield and recovery room of the earlier decades and has evolved into the modern intensive care units today. The early 1950s through the 1990s is an era in which unpredicted and radical changes occurred in the care of all patients with the development and growth of intensive/critical care units in hospitals. The reasons for initiating these units was multi-factorial and complex; the factors included the acute shortage of civilian registered nurses (RNs) during and following World War II, innovative surgical procedures developed in caring for wounded servicemen that later carried

This article was a study that was to look at the effect of advanced practitioners (APs), that include physician assistants and nurse practitioners, in a trauma intensive care unit (ICU) on care processes and patient outcomes. Due to the tremendous shortage of the resident physician (RP) workforce, many resident programs are having a hard time maintaining patient safety and good quality of care. For this reason, APs have been recognized as a possible solution to remedy this problem. The study performed was to evaluate outcomes from using APs on patients admitted to ICU, looking at mortality rates for inpatient, length of stay in the ICU, and mechanical ventilation days. The study looked at each care process provided, and the clinical outcomes

Changes in the Health Care System and the Practice of Nursing have become complex. Technological changes, complicated client needs, short hospital length of stay, and departure from acute care to community based care, all these changes have underscore the need for professional nurses to think critically in order to provide safe and effective client care. A better educated nursing workforce can provide good health education to patients and their families. The affordable care of 2010 has required the need for nurses to expand their role of practice to meet complicated patient demands. This has prompted the Institute Of Medicine to review the “Future of Nursing, Leading change and Advancing Health”. {Creasia & Fribery,2011}

“The unique function of the nurse is to assist the individual, sick or well, in performance of those activities contributing to health or its recovery (or peaceful death) that he/she would perform unaided if he/she had the necessary strength, will or knowledge. And to do this in such a way as to help him/her gain independence as rapidly as possible (Virginia Henderson, 1961).”

This study proposal will take place in one acute care hospital. Registered Nurses working in the Emergency Room, Intensive Care Units, and all Medical-Surgical Units who voluntarily offer to be study participants will be included. In attempts to maintain external validity, exclusion criteria will include any Registered Nurse who has under 2 years of experience as a Registered Nurse and any RN who works on a Per-Diem basis. In addition, factors such as age, race/ethnicity, sex, education level, socioeconomic status, and the shift in which the voluntary participant works will not be considered. Within the specific units, all volunteers who meet eligibility criteria will be included in the study. Within each unit, subgroups will be formulated for the purpose of data collection.