Advanced Practice Nursing Theory

The American Association of Colleges for Nurses [AACN], (2006) in 'The Essentials of Doctoral Education for Advanced Nursing Practice ' Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking, affirms "advanced nursing practice (APN) includes an organizational and systems leadership component that emphasizes practice, ongoing improvement of health outcomes, and ensuring patient safety. APNs should be prepared with sophisticated expertise in assessing organizations, identifying systems’ issues, and facilitating organization-wide changes in practice delivery". (p.10) Hameric, Hanson, and Tracy ( 2014) indicates that APN must assess the clinical microsystems in which they perform nursing practices, have knowledge of the medical organizations that impact their specialties, assist with establishing patient centered care reforms to enhance quality of nursing care, improve patient safety, and provide nursing indicators that evaluates nursing performance. (p.266) APNs perform leadership capabilities in four chief areas including clinical practice settings, in the nursing career, within organizations, and in healthcare politics at regional and national levels. (Hameric et al, 2014, p. 266)

I am currently employed in the Veteran’s Affairs Loma Linda HCS in the Emergency Department. Our target population are adults, mainly male, with multiple on-going health conditions. In our ED, we see a huge volume of veterans who have chronic illnesses and conditions. I noticed that many re-peat ED visits that could have been easily avoided and prevented. Some are legitimate emergencies and urgencies, but unfortunately the great majority are the result of non-compliance, lack of adequate knowledge in managing illness and failure to partner with their care provider to promote better overall health.

Now, the graduate level nurse’s leadership attributes have been described in scholarly sources. Based on the documents of the American Association of College of Nursing (AACN) (2013), essentials of graduate nursing must be skilled in organizational and systems leadership role. Specifically, they are supposed to assume leadership roles in quality improvement and patient safety initiatives while working in the interprofessional team context. APN must use communication in an effective way, with regards to speaking, scholarly writing, and group interaction. Nurse leaders should also demonstrate the working knowledge of the current healthcare system and its essential components, including delivery and payment models, sites of care, roles of various stakeholders in the process of care delivery (AACN, 2013).

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,

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.

Throughout the development of theory in the discipline of nursing there are concepts of knowledge that are fundamental. Four of these patterns of knowing were first explored by Carper (1978) which included: empirical knowing, ethical knowing, personal knowing, and aesthetic knowing. Later, an additional facet was added by Chinn and Kramer (2008) which introduced emancipitory knowing. While all of these forms of knowledge are critical for holistic nursing care, this paper will place an emphasis on personal knowledge and how it contributes to the development of knowledge within nursing and the roles of advanced care practitioners.

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).

Imagine you are in a boat, heading up stream you and your teammates had to get to the finish line first. The whole team was rowing at different times the boat would hardly move at all. In fact, it would be chaos as the current sucked you back toward the starting line. On the other hand if you worked concise as a team and rowed together you would get to the finish line first and hardly be effected by the current at all. This can be carried over into a hospital setting. The team of doctors and nurses face an uphill battle against the patient (the current) to get them to the finish line (curing the patient). If the team only does their individual roles it can anticipated the patient will get worse or could possibly die. However, if the team works together collaboratively, going above and beyond to fill their role, but also communicate to other team members, it would be safe the say the patient will be cured faster. According to QSEN, the definition of team work and collaboration is “Function effectively within

However the point is that greatest persons are not in important distress most of the time, and the attention must be on what will put up with them and recover their wellbeing diagnoses elsewhere their close condition. For that reason, care must be certain to the macro worlds of public and general public, where the rule results of societies from the circumstances lower which public live and in that way disturb their predictions for wellbeing.

In the increasingly complex, ever changing environment of today’s healthcare, effective leaders are essential to help drive positive change resulting in increased access to care with positive outcomes for as many as possible. In its 2010 report, The Future of Nursing: Leading Change, Advancing Health, the Institute of Medicine (IOM) recognized that nurses are well positioned to play a key role in the transformation of our healthcare system in the United States (U.S.) (Institute of Medicine [IOM], 2010). In The Essentials of Doctoral Education for Advanced Nursing Practice, the American Association of Colleges of Nursing (AACN) specifically identifies organizational and systems leadership as a core competency for advanced

For current and future needs we need to enable all healthcare professionals especially nurses to practice to the full level of their education and training. Advanced practice nurses can fulfill the primary care needs. This will free up physicians to address more complex cases which needs their expertise. Current practice focus on specialty and acute care only and a shift in practice to deliver more primary care and community care services is essential to improve the quality of nursing care and address the growing need of care in these areas.

The educational requirement for advanced nursing practice is a master’s level education in a program or track leading to APN licensure, including graduate degree-granting and post-graduate certificate programs with established educational standards and attainment of the APN core, role core and population core competencies (National Council of State Boards, 2012). APN’s acquire increased knowledge in the sciences of anatomy, physiology, microbiology, chemistry, pathophysiology, and pharmacology. The core curriculum for the advanced practice role includes priorities in

The role of Advanced Practice Nursing (APN) has changed dramatically in recent years. Currently, the Unite States (U.S.) health care is focusing on delivering a cost -effective health care to all patients. In the last decades, there were many efforts to control health care over spending in the U.S. One of such efforts is to focus on applying proven principles of evidence-based practice and cost-effectiveness to find the least expensive way to produce a specific clinical service of acceptable quality (Bauer, 2010). The vast changes in health care system, such as cost, need for high productivity, limitation on reimbursement, and the inadequacy on access have made APNs to think in a way where they most fit to provide independent care for

The role of the Advanced Practice Nurse (APN) is expanding internationally throughout the healthcare system. Since the initiation of the Patient Protection and Affordable Care Act in 2010, there has been an increased need for APNs due to the growing demand for primary care services and increased population that have gained healthcare coverage (Lanthrop & Hodnicki, 2014). The purpose of this paper is to explore the role of APN and develop a professional development plan for my future career.

According to the American Academy of Nurse Practitioners (N.D.), the progression of the advanced practice nurse (APN) began nearly 50 years ago. From the advent of the first APN program to the over 350 accredited programs and over 222,000 certified nurse practitioners in the United States, the role of the APN has significantly increased and expanded a profession to better improve healthcare for Americans (American Association of Nurse Practitioners, N.D., American Academy of Nurse Practitioners, 2016). Of these, more than half are in the field of family practitioners (American Academy of Nurse Practitioners, 2016).