History and Role Development of Acute Care Nurse Practitioner
Throughout the twentieth century, several critical factors had facilitated the emergence and development of four distinct roles in advanced nursing practice. Joined forces of medicine and nursing leadership have attempted to address health care crises by creating expanded roles for nurses (Asubonteng, McCleary, & Munchus, 1995, p. 3). Striving to eliminate the disparity, fragmentation, and sub-optimal care, nursing academia sought to prepare future nursing workforce, who would be able to work in “an autonomous and collegial way with physicians” to improve the quality and accessibility of health care (Stanley, 2011, p. 20). Ongoing changes in the delivery of health care, such as
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431). However, in 1992, the American Nurse Association defined the new role among advanced nursing practice – acute care nurse practitioner, who would be providing care to acutely and critically ill patients (Stanley, p.127). The American Association of Critical-Care Nurses outlined the standards of clinical practice and professional performance for ACNP (Hamric, Henson, Tracy, & O’Grady, 2014, p. 432). However, the role ambiguity arose from the fact that the specific scope of practice for an acute care nurse practitioner is regulated by multiple agencies on various levels, such as national (professional organizations), state (government), local (health care institution), service-related and individual (Hamric, Henson, Tracy, & O’Grady, 2014, p. …show more content…
The core competencies of adult gerontology acute care nurse practitioner center around health promotion, health protection, disease prevention and treatment (AACN, 2012). Consequently, The National Organization of Nurse Practitioner Faculties (NONPF) endorsed the evolution of the Doctorate of Nursing Practice (DNP) as the entry level for nurse practitioner and expanded related professional competencies. As outlined in the Nurse Practitioner Core Competencies statement (2011), demonstration of the independent and interprofessional practice; analytic skills for evaluating and providing evidenced-based, patient-centered care across settings; and advanced knowledge of the health care delivery system are essential qualities delineating full scope of practice for NP as a licensed independent practitioner (NONPF, 2011,
Our healthcare system is ever evolving, remarkably changing the sphere of nursing practice. The roles of Advanced Nurse Practice practitioners are expanding, taking up a multitude of roles across a diversified healthcare specialties. Advance Nurse Practice practitioner stands as leader in this comprehensive profession bridging the gap in management and clinical aspect of care (McDermott & Morant, 2010), reflecting the complexity of culture, organization and practice setting (Hyrkas & Dende,2008) to improve the quality of patient care. This paper is about the interview with a Certified Nurse Practitioner. The Certified Nurse Practitioner interviewed is from the Hematology/Oncology Department in one of the university affiliated hospitals in Chicago. The purpose of the interview is to learn about the competencies needed to successfully perform the various roles of a Certified Nurse Practitioner in this complex health system. The rationale of the interview process is to give an opportunity as a graduate student to “assimilate primary care competencies into specialty nurse practitioner practice that exemplify professional value, scholarship, service, and culturally global awareness” (Chamberlain College of Nursing, 2014) that can be advantageous for my professional development. The interview showed the importance of knowledge of competencies appropriately applied in practice essential in the functions and roles of a Certified Nurse Practitioner within the scope of practice for
As an acute care nurse practitioner I hope to utilize my experience as an Intensive Care Unit nurse along with clinical knowledge and skills acquired through a graduate level program to provide the highest quality patient care. In my current role, I place high value on patient-family centered care and advocacy as well as commitment to lifelong learning. I have built my nursing career upon these values. I am excited to begin the journey of becoming an acute care nurse practitioner and to further my education and expand my scope of practice in the field of critical care, for which I have already developed a passion.
While uncertainty about the role of an Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP) persists, what research has found about the role is that AG-ACNP’s provide advanced nursing care to those who are acutely, critically or chronically ill in both traditional and nontraditional healthcare settings (Kleinpell et al., 2012). Standard of scope differs between all types of scopes and nurse practitioners alike. The scope of practice (SOP) for an Acute Care Nurse Practitioner (ACNP) is not based on practice setting, but rather what type of care the patient will need, for example, someone who needs ventilator management in either the home or hospital environment (Kleinpell et al., 2012).
The APRN Consensus Model was released in July of 2008 to define advanced practice registered nurse, identify the titles to be used by APRNs, and define specialty area of practice. The Consensus Model also describes population foci, suggests a process for recognition of new APRN roles, and recommends requirements for implementation (American Nurses Association [ANA], 2010). The APRN regulatory model helps uniform scope of practice of APRN across the United States, which benefit individual APRN, enhance patient outcomes, and improve the quality of care. Consensus Model consists of Licensure, Accreditation, Certification, and Education. The Education criteria in LACE Consensus Model relate to all APRN programs regardless of master’s or doctoral
This organization was designed to secure the services of prominent members of appropriate professions in the examination of policy matters relating to the health of the public. “The Institute acts to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education” (Institute of Medicine [IOM], 2010, p. 5) In October 2010, The IOM (Institute of Medicine) released the report, The Future of Nursing: Leading Change, Advancing Health. This report examines the changing roles of nursing in healthcare, changes in nursing education and
In the traditional health care model, formal learning is not complete when a physician receives their medical degree and white coat at the end of their academic program. Medical school graduates are required to complete an accredited hospital residency program to become licensed to practice medicine, (Jolly, Erikson, & Garrison, 2013). However, acute care nurse practitioners (ACNPs) are not afforded, nor expected to complete, the same educational requirements. The current expectation that a new graduate ACNP learn their advanced nursing role “on-the-job” is unacceptable and leads to decreased job satisfaction and preparedness. In the every-changing climate of health care, the development of required residency programs for ACNPs should be maintained as a priority.
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,
The report shows that the part of nursing must be expanded so that nurses are able to practice to the fullest degree of their education and training. Currently, advanced practice nurses (APRNs) work according to the scope of practice guidelines set forth by their individual state, meaning these highly educated nurses may not be working to the extent of their training but to the individual state laws. The report offers recommendations to streamline these idiosyncrasies and get rid of the red tape so that nurses can work in their appropriate manner and deliver safe quality care to some 32 million Americans who will before long gain access to health care services (American Association of Colleges of Nursing [AACN], 2012). The report correspondingly finds that nurses need to attain advanced levels of education and training through an enhanced education structure which encourages a cohesive academic progression as to safeguard the delivery of quality health care services. Patients are becoming progressively more complex and nurses need to attain the proper skills to care for these persons. Nursing education must embrace the continuous move towards a streamline approach to higher degree programs (Institute of Medicine [IOM], 2010, p. 2). Nurse residency programs
The Gerontology Primary Care Nurse Practitioner competencies entail a combination of acute gerontology and primary care. In order to gain entry into this field, there is need to meet the requirements for an adult-gerontology care nurse practitioner. The competencies of this field are based on the APRN along with NP core competencies. Their scope of practice is based on patient healthcare needs. Their healthcare obligations tend to reflect the work of a national Expert Panel that entails a host of adults related to gerontology and acute care (Geetter, et al., 2013).
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).
Hello Megan as you mentioned, Advanced Practice Nurses (APN) are prepared typically in master’s degree programs and especially the Nurse Practitioners (NP) are often team trained alongside medical students sharing the same course work, patient rounds and other onsite clinical experiences. The APNs have either a masters or doctoral degree or a certificate requiring up to two years of additional clinical training. After reviewing the studies conducted in 1986, the Congressional Office of Technology Assessment (OTA) concluded that the quality of care provided by the NPs and physicians was equivalent for comparable services, based on the weight of evidence for both process measures and actual outcomes. These studies also found that quality of care
The American Association of Critical Care Nurses (AACN) is the world’s largest specialty nursing organization (“American Association of Critical Care Nurses,” n.d.). There are more than 100,000 practicing nurses that are members of the AACN (“American Association of Critical Care Nurses,” n.d.). The purpose of the AACN is to provide expert knowledge to critical care nurses to create a healthcare system that is driven by the needs of patients and their families (“American Association of Critical Care Nurses,” n.d.). Their mission is to promote and enhance consumer health and safety by establishing and maintaining high standards of professional practice (“American Association of Critical Care Nurses,” n.d.). The headquarters for the organization
Nurse practitioners provide an answer to many of the problems affecting healthcare today (DeNisco & Barker, 2016). For years nurse practitioners have provided cost effective quality care to the public, now with the recent changes in healthcare reform nurse practitioners are in even greater demand. Despite research citing their value, the role of the nurse practitioner must be clarified. To meet and support the growing demands of the health care system, an understanding of the nurse practitioner role is important. DeNisco & Barker state, “Advance Nurse Practitioners are licensed
The term scope of practice is used to illustrate the legal authority that is conferred upon a professional to provide health services and be reimbursed for providing such services (Hamric, Hanson, Tracy, &, O’Grady, 2014). The scope of practice for the advanced practice nurse illustrates the requirements and responsibilities that accompany the position. The scope of practice nurse provides regulations and guidelines for the advanced practice nurse to ensure that they maintain professionalism and conform to ethical standards whenever they provide services. The APN practice is founded in scientific evidence and entails many aspects that foster the enhancement of the nursing practice such as health education, research, mentorship, and leadership. Just like laws, the APN scope of practice is closely knitted to state and national statuses, and, therefore, it varies from country to country and from state to state.