Abstract This paper explains that the acute care nurse practitioner (APN) performs four roles: educator, researcher, clinician, and consultant/manager. The APN's role as consultant/manager is perhaps one of the most important of the four because this role helps to improve the use of existing scarce resources. The author points out that, in the acute care setting, the APN management role includes taking histories, conducting physical examinations, ordering, performing and interpreting appropriate diagnostic and laboratory tests, prescribing pharmacological agents, treatments, and non-pharmacological therapies for the management of the conditions, which they diagnose. The paper stresses that the structure of the acute care APN's role will depend upon the collaborative agreement with physicians and other members of the acute care team and organizational setting.
Table of Contents
Introduction
The Role as Consultant/Manager in an Acute Care Setting Implementation of APNs in Acute Care Settings
Summary and Conclusion
From the Paper "The research also shows that once an APN has started the implementation process, it is vitally important to continue to solicit timely feedback from other staff members, patients and management. This feedback will help solidify productive interpersonal relationships and the overall health of the acute care operation. The experts on organizational change say that staff members must feel comfortable in providing feedback to their managers, and likewise, supervisors must learn how to share their perceptions of individual job performance in an accurate, clear and honest manner. Managers at all levels can facilitate the communication process in their organizations by ensuring that the process is one in which people are able to provide and receive feedback in an open, honest and constructive manner."
Abstract The paper explores some of the trends that have created the role of advanced practice nurses (APNs) in psychiatric care and focuses on the autonomous role that nurse practitioners are sometimes required to play. The paper discusses how the new authority of autonomy has to to be balanced with the core values of the nurturing nurse-patient relationship.
From the Paper "Recent trends in medical care have brought the adult nurse practitioner into a position of not only support but primary care of psychiatric as well as other patients. The role of the adult nurse practitioner in the specialty of psychiatric care generates significant opportunity and can produce significant conflicts as traditional general practitioner roles are transcended, requiring additional training and specialized understanding of this new avenue of specialization. This work will address the literature surrounding this relatively new role, some of the trends that have created it and specifically the autonomous role that nurse practitioners are sometimes required to play, with the inclusion of legislation and authority to do so."
Abstract This paper discusses the different competencies of an advanced practice nurse (APN) and how they are closely related to each other. The paper discusses direct care by the APN, as well as teaching and coaching. It discusses how these competencies have a direct impact on patient care. It also looks at how they impact the development of non-clinical competencies.
From the Paper "While there are distinct advantages to the DNP program, there are disadvantages to its widespread implementation and possibly surpassing the masters in science in nursing (MSN) as the terminal degree. There is the possibility, as with all programs at the advanced degree level, that curriculum content may be in-depth in some areas while neglected in others. Another disadvantage is that, as an entry-level degree, DNP candidates may not possess adequate prior clinical experience that the APN candidate possesses, as it was also intended to attract individuals with non-nursing backgrounds. As a rigorous program that seeks to help candidates achieve end competencies, the clinically inexperienced DNP candidate may encounter "practical" knowledge gaps that may have to be covered by a longer course length."
Abstract The paper explores the reasons for advanced practice nurses' (APN) increasing power in the workplace. The paper looks at their response to collective action and the outlook for collective action in the future within the universe of APN professions. The paper also discusses how at a time when the number of skilled nurses is not keeping pace with demand, it's a good time for nurses to bargain with increasingly powerful insurance, physicians and hospital institutions.
From the Paper "The APN mirrors the physician population in its trends towards specialization, which accelerated in the 1990's years (as cited by Brown, 1996, p.1). As APN's took on increasing responsibility and health care systems pushed primary care responsibilities to nurses, the need for nurses has increased. At the same time, the low number of nursing graduates has crimped supply. The result is a high number of jobs available for qualified APN's (as cited by Nevidjon and Erickson, 2001, p.1)"
Abstract This paper discusses the educational requirements for advanced practice nurses (APN) of the National League for Nursing Accrediting Commission (NLNAC) in New York State. It describes what graduate nursing schools need to embody to be accredited and what graduate students need to accomplish to attain degree and certification. The paper also looks briefly at nationwide differences in regards to accreditation for advanced practice nurses.
Table of Contents:
Graduate Nursing School Requirements
Attaining a Graduate Degree
Attaining Graduate Certification
Keeping Accreditation, Graduate Degrees and Certifications
Nationwide Differences in Keeping Accreditation
From the Paper "A nurse practitioner is certified to practice in a specific specialty area; APNs may be certified in more than one specialty, but must submit a separate application and fee for each specialty and demonstrate that have satisfied the education requirements specific to that specialty area (Havens). Current specialty areas in the State of New York are: (a) Acute Care, (b) Adult Health, (c) College Health, (d) Community Health, (e) Family Health, (f) Gerontology, (g) Holistic Nursing, (h) Neonatology, (i) Obstetrics/Gynecology, (j) Oncology, (k) Pediatrics, (l) Palliative Care, (m) Perinatology, (n) Psychiatry, (o) School Health, and (p) Women's Health (Havens). Nurses seeking advanced practice nurse certification in the State of New York must file an application for certification and the other forms indicated, along with the appropriate fee, to the Office of the Professions at the address specified on each form; specific requirements for certification are contained in Title 8, Article 139, Section 6910 of New York's Education Law and Part 64 of the Commissioner's Regulations (Havens)."
Abstract The paper discusses how in the last decade, the United States' health care costs have grown faster than any other aspect of the economy. The paper looks at the advanced practice nurse (APN), an umbrella name or term identified to a registered nurse who has attained advanced educational and clinical practice requirements. The paper examines how the provision of health care by the government includes the distinction of new roles of registered nurses in society, who may be equal or superior to physicians. The paper shows how the challenges they encounter regarding ethical, economic and other issues are still part of their development as health workers moving forward to new times.
Outline:
APN- Ethical Issues Vs Medical Practitioner
APNs in Health Care Delivery
Economics and Cost Issues
Summary
From the Paper "The Pew Health Professions Commission (1995) analyzed the importance of cost containment in the American health care system as a priority that is rapidly changing. It has envisage a greater role for nurse practitioners (NPs) in the delivery of primary care in the not so distant future.
"The role of the RNs (APNs) has been seen with their specific expansion in the delivery of health care. The functions of RNs in the system are designed to facilitate healthcare institutions in meeting the demands for serving patients with increasingly complex needs, as well as cost-containment goals."
Abstract This paper presents information on self mutilation in today's society. The paper presents information on factors that can lead to self mutilation. In addition, the paper presents the role of the Advanced Practice Nurse (APN) when working with the victims and their families. Finally, the paper discusses the APN's understanding of self mutilation, as well as informing the patient and family of the care that is needed.
Abstract This paper presents a report on the communications aspects of an advanced practice nurse (APN). It suggests different case scenarios that reinforce the fact that APNs play a large part in formulating and implementing patient care plans, evaluating their outcomes and continuously improving the quality of care
Outline:
Introduction
Profile and Scenarios
Conclusion
From the Paper "Information problem. Teaching and coaching people utilizing both verbal and written communication in almost every media format is used interchangeably. From patients, peers or students, the APN must be able to convey complex ideas and concepts in order to be an effective team member or mentor. Collaboration is also an essential information exchange role the APN must be comfortable with. This may even include formulating new clinical queries relevant to her specialty. Being a researcher is also constant challenge, as S.M. found out when she had to adapt a novel approach to meet one particular patient's needs as hospital guidelines did not cover the specific situation. She applied evidence-based practice, the process of arriving at a clinically relevant research question(s), attempting to gather evidence that answered these questions, determining the applicability of evidence in practice by determining its benefits, risks, cost-effectiveness, etc. and putting the answers to practice. The evaluation of the new practice (compression stockings for patients without bathroom privileges for an extended period after becoming ambulatory) went hand in hand with implementation in order to determine effectiveness in the target population, make changes for quality improvement based on established benchmarks and assess whether the research was implemented properly (DePalma, 2004)."
Tags: responsibilities, colleagues, evidence, practice
Abstract The paper discusses how advanced nurse practitioners (APNs) have increased their scope of primary care delivery. The paper explains the tensions with doctors over the new power entrusted to APNs and the disagreements as to specific responsibilities. The paper concludes that as this role becomes more integrated into the framework of different societies and is better defined, it is expected that healthcare providers will collaborate better.
From the Paper "As healthcare in the United States becomes a more complex and crucial societal element, it will become increasingly important for providers to gain different levels of specialization and education. One area that is growing as a result is the advanced nursing practice. Although this area of advanced nursing practice can involve different areas of study and healthcare provision, in 2004, the American Association of Critical Care Nurses (AACN) broadly defined the term "practice" as "any form of nursing intervention that influences healthcare outcomes for individuals or populations, including the direct care of individual patients, management of care for individuals and populations, administration of nursing and health care organizations, and the development and implementation of health policy." (2004, p. 2). In its most basic terminology, this level of nursing refers to any nurse that has a Master's degree or, as is becoming more commonplace, a Doctorate in Nursing."
Abstract The paper focuses on management during labor and delivery of the HIV positive pregnant woman with emphasis on the efforts to reduce the risk of infant transmission. Information is presented on the use of medications, alternatives to vaginal delivery, and alternative methods of feeding the infant.
From the Paper "There are an estimated 12.2 million women worldwide who live with Human Immunodeficiency Virus (HIV). Six hundred thousand children are infected with HIV annually. This infection most often occurs from mother to child transmission (WHO, 2005). The risks of mother to child transmission are being managed through methods and interventions during labor and delivery. This paper will focus on management during labor and delivery of the HIV positive pregnant woman, to reduce the risk of infant transmission. Information will be presented on the use of antiretroviral medications, alternatives to vaginal delivery and methods of nutrition for the infant other than breastfeeding."
Abstract This paper researches the quality of health care services in the United States and analyzes the relationship between cost and quality in health care services. The paper examines the role of four agencies in addressing quality in healthcare - the Agency for Healthcare Research and Quality, the Centers for Medicare and Medicaid Services, the Joint Commission on Accreditation of Healthcare Organizations and the Institute for Healthcare Improvement. Finally, it addresses the implications to the profession of nursing relating to cost and quality in health care and particularly relating to advanced practice nurses.
Table of Contents:
Objective
Introduction
Review of Institute of Medicine Report
Role of Four Identified Agencies and Quality in Healthcare
Healthcare Cost and Quality and the Implications for Advanced Practice Nurses
From the Paper "It is extremely important in view of the limited supply of workers in today's health care workforce that the APN be highly educated, highly trained, and experienced to a great degree in health care service delivery. The APN must know the policies and regulations of agencies that regulate and monitor the health care organization. The APN must be well versed in indicators, procedure and protocol in order to avoid medical errors either in failing to test, monitor, or instruct the patient. The scope of the APN's duties require that the APN be technologically savvy, detail oriented, and conscious of all procedures and checks that will avoid useless and avoidable medical errors in the health care organization which has employed them. The APN must play an active role in development of education for nursing future APN's. The APN must furthermore, actively document the effectiveness of the APN role for the purpose of gaining the trust of the public in the quality of care received which has been provided by the Advanced Practice Nurse and in a cost-effective manner while showing that APN provided care is highly successful in avoidance of useless and avoidable errors in the health care organization."
Abstract The paper explains that chronic heart failure (CHF) is a progressive illness that is continually costing the U.S. health care system billions of dollars yearly in unnecessary admissions. The paper discusses how the advanced practice nurse (APN) or nurse practitioner plays a potentially vital role in the prevention of heart failure. The paper looks at behavioral interventions, patient education, frequent follow-ups and forging a strong therapeutic alliance.
Outline:
Review of literature
Summary and Conclusion
From the Paper "Chronic Heart Failure (CHF) is a progressive illness where the heart loses the capacity to circulate blood to adequately perfuse peripheral organ systems. The term has been revised because not all patients with heart failure are congested at the time of diagnosis (Hunt, Baker, Chin, Cinquegrani, Feldman, Francis et al, 2001). CHF affects nearly 5 million people in the U.S. alone, mostly the elderly population with 550,000 new cases being diagnosed yearly and is the attributable morbidity in more than 287,000 deaths (Centers for Disease Control [CDC], 2006). This disease is also the leading reason for Medicare hospital admissions (CDC, 2006)."
