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).
Those advanced practice nurses who hold a CTP may prescribe medications according to the Ohio Board of Nursing Formulary and as established by the Committee on Prescriptive Governance (CPG) (Napp, 2012). Since enactment, the CPG has met on several occasions to modify the formulary for schedule II drugs to pre...
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Cipher, D. J., Hooker, R. S. and Guerra, P. (2006). Prescribing trends by nurse practitioners and physician assistants in the United States. Journal of the American Academy of Nurse Practitioners, 18, 291–296.
IOM (Institute of Medicine). (2011). The future of nursing: leading change, advancing health. Washington, DC: The National Academies Press.
King, Martha. (2011). The affordable care act: a brief summary. Retrieved from http://www.ncsl.org/portals/1/documents/health/hraca.pdf
Napp, Carol. (2012). Am. sub. sb 83: Final analysis. Ohio Legislative Service Commission. Retrieved from http://www.nursing.ohio.gov/PDFS/AdvPractice/SB83_Analysis.pdf
Ross, J. (2012). Nurse prescribing in the USA: a nurse prescribing practice report. Nurse Prescribing, 10(2), 91-99.
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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 IOM report had four key messages needed for advancing the future of nursing. “Nurses should practice to the full extent of their education and training; achieve higher levels of education and training through an improved education system that promotes seamless academic progression; be full partners, with physicians and other health care professionals, …and; effective workforce planning and policy making require better data collection and an improved information infrastructure” (Institute of Medicine, 2011). The report also included eight recommendations needed to facilitate the necessary changes to in the nursing profession so meet to demands of the healthcare reform.
My plans after obtaining my advanced degree is to acquire licensure to practice as AGNP in the state of Texas. The Texas BON acknowledges that APN education, experiences, and competency levels vary, hence, holds individual APN accountable for knowing and practicing within their own scope of practice and competency always. The APN’s education is the grounds to their scope of practice: however, the APN can expand the scope of practice within the role and population-focus, as long as it remains within limits of the law. The Texas BON restricts the scope of practice for the APNs. The Nurse Practitioner Supervision Laws require¬¬¬¬¬ APN to work under physician supervision within seventy five mile perimeter. In addition, there is the Texas ' Nurse Practitioner Prescribing Laws which require APNs to prescribe medications under physician supervision and APNs are not allowed to prescribe schedule two drugs. All prescriptions written by the NPs must include the supervising physician 's name, address, Drug Enforcement Administration (DEA) number and phone number (Texas BON,
The medical field is among the largest and ever growing career fields, especially when dealing with Physician Assistants (PAs) and Nurse Practitioners (NPs). In the 1960’s when the physician shortage began, the medical field created the PA and NP positions to fill in the gaps (Curren, 2007, p. 404). This matter has opened up numerous questions as more and more PAs and NPs begin practicing, especially concerning their education level. Many patients are concerned that they will not get the proper care. PAs/NPs are beneficial to everyday life by providing patients with the necessary skills needed to successfully treat them.
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
Overall, I retain three goals for this clinical day: Safely and efficently administer medication, enhance my nursing/CNA skills, and determine how to implement infection control into a health care setting. This week reflects my assigned time to administer medication in a health care setting for the first time, with a resident who retains nearly twenty medications. I except this experience will be a great learning experience, but it will also subsist slightly stressful. With the assistance of my FOR, my goal is to administer all of my resident 's medications without complications. To ensure that medication safety, I will perform the six medication rights and three checks prior to administration. Along with medication administration, a goal
The 2010 Institute of Medicine (IOM) Report- The Future of Nursing described the role that nurses have in the current and future US health care environment (IOM, 2011). This report was completed at a time when the Affordable Care Act had been passed and a new emphasis was being put on interdisciplinary healthcare teams, care coordination, value-based payment systems, and preventative care (IOM, 2011). Nursing is the largest profession in health care and with an aging baby boomer populace, the expanded role of nurses will be critical in meeting the growing healthcare burdens (Sisko et al., 2014).
Currently, through observations and clinical experience on Med/Surg at Cary Medical Center, medication is administered by the nurse. Nurses are responsible and accountable for administrating medications to patients. Patient medication education is conducted by the nurse. Medication education includes informing the patient the reason for the medication, when and how long to take the medication, drug interactions, and importance of checking with primary care provider prior to taking any over-the-counter or herbal products. If the nurse is unfamiliar with a certain medication, a drug book is available for the nurse to utilize and gain knowledge regarding the drug use, action, adverse reaction, and contraindications.
Every day there is a constant trust adhered to many different people in the profession of Nursing—the decision of what will help patients in terms of medicine, and the confidence to make these decisions. One false act or one slight misdiagnoses of medication to a patient could be the prime factor in whether the patient lives or dies. Nurses in hospitals across the country are spread thin, and thus makes the probability of mistakes higher. If a medicinal dose is off by even one decimal a patient could die, so the only real answer is for nurses to not be afraid to ask for assistance, always follow procedure and voice opinion is they feel something is wrong.
The Institute of Medicine has released a report that discusses the future in nursing. The IOM has developed four key messages that outline the barriers that need to be overcome, so that nurses can work effectively and to their fullest ability.
The American Nurses Association (2008) has defined the FNP, under the broader title of Advanced Practice Registered Nurse (APRN), as one “who is educationally prepared to assume responsibility and accountability for health promotion and/or maintenance as well as the assessment, diagnosis, and management of patient problems, which includes the use and prescription of pharmacologic and non-pharmacologic i...
When nurses with untreated, active dependency are providing care, the practice of the nurse is impaired and can negatively affect patient safety (Kunyk & Austin, 2012). If the drugs are acquired from the hospital or workplace, patients may suffer by being under-medicated. Nurses are required to address threats that occur in the del...