Advanced Practice Roles Assignment

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Advanced Practice Roles Assignment

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Role of Advanced Practice Nurse Assignment – Essay

Role of Advanced Practice Nurse

Framework for Clinical Practice

Person/Client/Client System

Environment

Health

Nursing/APN (Factors Effecting APN’s Practice and Implementation of the APN

Nursing Process)

Interrelationships of Client System, Environment, Health, and Nursing/APN

Role of Advanced Practice Nurse

Research shows that an advanced practice nurse (APN) is first of all a nurse that has been recognized as a person that has advanced education. This person is also known t knowledge and skills prepared at the masters or doctorate level. It advanced practice nurse have a broader scope of practice than Registered Nurses (RN) often performing the same duties as those that are doctors. Their primary care duties involve things such as diagnosing and managing the treatment of chronic and acute illnesses. Advanced practice nurses are the ones that keep the emphasis on advanced practice nurse and health promotion, with a stress on wellness. Advanced practice nurses may choose to work independently or in collaboration with doctors. To practice they all will have to pass what is recognized as the national certification exam and then be able to maintain a state license as an RN. In addition, they can be expert e.g. family nurse practitioners nurse anesthetists, and nurse-midwives. Advanced practice nurse’s work in a variety of health care settings and are considered to be uniquely qualified in order to resolve the physician shortage as primary providers in country and underserved populations. Advanced practice nurses are next only, to the doctor in providing things like patient care.

Many are unaware that the role of the Family Nurse Practitioner (FNP) is known for being an area a is diverse and broad and continues to keep on evolving. FNPs are the guys that are known for assume a variety of roles which includes a primary care provider, clinical leader and educator, researcher. Like medical doctor Family Nurse Practitioner’s are the ones that can order, conduct and solve diagnostic and laboratory test. Family Nurse Practitioner y may use pharmacological and non-pharmacological treatments (e.g. Stress reduction, weight loss) to enhance patient outcomes. Advanced practice nurse’s cooperated with other health providers and refer to physicians and other providers (e.g. Physical therapy, dietician) to make the most of quality of care. The advanced practice nurse assesses and documents patient/family results and provides patient discussion to enhance the plan of care. The advanced practice nurse provides complete case management and sponsors for patients within the health care system.

Framework for Clinical Practice

In search of acknowledgment of nursing as specialists and elevation of practice upgrading aroused the nursing leaders to start wanting to come up with putting together a big collection of nursing information that will be able to lead the practice of nursing in a better direction (Delametter, 2002). Research shows that this kind of crusade can be traced back to first known Nurse, Phoebe, was mentioned in Romans 16:1. During the early years of the Christian Church, St. Paul sent a deaconess Phoebe to Rome as the first visiting nurse. She took care of both women and men (Castner, 2011). Entrenched in the pioneering labors of Florence Nightingale, nursing is every so often described as both an art and a science. Even though much of what we do in nursing is directed by empirical evidence and scientific theory, we also stem a great deal of the practice from more abstract, aesthetic knowledge for example theories founded on caring and understanding. Many experts argue they do see patients as a physical illness, they see the whole person in body, mind, and spiritual context (Villegas, 2012). Nursing necessitates that first and primary that their patients are taken care of.

Over the years, as nursing started going to the next level which involved the expansion of new technology within the field, nursing began moving to a more cutting-edge type of a profession. At that time, graduate level programs started encompassing things such as the courses that are in research. However, study was lacking theoretical outlines in order to define results of study. Soon, leaders in nursing came to the conclusion that it was the mixture of research and theory that was missing in order to convert nursing practice to knowledge (Swain, 2009). Further research shows that the new doctoral nursing programs turned out to be focused on theory development in order to address this shortfall (Castner, 2011). The Nursing field nonstop was able to advance skillfully, changing definitely for self-sufficiency in spite of outside variables that were having some kind of an effect on health care.

Lastly, Delametter (2002) introduced a lot of changes that needed to take place within the profession in order to make it as successful that is today. Establishing nursing ideas in this technique for the since nursing came on the scene has permitted a mutual outline for nursing to marry and apply meaning to research statistics that has helped describe possibility of practice for simple Family Nurse Practitioner and advanced practice nurse concentration.

Villegas, (2012) makes the point that the conceptual model is recognized “an established set of comparatively ideas and overall notions that speak to the phenomena of central interest to a discipline, the proposals that approximately define these ideas, and the intentions that state comparatively abstract and general affairs among two or more ideas.” A conceptual framework can likewise be defined as “a reasonable combination of connected theories or concepts, typically made to pull together various characteristics that are relevant in the direction of a complex situation for instance an educational program or a practice setting” (Swain, 2009). Research shows that most of these conceptual definitions are suitable to the behind critical thinking and role development in the setting that is clinical. The definition of an advanced practice nurse augments implementation of practice-based conceptual outlines by the subsequent declaration “Advanced Practice Nursing is the application of an expanded range of practical, theoretical, and research-based capabilities to phenomena within the clinical setting” (Castner, 2011).

Strategies with clear descriptions endorse the practice and conceptualization of theory in the advanced practice nurse s roles and responsibilities (Swain, 2009). Villanueva (2008) also portray conceptual frameworks as well as explanations of the nursing procedure which provides a basic structure for practice and research. Today conceptual frameworks have been lengthily studied and support the profession in evidence founded care provided with positive results based on theory concept operation. An instance of one conceptual outline is Castner (2011) Clinical Practice Framework for the Advanced Practice Nurse. Castner’s framework is a the backbone on which nursing research is built upon. The framework comprises the principles and molds that motivate the research. When coming up with the conceptual framework, you have to decide whether to use a qualitative or quantitative approach to the nursing research.

This project sets out to give some kind of an description of the utilization of the Clinical Practice Framework for the Advanced Practice Nurse (Delametter, 2002) The framework is put in a way that it adheres to the description of the four concepts of the nursing metaparadigm and the connection of how these all play a huge part in the field. In nursing all of these ideas are able to form the family nurse practitioner’s clinical practice outline.

Systematic comparison of Neuman’s major model views the client as an open system that makes the responds to stressors in the environment. Research shows that the client variables are psychological, physiological, developmental, and sociocultural, spiritual. The client system consists of a basic or core structure that is sheltered by lines of resistance (Delametter, 2002). The typical level of health is acknowledged as the normal line of defense that is made secure by a bendable line of defense. Stressors are considered to be intra-, inter-, and extra personal in nature and ascend from the external, internal, and created environments. When stressors are breaking through the flexible line of defense, the system is attacked and the lines of resistance are triggered and the system is labeled as moving into illness on a wellness-illness range. If satisfactory energy is available, the system will be reconstructed with the normal line of defense reestablished at, below, or above its earlier level. The client system regulates to stressors for that reason with flexible lines of defense and resistance. If theses stressors continue and penetrate the protective concentric circles then this leads to a client system that is unstable (Delametter, 2002). Also health ideas are what address the outcomes that derive from optimal wellness to death and illness. Family nurse practitioner communication through the nursing process of the advanced practice nurse is the ones that are wanted in order to help for reduction of negative system reaction and patient re-formation (Delametter, 2002).

The nursing concept applied to the advanced practice nurse is to achieve a stable client system because Nurses know how to expand access to care and make better quality at a cost that is much lower cost. Some systems have developed innovative care models in order to prove it, as well as nurse-managed health clinics, home visiting programs for low-income mothers, and the…….

The Advanced Practice Nurse Role Assignment SAMPLE 2

An advanced practice nurse is a nurse with advanced didactic and clinical education. Whether they are nurse practitioners, clinical nurse specialists, nurse anesthetists, or nurse midwives, play a pivotal role in the future of health care. APNs are often primary care providers and are at the forefront of providing preventative care to the public. Because of different title they can have, their role can be very confusing; mostly in defining their role as practitioners or as researcher. The groundwork of nursing is evidence base practice; which open opportunities for APNs to be in research studies. Nurses tend to avoid research because of lack of knowledge or simply not aware about the fields. It is vital that nurses be more involved in research because it will help the profession to evolve better. Therefore training and educational opportunities should be available to enable nurses to progress in career like clinical, medical, or nursing research. As a result, experienced nurses as well as novice nurse researchers will play a more active role in educating and motivating others to not only apply research that was conducted by others, but to be involve in research which in turn will be incorporated in their daily practice.

Introduction

Advanced practice nurses are taking their place in the forefront of the rapidly changing health care system, developing an innumerable of roles in organizations that aim to provide cost-effective, quality care. Due to the variety of specialty under the APN umbrella it becomes confusing to define APN and their role. The International Council of Nurses (ICN) defines Advance Practice Nurse (APN) as “a Registered Nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice; the characteristics of which are shaped by the context and/or country in which she is credentialed to practice.” http://icn-apnetwork.org/. Hamric, Spross, and Hanson( 2009) state that: the State Nursing Practice Act uses APNs to refer to Nurse Practitioners (NPs), Clinical Nurse Specialist (CNSs), nurse anesthesiologist (CRNAs), and Nurse Midwife (CNMs). In spite of the title or area of practice, it is obvious that research is important in healthcare practice nowadays. In this paper, a general overview of the role of research in healthcare will be presented, which then will follow by the different roles of the APN in research. Also, a look at some of the literatures that outlines the current trends in APN research activities will also be elaborated. The advantages and disadvantages of research will be presented.

Discussion

According to Hamric, Spross, and Hanson (2009), research is one of the core competencies of advanced practice nursing, and research skills are imperative for the Advanced Practice Nurse (APN) to be able to fulfill their roles. The core APN research competency has three individual competencies: interpretation and use of research findings and other in clinical decision making, evaluation of practice, and participation in collaborative research (Hamric et al., 2009). There is different level of Core competency which shows exactly what APNs can be involved in during their practice. For example, Core competency I is demonstrated by the APNs when they make practical decision that is based on the best and most current evidence which helps them to develop and promote changes in practice based on evidence. According to Hamric et al. (2009) the Evidence Based Practice (EBP) process involves understanding the clinical issue and being able to state the problem, followed by finding, evaluating, and synthesizing the evidence in order to make a decision or recommendation based on the evidence. Secondly, there is Core competency II which is very important to the APN practice because it can provide evidence to support the care provided. Lastly, in the Core competency III the APN needs to be involved in nursing or interdisciplinary research studies in order to generate knowledge. Hamric et al. (2009) report that regardless of the APNs’ work setting or responsibilities, they must apply competency III because it has a fundamental and an expanded level needed for the profession. For example, in the fundamental level, the APN who has a master’s degree can function as a consultant or clinical expert to a study. Even after the completion of DNP program, the APN is still in the fundamental level. Furthermore, the expanded level is obtained after many years of practical experience in research or it can also be after graduating from a PhD program. Once the APN is at that level, he or she is the perfect candidate for the position of Principal Investigator (PI) or co-Investigator (Hamric et al., 2009). Therefore, APNs can be involved in a wide range of research activities, and they can be a good contribution by making valuable contributions to all the phases of the research process. Advanced Practice Roles in Nursing Assignment SAMPLES

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The APN can be a research nurse or a nurse researcher; these two terms can be very confusing and people may use one for the other. However, after exploring those two terms carefully, it will be evident that they are not at all the same. For instance, the research nurse can be research coordinators, data managers/collectors, research assistant who works under the supervision of a medical practitioner (Richardson, 2005). Moreover, the work of the research nurse does not necessarily contribute to the advancement of the nursing profession as the majority of the studies are non-nursing. On the other hand, the nurse researcher can be a Principal Investigator (PI) as well as an Assistant Investigator (AI).   A PI is a credentialed member of the medical, nursing, pharmacy or psychology staff. This is the kind of nurse who is responsible for the design, conduct, and oversight of research protocols. The role is to ensure the protection of human subjects, the integrity of the informed consent process, and analysis of research data. Rosenzweig, Bender, and Brufsky (2005) report that doctorally prepared nurses are uniquely positioned for the role of PI in pharmaceutical trials. Nurses with appropriate preparation and partnership with a physician listed as a co-investigator are permitted to be principal investigators of clinical trials involving medications (Rosenzweig et al. 2005). In addition, an AI is a credentialed member of the medical, nursing, pharmacy staff who supports the conduct of protocols. http://oma.od.nih.gov/manualchapters/intramural/3014/. Gardner, Webster, and Geary (2010) reported that the role of a nurse researcher is to conduct and facilitate nursing-oriented research, rather than simply providing support for research conducted by others. They also state that nurse researchers need to have post graduate qualifications; however, knowledge and or experience of research is not necessarily a requirement for research nurses’ positions.

Graduate Education, Mentorship and access to funding according to Edwards, Webber, Mill, Kahwa, and Roelofs (2009) are enablers that can help strengthen nursing research capacity, as with other disciplines, graduate education prepares nurses to better use and conduct research. Unfortunately, a lack of graduate training contributes to inadequate requisite knowledge and skills to initiate research compete for funding knowledge (Edwards et al., 2009). Because of the tendency to undervalue nursing research, there is a perception that nursing research lacks importance resulting in underfunding by national granting (Edwards et al. 2009). The other issue is that the private research sponsors such as the pharmaceutical companies and the medical device manufactures tend to target physicians as their Principal Investigators for efficacy and effectiveness trials along with biomedical scientists. They tend to leave APNs out of a very profitable area of research. Advanced Practice Roles in Nursing Assignment SAMPLES

Weyer and Werner (2010) present the concept of Practice Based Research Network (PBRN).

PRBNs enable research to be conducted in ambulatory primary care setting where most patients receive their healthcare. Historically, PRBNs have been led by physician; advanced practice led PRBNs have emerged within the past few years (Weyer and Werner 2010). As the role of the NP continues to evolve in response to the changing healthcare environment, Weyer and Werner propose that PBRNs offer NPs the opportunity to participate in the discovery of new knowledge (research) and the translation of the new knowledge into clinical practice.

Wallerstedt, Sangare, Bartlett, and Mahoney (2009) conducted a study with the purpose of the study was to characterize the role of APNs particularly Nurse Practitioners (NPs) in the practice setting of the NIH. NIH NPs combine clinical research responsibilities with the provision of comprehensive medical management to patients enrolled in NIH protocols, blending: clinical, research, educational, and administrative task into a unique multifaceted role. Many of the NPs served as AIs; the goal of the NIH NP group is to work toward developing collaborative relationships and to initiate research protocols with NPs as lead investigators ( Wallerstedt et al., 2009)

Chan, Gardner, Webster, and Geary (2010) conducted a study to examine the nurse researcher role of the nurse researcher in the Nurse Researcher Project (NRP). The nurse researcher project first started to support development of a nursing research and evidence based practice culture in cancer care services in a large tertiary hospital in Australia. The role of the nurse researcher was to conduct primary research and systematic reviews with the goal to address pertinent clinical issues, promote evidence base nursing and supervise clinical nurses in their research activities. It was found that: the nurse researchers were able a crucial role in the advancement of nursing knowledge. Also, it facilitate the evidence based practice because it was placed to support a specialized team of nursing at a service level.

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Nowadays, The evolution of nursing services is evident, a new generation of nurse leaders are required to provide evidence to justify charges. Continual development and utilization of research knowledge in nursing practice is necessary to respond to the contemporary changes in the environment. Nursing research has historically been seen as the responsibility of nurse academics. Nurses wanting a career in research have been traditionally employed in the position of research nurses, assistants, trial coordinators or data collectors to conduct research under the supervision of a medical practitioner (Richardson, 2005); but this is all changing with the current trend of APN working as PI, or AI in multiple settings. Advanced Practice Roles in Nursing Assignment SAMPLES

Summary

Research is crucial to the development of healthcare in general, particularly in nursing; the importance of research is recognized increasingly. For a novice RN, the role of the nurse researcher can be a good career choice. However, Advanced Practice nurses (APN) need to be more involved in research under the supervision of a nurse researcher. The nurse researcher is a more suitable role for an APN because it synchronizes with the roles of the APNs as clinicians, leaders and educators. From the review of diverse literatures, the evidence is clear that there are a lot of research opportunities for APNs to explore. Unfortunately, this information is known to only a few APN.

Conclusion

The Evident Base Practice (EBP) is a requirement to the current trend in healthcare. Research is important to the practice of the APNs because it provides the evidence that has been tested and can be used which then can be applied in patient care. Research is very important to the nursing profession, for it helps to set the standards, guidelines, policies and procedures. Applying Proven Outcomes (APO) means that a practitioner is using evidence based on interventions. According to McSherry at al. (2006), Evidence Based Practice (EBP) is done by the combination of social, political and professional factors. Politically, helps the practitioner to save time and money. Furthermore, The APN has access to protocols and treatment plan which enable them to prescribe or follow what have already been proven to be effective. The use of EBP can also facilitate the patients and 3rd party payers to save money which then can lead to good patient’s outcome. Being able to use Evidence Based Guidelines can influence the reimbursement positively because it will give the APN will have guidelines to justify their clinical decisions. Advanced Practice Roles in Nursing Assignment SAMPLES

Implications

The application of research findings through Evidence Based Practice (EBP) is very crucial when it comes to the reimbursement of APNs for their services. In addition, There was a law passed by Congress about Medicare regarding reimbursement for Nurse Practitioner. This law was signed by the president on August 1997, it stated that regardless of the area of practice, “Nurse Practitioners are being reimbursed at the rate of 80% of the lesser of the actual charge or 85% of the fee schedule amount for physicians (Section 1848).” “Medicare reimbursement fact sheet”. It is in the APNs’ best interest to continue to be involved in research because it will show their importance in the healthcare system. In addition, more outcome studies are needed to support the already proven fact that shows that the APNs’ care is comparable or similar to the physicians’. Therefore, they can still continue to argue or to push for 100% reimbursement for APN services. Also, APNs’ involvements need to be more visible in pharmaceutical trials because pharmaceutical studies are very profitable; of course, it will be beneficial for the APNs as they gain the experience needed on medical trials. It will also help them to develop a relationship with the organizations that conduct those studies. As a result, it will open doors for other APNs to take on the role of PI in pharmaceutical trials which in turn will give APN more confidence. Advanced Practice Roles in Nursing Assignment SAMPLES

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