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Nov 24, 2024
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Karen Lanpher
YesterdayNov 1 at 9:59pm
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Watching the video Sick Around the World (Brabantstraat, 2017), opened my eyes to
the much improved healthcare systems that other countries have. Improved
healthcare does not equal free of problems. Even some of the most advanced
healthcare systems still face challenges such as financial deficits that the country is
not able to pay for and falling into debt due to being unable to pay for the expenses
for the healthcare of the population. One thing that can be done, and is starting to
happen on a global scale is the task-shifting from physicians to nurses. In Europe,
this has started for multiple reasons including physician shortage, limited access to
or quality of care, long waiting times, and high costs (Maier, 2015). Making the task
switch from physicians to APRNs can positively improve the global healthcare
system. NPs increased patient satisfaction, increased the length of consultation, and
performed more investigations than GPs, and no differences were found in health
outcomes or prescriptions( Fagerstrom, 2012). Having such positive patient
outcomes with a decrease in healthcare costs that the nurse practitioner represents
in comparison with physicians can help reduce the cost and improve healthcare
globally. Removing barriers to the full scope of practice for Nurse Practitioners( and
Physician Assistants) was estimated to save the U.S. healthcare system between 0.3
and 0.5% of national health spending(Maier, 2015). I agree with removing the
barriers for APRNs to practice to the full extent of their education. However,
regulations need to be in place for adequate control and to ensure patient safety.
Regulation was identified as a potential barrier if of a restrictive nature or an enabler
to advance practice if up-to-date with educational competencies (Maier, 2015).
APRNs need to have an obligation of a certain level of education, expertise, and
continued education to provide safe care.
There has been significant global interest and development of the NP role,
especially within high
‐
income countries, for example, North America, Europe, the
Caribbean, Australia, and New Zealand(Rosa et al., 2020). However much work still
needs to be done in lower-income countries about the under-utilization of
nurses. The readings or the video did not mention South America. I find myself
having to give long explanations to my family in Colombia about what I am going to
school for. The term "advanced practice nursing" is not well recognized in Latin
America and the APN is a relatively new role in the region( Zug et al., 2016). Having
lived in Colombia and seeing how much of a deficit the healthcare system has for the
population, the country will certainly benefit from nurse practitioners providing care
to the patients.
Brabantstraat. (2017).
PBS Frontline: Sick Around the World
[Video]. YouTube.
https://www.youtube.com/watch?v=h4rg-DJBd34&feature=emb_logo
Fagerström, L. (2012).
The impact of advanced practice nursing in healthcare:
Recipe for developing countries
. Annals of Neurosciences, 19(1), 1–2.
https://doi.org/10.5214/ans.0972.7531.180401
Maier, C. (2015). The role of governance in implementing task-shifting from
physicians to nurses in advanced roles in Europe, U.S., Canada, New Zealand and
Australia.
Health Policy, 119(12), 1627–
1635.
http://dx.doi.org/10.1016/j.healthpol.2015.09.002
Rosa, W. E., Fitzgerald, M., Davis, S., Farley, J. E., Khanyola, J., Kwong, J.,
Moreland, P. J., Rogers, M., Sibanda, B., & Turale, S. (2020). Leveraging nurse
practitioner capacities to achieve global health for all: COVID
‐
19 and
beyond.
International Nursing Review
,
67
(4), 554-559.
https://doi.org/10.1111/inr.12632
Zug, K. E., Cassiani, S. H., Pulcini, J., Garcia, A. B., Aguirre-Boza, F., & Park, J.
(2016). Advanced practice nursing in Latin America and the Caribbean: regulation,
education and practice.
Revista latino-americana de enfermagem
,
24
, e2807.
https://doi.org/10.1590/1518-8345.1615.2807
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Owen Kiernan
Owen Kiernan
YesterdayNov 1 at 10:16pm
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In a world with a rapidly increasing aging mean population, accommodating ratios of
healthcare providers are a necessity to ensure patients receive their deserved high-
quality care. Across the world we are seeing task-shifting from physicians to nurses
being implemented in an increasing number of countries (Maier, 2015). The broad
advantage of implementing APRNs into healthcare globally means more providers of
healthcare. More providers equate to less wait times and improved patient outcomes.
APRNs specifically are trained to incorporate a holistic approach to care provided,
and their further utilization will increase the quality of healthcare on a global scale.
Specifically, regarding the United States, there has been a push over recent years
legislatively to give APRNs more autonomy. The United States healthcare system
currently faces an economic and quality crisis due to an aging population and more
patients living with chronic diseases needing timely access to high quality care
(Schirle et al, 2020). This was seen most significantly with the introduction of the
ICAN act in July of this year. According to the AANP, “… NPs are the fastest-growing
Medicare provider group, and approximately 40% of Medicare beneficiaries receive
NP-delivered care. The ICAN Act would improve timely access to care by authorizing
NPs to order cardiac and pulmonary rehabilitation, certify when patients with
diabetes need therapeutic shoes, have their patients fully included in the beneficiary
attribution process for the Medicare Shared Savings Program … and more” (
AANP
Applauds Senate Introduction of ICAN Act
, 2023). This national recognition of NP
autonomy will play a large role in reducing the strain of needed physicians and
provide Americans further access to quality healthcare providers.
APRNs scope of practice is most significantly impacted through state legislation and
organizational limitations. Most importantly, APRN autonomy is dictated by state
legislation. Depending on where you are in the United States dictates whether an
APRN can assess, diagnose, and treat you with or without physician oversight.
Currently, Rhode Island allows APRNs full autonomy of practice. Also, at an
organizational level, certain policies can inhibit APRN autonomy. In particular, the
inability to prescribe, admit patients to facilities, and the need for physician co-
signatures constituted barriers to APRN practice (Shirle et al, 2020). Further
advocacy for APRN autonomy both on a state and organizational level will ensure
individuals receive the quality healthcare they need and deserve from APRNs.
References:
AANP Applauds Senate Introduction of ICAN Act
. (2023, July 20). American
Association of Nurse Practitioners.
https://www.aanp.org/news-feed/aanp-applauds-
senate-introduction-of-ican-act-2
Links to an external site.
Maier, C. (2015). The role of governance in implementing task-shifting from
physicians to nurses in advanced roles in Europe, U.S., Canada, New Zealand and
Australia.
Health Policy, 119(12), 1627–
1635.
http://dx.doi.org/10.1016/j.healthpol.2015.09.002
Links to an external site.
Schirle, L., Norful, A. A., Rudner, N., & Poghosyan, L. (2020). Organizational
facilitators and barriers to optimal APRN practice: An integrative review.
Health care
management review
,
45
(4), 311–320.
https://doi.org/10.1097/HMR.0000000000000229
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