Leadership Position: Practice Requirements for Advance Nurse Practitioners in Primary Care
Introduction
Nurse practitioners (NP’s) are registered nurses that have advanced education and training to provide services in academia and clinical services. Nurse practitioners have to follow state practice regulations. Now more than ever, NP’s can assert role significance by participating in health policy activities at the local, state, national, and international levels (American Association of Nurse Practitioners, n.d.). The American Association of Nurse Practitioners (n.d.) reports that NP’s offer high-quality care during a time that the U.S. faces a major population increase and primary care shortage. The increasing demand for primary care providers
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Since NP’s have a vital role in today’s and the future’s health care delivery system, NP’s should establish an official design of practice requirements. NP’s have a large workforce in primary care practice. Clinical experience and research ability will facilitate health care design to increase quality care. By providing research and rendition of evidence-based data, NP’s can influence current and future public health. NP’s that are doctoral-prepared, have the skills and training to offer research, interpret data, and implement the clinical translation of research and offer concrete feedback (Wysocki et al, 2015). Although it is important to note that terminal degrees may either be phD or DNP, for the purpose of this paper the distinctions of terminal degree are not considered …show more content…
All NP’s should possess a terminal degree to have high level educational ranking such as
The face of healthcare has been changing over the last decade. The role of nurse practitioners has become ever more important. This paper conducts a policy analysis as a systematic investigation of alternative policy options, for the emerging nationalized healthcare plan and the increased use of nurse practitioners. It looks at the goals of nationalized healthcare 's use of nurse practitioners and discusses to what extent this policy meets these goals. This paper begins with a detailing of the problem addressed by the policy and the goals and objectives of nationalized healthcare 's increased use of nurse practitioners. Next, alternatives to meeting the increased needs of the health industry,
This paper explores the perception of clinical practitioners to the change in policy related to the advanced practice registered nurse (APRN) full practice authority. The author conducts a one-on-one, open-ended interview of 5 nurse practitioners and 5 physicians licensed to practice in Maryland on their perceptions of the recent passage of the Advanced Practice Registered Nurse Full Practice Authority. A literature review was conducted in a policy report by the professional nursing organization, and discussion within the peer-reviewed article supported an overview, regulatory differences among 50 states, including the District of Columbia. Their policy implication for enhancing APRNs role nationally. The author discusses a critical component
The role that nurse practitioner (NP) plays within the increasing complex health care system is a constant changing role with the Consensus Model and the introduction of the Affordable Care Act in 2010. The scope of the nurse practitioner (NP) includes the care of the young, the old, the sick and the well. The educational needs of a nurse practitioner vary greatly from that of a Registered Nurse (RN), in the amount of education as well as the focus of the education. NPs provide coordinated primary care with the use of comprehensive health histories and physical examinations, diagnosing and treating acute and chronic illnesses, the management of medications and therapies, ordering and interpreting tests results, and educating and
As resistant as some states’ legislative and regulatory bodies are to grant APNs autonomy of practice, the damage being done by over-regulation is clear (Safriet, 1992). Physicians are forced into a position to either supervise the APN’s practice or be constantly consulted for approval of their practice decisions. Safriet (1992) described that in and of itself, this constant supervision may appear to patients that the APN is not competent to provide adequate or care equivalent to that of a physician. If the role of the APN is to bridge gaps in health care by relieving the medical establishment of some of the patient load by performing the same function as a physician in a primary care setting, it seems wholly unnecessary to restrain their scope of practice in those areas. This type of restrictions affect cost and patient care accessibility (Safriet, 1992). This was a problem stated in the article, however 25 years later, populations of patients remain unseen or cared for and APNs continue to be underutilized (Safriet, 1992). Rigolosi and Salmond (2014) cite the American Association of Nurse Practitioners (AANP) when they state that not utilizing nurse practitioners due to practice restrictions costs $9 billion annually in the US (p. 649).
Over the last several years, the majority of graduating medical students (90%) has been focused on careers in specialized care. (Pickert, 2009) This is because they will make more money in comparison with doctors that are working in a primary care environment. As a result, a shortage has developed with many health care providers turning to Nurse Practitioners. These are nurses with some kind of advanced degree in Nursing. Their job is to diagnose / treat patients and prescribe medication. To fully understand what is happening requires looking at how this trend is having an impact on accountability, quality, costs / health promotion and risk reduction. These different
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,
These impose severe constrictions on the ability of the nurse to move forward or advance into the areas of practice where traditional nursing practices were not allowed {Institute of Medicine, 2010}. However with the increase in the number of nurses graduating with advance degrees in nursing; the situation is changing. These well educated nurses are leading the charge to confront the complex issues that the rapidly changing health care situation presents. Regulatory barriers must be lifted so that nurses can practice within their scope in order to be reimbursed by private insurance for the services they provide. These changes can be done through the federal and state legislators as well as supervisory agencies and bodies such as congress and licensing regulatory boards. The IOM also recommends that nurses will expand their scope of practice and increase their responsibility through teaching and counseling of patients. {Institute of Medicine,2010}. The use of Advance Practice Registered Nurses and Physician Assistant in providing primary care services will decrease wait time and increase patient satisfaction. The high turnover of nurses transitioning from school to practice also affects the quality of care. These nurses do not have enough experience to make decisions in patient care.{Institute of Medicine,2010}.The IOM and JCAHO{2012} report supports the recommendations for the introduction of nursing residency
The Institute of Medicine’s 2010 report on The Future of Nursing: Leading Change, Advancing Health acknowledges the changing healthcare sector in the US and describes future vision of healthcare and the role of nurses to fulfill that vision. The United States always strives to provide affordable and quality healthcare to the entire population of the country. In order to achieve this goal an overall restructuring of the healthcare system was necessitated. Nurses are considered to be the central part of the healthcare system to provide high quality and safe patient care. Nursing in the US is the single largest segment of the healthcare workforce with almost 3 million nurses working in different areas across the county. The changing
Budzi, Lurie, Singh, and Hooker (2010) state, “Nurse Practitioners’ (NP) interpersonal skills in patient teaching, counseling, and patient centered care contribute to positive health outcomes and patient satisfaction.” According to their research they encourage healthcare systems in the U.S. to hire more NPs to allow for better access affordable, and quality care (Denisco & Barker, 2016). With the demand for primary care providers, The NP role aids in delivering a solution to some of the healthcare issues that exist today. Organizations like the Institute of Medicine (IOM) and Centers for Medicare and Medicaid (CMS) all agree to allow nurses to practice to their full abilities to make healthcare more accessible and affordable, especially for the aging baby boomers and less accessible rural neighborhoods, and densely populated urban areas. Research has proven that NPs that provide primary care have similar health outcomes to primary care physicians (DeNisco et. al., 2016). NPs particularly take pride in their holistic approach, forming therapeutic relationships between other providers of the healthcare team, patients, and their families, aiding the informed decision making process, use of the evidence based practice approach in health management (Brown, 2005). Some of the other actions or qualities that
While the demand of healthcare need increasers the United States facing a physician shortage. In recent years the number of nurse practitioners (NPs) and physician assistants (PAs) has significantly increased and they are taking the part in providing healthcare cervices to the majority of patients. I believe nurse practitioners and physician assistants can practice independently from doctors and be free of oversight. Expanding the scope of NPs and PAs is essential to overcome the healthcare crisis we are facing; it will increase patient satisfaction and stabilizing the healthcare economy.
Although the American Association of Colleges of Nursing clearly defined the role of Doctor of Nursing Practice (DNP) degree in 2004, some confusion about the academic programs still exist. The role of both the DNP and PhD-prepared individuals is to improve the quality of health care and the health of population through the use of the best evidence when assisting them in making decisions about treatment options. Melnyk, B. M. (2013). According to the national leaders in major healthcare fields, mentioned a gap between research and practice and the importance to apply research findings and engage in evidence-based practice. In order to translate this knowledge, the clinician must understand the healthcare delivery in order to help narrow the research-to-practice gap and transform health care. DNP-prepared nurses are trained to reduce the research-to-practice gap. Because most nurse lack knowledge to critically appraise research studies and the skills to effectively implement evidence-based practice (EBP) in their clinical settings.
Recommendation to double the number of doctorate by 2010, ensure that 10% of BSN graduate will matriculate into Masters with in 5years of graduation, which will take care of the faculty issue. Loan forgiveness and repayment plans will encourage significant number of nurses to go for higher advanced education.
First, the state licensure regulates NP practice and it has been a big issue since NPs are not able to practice to the fullest extent despite of their education and training. NPs practice is regulated by state licensure and only about one-third of the nation has adopted full practice authority licensure and practice laws for NPs (Hain & Fleck, 2014). The American Association of Nurse Practitioners (AANP) reports that, under a full practice authority model, NPs are still required to meet
Historically, nurses focused on the diagnosis and treatment of a disease, sickness or condition and emphasis on health promotion was nonexistent. However, today that has all changed. Nurses are now expected to expand their primary care services to include psychosocial nursing, advocacy, behavioral science, counseling and advocacy in addition to patient assessment, clinical diagnosis and patient-case management. In the article “Defining Nurse Practitioner Scope of Practice: Expanding Primary Care Services,” Sherwood, Brown, and Wardell (1997) state “the role of the nurse practitioner continues to evolve in response to changing societal and health care needs as consumers in all settings seek increasing services”. (Sherwood, Brown and Wardell, 1997).
There is an increasing demand for nurse practitioners, which makes this a crucial period in the development of their practice and profession. Nurse practitioners must face increased opportunity and continuing opposition towards independent practice all while defining their role in health care delivery and establishing their connections. The practice of nurse practitioners still varies widely across the states. These inconsistencies make it difficult for nurse practitioners as well as patients when practice