The Importance Of Interdisciplinary Collaboration

I have scheduled an interview and time to observe a nurse leader with the Director of Nursing (DON) for the Virginian Nursing and Rehab facility in Fairfax, Virginia for Thursday October 2, 2014 at 7:30am. I plan on spending a full eight-hour shift with the nurse leader observing the following three leadership activities: 1) Observing her making rounds on the units 2) Observing and or participating in a nursing leadership meeting and 3) Observing the facility’s interdisciplinary team meeting.

As popular as the ADN is today, there is a huge momentum to encourage nurses to receive their BSN instead of an ADN. Nurses that are already entering the workforce at the BSN level are not only more skilled at following and understanding evidenced based practice, but they are also more prepared to go on to school to complete their masters or doctorate degrees. In the changing face of healthcare, more nurses with advanced degrees will be needed to provide primary care as in the role of nurse practitioners. APRNs are going to be in higher demand in community care, public health nursing, evidence based practice, research, and leadership. Shortages of nurses in these positions create a “barrier to advancing the profession and improving the delivery of care to patients” (IOM, 2010, p. 170). Shortages of APRNs and the increasing need for nurse practitioners to provide primary care is why the IOM is recommending to increase the amount of BSN educated nurses entering the workforce to 80% and to double the number of doctorate nurses by 2020 (IOM, 2010, p. 173) The goal to increase the nursing workforce to 80% BSN educated nurses and double the amount of nurses with doctorate degrees is a formidable goal, but increasingly necessary. Patients are becoming more complex inside and outside of the hospital setting with chronic multiple comorbidities. BSN educated nurses are not only better prepared to care for these

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

Since the inception of the Nurse Practitioner (NP) role in the 1960s, NPs have thrived in the delivery of primary healthcare and nurse case management. Despite patient satisfaction with NPs ' style of care, nurses have been critical of NPs, while physicians have been threatened by NP encroachment on MD practice. Balancing assessment, diagnosis, and treatment with caring defines NPs ' success as primary care providers. Understand the role and Scope of Practice of NPs is sometimes difficult for some to understand. The purpose of this paper is to define the role and history of NP, compare and contrast licensure versus certifications, understand NP Scope Of Practice and Standards of Care, discuss how the State Practice Acts regulate FNP practice, discuss credentialing and privileging, and differentiate between legislative and regulatory processes.

According to the American Association of Colleges of Nursing (2015) the traditional roles of the advanced practice nurses include nurse practitioners, clinical nurse specialists, nurse midwives and nurse anesthetists. Therefore, the impact of the research on the practice of the preparation of DNP nurse educator requires education in evidence-based practice, quality improvement, leadership, policy advocacy, informatics, and systems theory. Furthermore, transitioning to the DNP as a nurse educator does not change the current scope of practice of the Advance Practice Registered Nurses (APRNs) for their current roles. The transition of the DNP better prepares APRNs by utilizing new models of the care delivery system and growing complexity of health

It's important for nurses to be actively involved with an interdisciplinary team because of the increasing complexity and scope of patient problems. As these complexities and problems increase, patient care necessitates the combination of efforts of physicians from different disciplines. Actually, comprehensive patient care in today's healthcare settings incorporates attempts to solve problems that are beyond the scope of expertise and training of a single professional. Therefore, the active involvement of nurses in interdisciplinary teams is vital for the provision of comprehensive and effective patient care that help in dealing with the evolving patient problems

Advance practice nursing has been applied to variety of roles like Acute Care Nurse Practitioner (ACNP), Nurse Practitioner (NP), Clinical Nurse Specialist (CNS), Certified Nurse- Midwife (CNM) and Certified Registered Nurse Anaesthetists (CRNA). Even though clinical expertise is the core ingredient for APN practice, these nurses are expected to demonstrate competencies like use of holistic perspective, initiation relationship with patients, use of expert critical thinking and use of diverse health and illness management (AACN, 2006). Additionally they need to express core competencies like consultation, collaboration, leadership, research and expert coaching (NACNS, 2004). Experienced staff nurses may exhibit these competencies whereas the APN make it visible in their practices and they are believed to be basic components of every APN (Hamric B, 2009 p 84). Furthermore a brief consideration of Benner’s model is required to understand the acquisition of expertise in nursing. Benner defines expertise as a mixture of theoretical and practical knowledge and every APN begins as a novice and ends up with some expertise.

Professional practice models can help guides nursing practice in any healthcare setting. Nursing care models are commonly adopted by Magnet organizations because they promote staff autonomy, shared decision making, patient-centeredness, and quality care. Nurses most often develop PPMs which reflect not only nursing values but the organization’s values as well. This paper will explore several elements of the Brigham and Women’s Hospital’s (BWH) Professional Practice Model (PPM). First, the model’s fundamental nursing framework will be identified. Next, a brief discussion on how the model promotes patient-centeredness, evidence-based practice, and interdisciplinary collaboration will be presented. Lastly, a summary of how the model fosters quality, safety, informatics, shared governance and leadership will be reviewed.

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.

In its Position Statement on the Practice Doctorate in Nursing, American Association of Critical Care Nurses (AACN) recommended that the DNP should become the graduate degree for the current Advanced Practice Nurse (APN) roles of clinical nurse specialist, nurse anesthetist, nurse midwife, and nurse practitioner. Therefore, the DNP will be the educational requirement for APNs by 2015 and will coexist with PhD programs. Although PhD prepared nurses will continue to perform research and disseminate findings, DNP prepared nurses will apply and evaluate these findings in the clinical setting. In this manner, the two degrees work together to improve patient outcomes rather than threaten each other’s existence. Additionally, two terminal degree paths are expected to attract more students by offering the opportunity to focus on either clinical practice or research (AACN, 2011).

A research titled “Economic Evaluation of the 80% Baccalaureate Nurse Workforce Recommendation” found that the 80% of the nurses employed who have BSN degree resulted in significantly lower readmission rates and shorter lengths of stay. The BSN-trained nurse incorporates evidenced-based practice into the nursing care which resulted into more cost- efficient outcomes. Evidence-based practice consists of research evidence, experience and expertise in the process of patient care. The patient is the center of the care, who describes their personal values and past encounters and nurse develop a nursing process to implement the best individualized care specific for the patient. The nursing process involves assessing the patient, gathering information by asking questions, acquiring evidence from research studies and implementing nursing care after discussing with the patient and lastly, evaluating the results. Evidenced-based research has a holistic approach in which the nursing care is individualized to fit the patient’s health conditions. EBP is strongly proven to be scientifically heavy with evidence. It intends to improve patient outcomes by promoting health and recovery. On the other hand, Associate nurses were more interested in “content driven nursing tasks” (Giger & Davidhizar, 1990). The nursing practice goes beyond these basic technical nursing tasks. A deeper understanding of the nursing theories and concepts provides nurses the autonomy of their practice, further increasing their level of professionalism (Catalano, 2003). BSN-trained nurses view EBP as the main core of their nursing practice. A great example of an EBP is the implementation of core measures in the hospital setting. Core measure are “national standards of care and treatment processes to reduce complications and lead to better patient outcomes (John Hopkins

My practicum concern is related to the Essential 7: CNL competency, which states to “advocate for the value and role of the Clinical Nurse Leader (CNL) as a leader and member of interprofessional healthcare teams” (American Association of Colleges of Nursing, 2013). The interprofessional staff at my clinical site are not aware of the CNL role and therefore, do not have a full understanding of its importance or my future role in improving patient outcomes.

In the early 2000s, NPs were introduced in a surgical unit in Sweden to help reinforce knowledge, strengthen interpersonal collaboration, and improve patient safety and quality of care. For this study, eight graduates from a new NP program in a university in Sweden participated in initial and follow-up interviews regarding their transition into new NP roles in a surgical unit. The curriculum’s theoretical framework based its learning plan from the Nordic model of Advanced Practice Nurses (APN). Additionally, the participants attended a 10-week NP program in the United States to understand the level of knowledge, the scope of practice, and the competencies associated with the role. Moreover, video conferences and visits from American collaborators

Interdisciplinary utilizes different fields or disciplines together for a common goal. This concept provides a unique perspective on tackling issues. When implementing an interdisciplinary approach, communication can be challenging since the various disciplines have a unique set of terms and vocabulary that may not be common. Doctors, mathematician, and computer programmers to name a few all have a different way of communicating. Barriers such as these can slow the process equating to higher cost. However, the benefits of combining unlike fields can create a different experience by approaching the problem from different perspectives removing like-minded people from the trenches of their discipline.

Interdisciplinary collaboration is apparent in the ADN curriculum. In NUR 10505, students learn the basic skills to promote psychological stability, physiological stability and safety, communication techniques, patient rights, and the delegation process. Student’s learn to apply the knowledge of basic skills to collaborate with patients and healthcare team members to care for pregnant patients and newborn patients NUR 10606. Collaboration is demonstrated with patients, families, and the healthcare team and learning to apply the principles of delegation and prioritization in the course NUR 20505. In NUR 21303 student’s focus on collaborating with a healthcare team to experience