Consensus Model Currently, there are multiple challenges to the US healthcare system like the nation’s aging population and the staggering reports of alarming rates of increase in chronic diseases in both pediatrics and adults (Stanley, 2012). While the need for more healthcare providers who can take care of these populations increases, a study by Peterson et al. (2012) states that there is a foreseen shortage primary care physician due to new physicians opting to specialize. Coincidentally, the availability of Advanced Practice Registered Nurses (APRNs) has been increasing throughout the years. APRNs, specifically Nurse Practitioners (NPs) and Clinical Nurse Specialists (CNSs), can fill in the shortage of primary care providers (Stanley, 2012). …show more content…
In a study done by Traczynski and Udalova (2013), it was found that increasing the practice independence of NPs leads to a better healthcare utilization and improved patient outcomes. In a different study done by Oliver, Pennington, Revelle, and Rantz (2014), they found that any levels of restrictions to NP practice negatively affects state health outcomes. Correlating these two independent studies, it is determined that restrictions to NP practice adversely affects healthcare outcomes, which in turn increases unnecessary health care costs (Hain & Fleck, 2014). Moreover, according to Traczynski and Udalova (2013), allowing APRNs to practice with full independence upsurges medical care availability to underserved populations and it also decreases the inappropriate emergency department utilization. Based on this statement, restricting one or more of the APRN functions will greatly affect healthcare access and healthcare …show more content…
Consequently, combined efforts of various nursing organizations resulted to a Consensus Model for APRN Regulation. The Consensus Model is a national effort to guarantee uniformity in APRN education and practice (Kendig, 2014). The Consensus Model outlines the structure for a consistent regulation of APRN practice in all states (Kendig, 2014). The state of Georgia (GA) has completed the process of statutory or regulatory modifications following the APRN Consensus Model (Phillips,
Association, A. N. (2010). Nursing Scope and Standards of Practice. (2nd ed.) Maryland: American Nurses Association. Retrieved January 20, 2014 from http://media.wix.com/ugd/8c99f2_4fde86431966e34f2e03bbb137edfee3.pdf
I now that I have the knowledge to aspire to take up my role within one of the identified population foci. APRNs program developed my core competencies by allowing me to be more efficient adaptability with regards to newly emerging APRN roles or population focus. Furthermore, achieving my course objectives enable me to understand the specific APRN roles. For example, course objectives provide me with a better detail, and align my licensure goals with the responsibilities expected of each role. Licensure will provide me and my fellow APRN graduates with the full authority to practice. Also, certification is required to meet the highest possible standards as APRNs are expected to align knowledge, skills and experience with the standards of health care professionals. This field has very narrow margins for error, and it is therefore important, for APRNs to meet the highest and most stringent academic qualifications. In order to be a recognized as APRN graduate, one is required to complete formal education with a graduate degree or post-graduate certificate awarded by an academic institute and accredited by a recognized accrediting agency empowered by the relevant government education
Nurses and physicians need to become partners in health care reform. We have a responsibility to provide competent care to our patients. National standards need to be put in place to decrease the inconsistencies in APN practice. Overwhelming data supports the APN over the physician in cost effectiveness, quality and access to care and many other aspects.
In fact, there have been numerous studies supporting the clinical performance and outcomes of NPs. A systematic review covering the literature from 1990-2008 found that patient outcomes of care provided by APRNs in collaboration with physicians were similar to and in some manners, exceeded those of physicians alone (Newhouse et al., 2011) Newhouse, et al’s review added to the available evidence that APRNs provide safe, effective, quality care to specific populations (2011). In their review, they did not separate outcomes of NPs with full practice authority from those with reduced or restricted practice. Due to the patchwork of state regulation and restrictions on NP practice, it may be challenging to compare the outcomes of NPs with full independent practice from those with reduced or restricted practice. Furthermore, the AANP states “there are numerous studies that demonstrate nurse practitioners consistently provided high-quality and safe care” (n.d.). They go on to state “in the more than 100 studies on care provided by both nurse practitioners and physicians, not a single study has found that nurse practitioners provide inferior services” (AANP, n.d.). The Federal Trade Commission (FTC) has also reviewed the literature and determined there is not a significant difference in the outcome of NPs and physicians that would necessitate the anti-competitive nature of scope-of-practice regulations and restrictions on advanced practice nursing (Federal Trade Commission [FTC],
Access to quality healthcare is a growing concern in the United States especially in light of healthcare reform coverage expansions made possible by the Patient Protection and Affordable Care Act of 2010. It is estimated that 94% of all Americans will acquire healthcare coverage under the law, an increase of nearly 30 million people (King, 2011). This dramatic influx of patients into the healthcare system has projected to cause an immediate increase in added pressure on an already challenged healthcare workforce (King, 2011). Notably, at a time when healthcare demands are growing, graduate rates from medical schools remain unchanged while advanced practice registered nurse (APRN) graduate rates are rising (Cipher, Hooker, Guerra, 2006). The increased availability of APRNs, along with enhanced delivery of healthcare skills, gives the role a unique advantage in the current state of healthcare. These specialized advanced practice nurses provide services often at a patient’s first (and in some cases, primary) point of contact into the healthcare system (Brassard, 2013). Due to this, many states have started to take action to mitigate the increased healthcare system burden by enhancing the APRN’s scope of practice by broadening prescriptive authority. This has been shown to be one of the fundamental ethical avenues of increasing not only access to healthcare, but also efficiency and quality of care (Ross, 2012).
Most APNs or NPs posses a master’s degree; however the American Association of Colleges of Nursing (AACN) member institutions voted to change the current level of preparation for advanced nursing practice from a masters degree to a doctorate level by 2015”. “An individual who wished to apply for a license must meet the following requirements; a complete application, pass the NCLEX, provide any felony or misdemeanor conviction information, any drug related behavior, functional ability deficit and license fee to Virginia State Board of Nursing”. Most RNs gain their clinical experience by working a staff nurse before entering into a graduate program for their nurse practitioners, but once they gain a significant of experience as a nurse t...
Yee, T., Bokus, E., Cross, D., & Samuel, D. (2013). Primary care workforce shortages: nurse practitioner scope-of-practice laws and payment policies. National Institute for Health Care Reform, 13, 1-7.
It is no secret that the current healthcare reformation is a contentious matter that promises to transform the way Americans view an already complex healthcare system. The newly insured population is expected to increase by an estimated 32 million while facing an expected shortage of up to 44,000 primary care physicians within the next 12 years (Doherty, 2010). Amidst these already overwhelming challenges, healthcare systems are becoming increasingly scrutinized to identify a way to improve cost containment and patient access (Curits & Netten, 2007). “Growing awareness of the importance of health promotion and disease prevention, the increased complexity of community-based care, and the need to use scarce human healthcare resources, especially family physicians, far more efficiently and effectively, have resulted in increased emphasis on primary healthcare renewal…” (Bailey, Jones & Way, 2006, p. 381). The key to a successful healthcare reformation is interdisciplinary collaboration between Family Nurse Practitioners (FNPs) and physicians. The purpose of this paper is to review the established role of the FNP, appreciate the anticipated paradigm shift in healthcare between FNPs and primary care physicians, and recognize the potential associated benefits and complications that may ensue.
Considering this problem, I would propose to introduce a new policy to establish independent practice authority for APRNs in Texas in accordance with the educational preparation to meet the health care needs of Texas’ population and reduce primary care shortage.
In the United States, depending upon the state in which they work, nurse practitioners may or may not be required to practice under the supervision of a physician, frequently referred to as a “collaborative practice agreement”. However, in consideration of the shortage of primary care/internal medicine physicians, many states are eliminating or lessening the restrictive authority which allows and nurse practitioners the ability to function more autonomously (AANP 2015).
The American Nurses Association (ANA) developed a foundation for which all nurses are expected to perform their basic duties in order to meet the needs of the society we serve. The ANA “has long been instrumental in the development of three foundational documents for professional nursing; its code of ethics, its scope and standards of practice, ands statement of social policy.” (ANA, 2010, p. 87) The ANA defined nursing as “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations” and used to create the scope and standards of nursing practice. (ANA, 2010, p. 1) These “outline the steps that nurses must take to meet client healthcare needs.” () The nursing process, for example, is one of the things I use daily. Other examples include communicating and collaborating with my patient, their families, and my peers, and being a lifelong learner. I continually research new diagnoses, medications, and treatments for my patients. As a nurse of ...
There are less medical students electing to enter primary care; therefore, it is predicted that there will be a scarce amount of family medicine physicians available. Recent evidence indicates productivity and quality of care are enhanced when PAs and NPs are added to the primary care collaborative team. Increasing the role of PAs and NPs could be a great approach for addressing the growing need for primary care providers as coverage expands under the ACA. A greater framework of PAs and NPs would expand access to care and reduce over-utilization of costly emergency services. Overall, PAs and NPs are advantageous in the provision of primary care services through interchangeable roles, efficiency, and reimbursement (Hooker and Muchow, 2015).
There has been a drastic cut in both the Medicare and Medicaid reimbursement rates. According to Robert (2012), “cuts of more than $360 billion to Medicare and Medicaid will be made over the next 10 years. The focus of nursing needs to emphasize more on wellness care and prevention rather than acute care” (McNeal, G., 2012). Nursing practice will need to shift more towards community and population focused nursing. Baccalaureate prepared nurses are provided with a curriculum that includes both community health and leadership skills that are not included in the associate program. By encouraging associate’s degree nurses to obtain a bachelor’s degree in nursing, an increase in the awareness of the needs of the community and population may be seen. The IOM report has outlined the anticipated obstacles that healthcare will face if changes are not made. By allowing nurses to provide care within their full scope of practice, quality care may be provided at an affordable cost to the population. The use of advanced practice nurses in primary care may provide quality, access, and cost efficient healthcare to high-risk populations and possibly decrease hospital admission rates, thus lowering the overall cost of healthcare. If nurses partner with doctors and other healthcare providers, it may improve healthcare by providing seamless transitions (Institute of Medicine,
Chronic Obstructive Pulmonary Disease (COPD) is a chronic lung disease that includes many different chronic lung conditions, such as chronic bronchitis, emphysema and asthma (Hodson & Sherrington, 2014). COPD is a leading cause of emergency hospitalization in the United States and European countries. The most common causes of COPD are tobacco, environmental factors, occupation exposures and genetics (Hodson & Sherrington, 2014). For some patients COPD can add difficulties and hinder their everyday activities. Patients with COPD have many stages of medical and social healthcare needs. This makes it difficult for health care providers to manage their symptoms (Hodson & Sherrington, 2014). Throughout this paper I will be discussing the pathophysiology practice management, and the population health as it pertains to COPD. I will also be examining the Dorothy Orem theory and the scope and role of an Advance
The nursing profession that has a workforce of over three million registered nurses is the backbone of the United States of America’s healthcare system that efficiently responds to the nations’ health needs. However, the nursing fraternity faces a number of challenges that make it strenuous for it to meet the present and future needs of the health care sector. Shortage in the number of nurses, a fewer number of experienced nurses in terms of advancing education as well as technological change pose a great danger for the future of nursing and the healthcare sector as a whole. Thus, these challenges have to be solved so as to ensure a reliable, stable and competent nursing workforce functioning at all levels of health