Nursing Promotion
Errors
The advanced practice nurse (APN) will join a workforce with many other health professionals. Educated and trained, the APN will contribute to current practice and that includes safety measures to prevent patient harm, and provide more effective work that is financially more soluble. The Institute of Medicine has developed six aims for nursing, and eight recommendations to assist nursing in reducing errors, and providing more educated quality care. These aims also pave the way for the future nursing work force.
Safety
This is a dual-purpose aim, as medical practice is supposed to be safe for the practitioner and patient both. Safety in regard to the patient is the ability to not be accidentally harmed while receiving
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Each patient should experience the shortest wait possible for care with prompt sharing of test results. The inability to effectively manage time throughout the care experience reflects poorly on the one providing care, be it an individual or an institution. Timeliness also involves spending an appropriate amount of time with the patient (Institute of Medicine, 2001). The balance of time is difficult to spite current practices, and the APN will continue to face critique based on the timeliness of care.
Efficiency
Efficiency is also a part of timeliness, but is singular as well. Economically, the health care system needs to provide as much product or service for time or resources spent. Efficiency in the grand scheme means reducing waste, and reducing production costs. It is noted that some quality improvements do not result in fewer resources used, and can be applied to effectiveness in decreasing overuse (Institute of Medicine, 2001). The APN will be responsible for efficiency now and in the future.
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These recommendations promote the function to the broadest scope of nursing as a profession in practice. This is in response to the fact that nursing has a larger role, and more demanding role in healthcare.
Remove Barriers The role of the advance practice nurse is called to expand, and envelope practice to the fullest extent. It is recommended, by the IOM, that services provided by APNs be fully reimbursed under Medicare. While some APNs have greater freedom in practice with pay equal to the work they do (IOM, 2011). This will affect all areas of advance practice, and provide a more knowledgeable group of greater numbers.
Expanded Opportunities, Nurse Residency Advance practice nurses should have collaborative relationships in research with physicians and other health professionals. This relationship, while providing care, will be mutually beneficial and promote best practice through research efforts. This is also a call for health care organizations to provide support to APNs wanting to implement newer care models and
Nurse practitioners (NPs), one type of advanced practice nurses, are licensed by the states where they practice and certified by private boards. Nurse practitioners hold advanced degrees in clinical practice and function in a wide variety of settings and across the life span. They provide a broad array of healthcare services ranging from managing treatment plans, to prescribing medications, to implementing health promotion services. As of 2014, 205,000 NPs were licensed in the United States with 86% of those prepared to deliver care to patients in primary care settings (NP Facts, 2015). The progression of the Nurse Practitioner movement that occurred in the 1960 and 1970s emerged as a creative and
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.
The model discusses the impact of new regulations on education for APRN, Licensure Accreditation, Certification & Education Document, certification and practice. The model is implemented to grasp the general understanding and definition of advance practice registered nurse APRN role, inconsistencies with state by state recognition of APRN roles, and determining eligibility for APRN licensure (Consensus Model for APRN Regulation, 2015). The consensus model definition of APRN is a nurse who is educationally rounded to assume the responsibility of assessing, diagnosis, treating, teaching health promotion and disease maintenance, acquired advanced clinical knowledge and skills to provide direct patient care, has passed a national certification examination, and licensed to practice in one of the four roles (Consensus Model for APRN Regulation, 2015).
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],
The Affordable Care Act (ACA) was passed in 2010 with the goal of expanding healthcare coverage to all Americans by reforming insurance policies and practices (Tillett, 2011). The ACA upsurges the demand for an increase in primary care providers in order to supply quality care to the much larger population that will have coverage and therefore acquiring healthcare. The Institute of Medicine (IOM) through its report The Future of Nursing: Leading Change, Advancing Health has generated a solution to the shortage of primary care providers by promoting a transformation of the nursing profession to fill the gap.
In fact, Researchers had shown the results of outcomes having different degrees of level. According to AACN, Today 61% Nurses in the United States have a BSN degree who works in health settings. In fact, BSN nurses reduce death rate mortality, and readmission rate by using clinical practice knowledge (AACN) . Having advance level of knowledge involves nurses to manage the patient level of care and monitor for progress. American Organization of Nurses Executives states that nurses who have a higher education level promotes safe nursing care and improves patient safety. Higher educational nurses prepare herself for clinical challenging and complex roles (AACN, page 1). They develop more ideas, better intervention, and focus more on clinical
Nursing is a knowledge-based profession within the health care sector that focuses on the overall care of individuals. According to The American College of Nurse Practitioners (ACNP), “defines nurse practitioners as registered nursed who have received graduate-leveling nursing education and clinical training, which enables them to provide a wide range of preventative and acute health care services to individuals of all ages. They deliver high-quality, cost effective care, often performing physical examinations, ordering tests, making diagnoses, and prescribing and managing medication and therapies”. Nurse Practitioners are able to specialize in a particular area, such as family and adult practice, pediatrics, and women’s health; and refer patients to other specialist when necessary. Some Nurse practitioners work under the supervision of a physician; while others run their own practices.
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 ...
Healthcare is a continuous emerging industry across the world. With our ever changing life styles and the increased levels of pollution across the world more and more people are suffering from various health issues. Nursing is an extremely diverse profession and among the highest educated with several levels ranging from a licensed practical nurse (LPN) to a registered nurse (RN) on up to a Doctorate in Nursing. Diane Viens (2003) states that ‘The NP is a critical member of the workforce to assume the leadership roles within practice, education, research, health systems, and health policy’.
As an advanced practice nurse (APN), one must interact with other medical professionals cooperatively and collaboratively to ensure the best outcomes for his or her patient population. Interprofessional collaboration happens when providers, patients, families, and communities work together to produce optimal patient outcomes (Interprofessional Education Collaborative Expert Panel, 2011). This type of teamwork and cooperation ensures that all of the providers caring for a patient act in a cohesive manner in which everyone including the patient plays a role in the management of the individual’s health. The purpose of this discussion is to evaluate interprofessional practice and provide the view of a
Advanced Practice nursing (APN) is considered the usage of a broader scope of constructive, logical and research-based expertise related to the health and well-being of patients, within a varying disciplines (DeNisco & Barker, 2013). What is the future position of APNs in the progression of our healthcare system? What role will this writer assume, educator, practitioner, population health coach, or all three? The use of theory, primarily Sister Callista Roy’s Adaptation Model, and EBP give this writer a firm foundation to develop and modify her own practice framework.
Advanced practice nursing roles are expanding throughout the world, including here in the United States (U.S.) (http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-19-2014/No2-May-2014/Advanced-Nursing-Practice-Worldwide.html). While the scope of practice for these advance practice nurses varies between the states greatly (https://www.aanp.org/legislation-regulation/state-legislation/state-practice-environment). There is a push for full practice authority across the U.S. by nurse practitioners (https://www.aanp.org/images/documents/policy-toolbox/fullpracticeauthority.pdf). The American Nurses Association (ANA) and the American Association of Nurse Practitioners (AANP) are resources that are
The passing of the Affordable Health Care Act bill on March 23, 2010 places Nurse Practitioners (NPs) at the forefront of health care reform, with the opportunity to be creative and innovative. I envision primary care, preventive care, case management, nurse leaders and educators as critical components of the health care reform. The healthcare reform bill has included provisions through grants for advanced practice, general nurse education and innovative nurse-manage health clinics. This incentive for Nurse Practitioners is timely as the role of Advance practice registered nurse (APRN) continues to evolve. It is a wonderful opportunity as I ...
To begin with, efficiency, with the aim of maintaining time for doctors to take care of patients. Efficiency is the optimum method for getting from one point to another. For general out-patient clinics, making an appointment is necessary before you get a consultant. Doctors only spend around a few minutes consulting with a patient, and one case at a time in order to manage large number of patients who were waiting. In addition, there is an accident and emergency service provided for the public.
Several years ago in 2008 the RWJF and the IOM collaborated for two years to discern the future needs of the nursing profession. Most importantly, the objective was to outline the critical actions needed to ensure nursing was ready to seamlessly move towards the future. This was no easy task as nurses work in such diverse settings such as outpatient areas, acute care settings, the community, and long term settings to name a few. Couple this with the fact that nurses have a variety of educational avenues such as the associates, diploma, or bachelor’s degree open to them to achieve the status of registered nurse (Institute of Medicine, 2010). All of this considered, the committee did design four key messages regarding the future of nursing as key in the transformation of health care as evidenced in their "Future of Nursing" report.