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The Role of Advanced Nurse Practitioner In Healthcare Discussion

The Role of Advanced Nurse Practitioner In Healthcare Discussion

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Advanced nurse practitioners (APRNs) use their knowledge, skills, and competence to assess, diagnose, and treat patients presented with various conditions. In some states, advanced nurse practitioners practice under the supervision of a physician. However, they are allowed to practice independently in states that have embraced full practice policy. Thus, advanced nurse practitioners diagnose and treat various health conditions independently. While the role of advanced nurse practitioners in the healthcare setting is broad, this paper focuses on their role in managing chronic illnesses based on the review of the provided article, including the definition of advanced nurse practitioners based on the consensus model and the role of APRNs in managing chronic illnesses; increasing demand for APRNs; the significance of APRNs incorporating nursing theory in their clinical practice; how can APRNs practice move them from the nursing value if they fail to provide patient-centred care; integration of nursing theory into advanced nursing practice, and the significance of nursing theory at all nursing practice levels. The Role of Advanced Nurse Practitioner In Healthcare Discussion

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Review of the Article

The article was authored by McCarthy and Jeffrey (2019) to capture substantial changes in the role of advanced practice nursing and the entire nursing profession. Consequently, nursing curricula have changed at both undergraduate and graduate levels. The current programs focus on evidence-based practice based on a scientific/fact paradigm. These programs do not consider the postmodern perspective, mainly based on curricular guidelines. Additionally, accrediting organizations such as the Joint Commission have urged healthcare organizations to embrace EBP. The Institute of Medicine (IOM) also considered EBP the most important skill every healthcare provider should possess. Thus, evidence-based practice (EBP) has become the most common standard, utilised at all nursing practice levels to improve the quality of patient care and health outcomes. The Role of Advanced Nurse Practitioner In Healthcare Discussion

Furthermore, the article has presented the significant role of nursing theories in advanced nursing practice. Theoretical frameworks have changed the structure of the professional nursing practice. The nursing profession is a body of knowledge that focuses on caring, preventing illnesses, promoting health, and paying attention to the environmental factors that influence individuals’ health (McCarthy & Jeffrey, 2019). As a result, nursing promotes individuals’ natural healing and holistic health outcomes. Therefore, nursing theories have separated the nursing profession from medicine, mainly aimed at identifying and treating a particular illness without considering other factors.

The Definition of Advanced Nurse Practitioners Based on the Consensus Model and the Role of APRNs in Managing Chronic Illnesses

APRNs’ Definition based on the Consensus Model

The Consensus Model defines APRNs as nurses who have completed their graduate-level education for nurses and have passed the national certification examination. While completing their graduate-level programs, APRNs are equipped with clinical skills, knowledge, experience, and competence needed to assess, diagnose, and treat patients presented with various clinical manifestations. Additionally, the model defines APRNs as nurses who have been licensed to perform one of four advanced nursing roles, including certified nurse-midwife (CNM), certified registered nurse anaesthetist (CRNA), and certified nurse practitioner (CNP), and clinical nurse specialist (CNS)The Role of Advanced Nurse Practitioner In Healthcare Discussion.

The Role of APRNs in Managing Chronic Illnesses

The prevalence of chronic illnesses, including diabetes mellitus, hypertension, stroke, cancer, asthma, and cardiovascular diseases, has increased dramatically in the United States (Raghupathi & Raghupathi, 2018). Additionally, the rate of multiple chronic conditions and other serious illnesses is rising dramatically worldwide, becoming a global public health concern (Hajat & Stein, 2018). Individuals diagnosed with these illnesses have disproportionately high health care needs. They need more frequent and intensive care, imposing a huge burden on primary care providers (Fraze et al., 2020). Providing these patients with an intensive focus on improving their quality of life and overall well-being.

For this reason, healthcare organizations have engaged nurse practitioners in caring for these patients to meet their increased healthcare needs. APRNS play various roles in managing chronic illnesses. First, APRNs make an initial diagnosis for various chronic illnesses based on a patient’s medical history, physical exam results, and diagnostic test results. APRNs can diagnose chronic illnesses independently or can collaborate with primary care providers. Secondly, APRNs engage in home telemonitoring, in which they monitor disease symptoms, evaluate patient’s adherence to the prescribed medication, and monitor patient’s parameters, including weight, heart rate, and blood pressure to detect danger signs which indicate exacerbation of the illnesses (Coates, 2017). Thirdly, APRNs play a significant role in Nurse practitioners managing chronic diseases. They enable people with chronic illnesses to access intensive, frequent, and coordinated care. APRNs serve as primary providers and ensure that patients with chronic illnesses access the required healthcare services. According to Fraze et al. (2020), nurse practitioners provide patients with healthcare similar to that primary care providers offer in terms of quality, satisfaction, safety, and accessibility metrics. APRNs utilize their clinical skill, knowledge and experience to provide high-quality care to patients with diverse healthcare needs. The Role of Advanced Nurse Practitioner In Healthcare Discussion

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Increasing Demand for APRNs

            The need for APRNs has increased dramatically in the US healthcare system. This trend is associated with the significant contribution of APRNs in managing acute and chronic illnesses. According to Fraze et al. (2020) are involved in providing regular and intensive care to patients with chronic illnesses, reducing the huge burden of healthcare services these patients impose on primary care providers. Additionally, APRNs assist primary care providers in meeting healthcare recommended for a patient with particular chronic illnesses. Poghosyan et al. (2020) indicated that primary care practices that employ APRNs have high chances of completing care management recommended for patients with chronic illnesses. APRNs also play a significant role in assessing, diagnosing, and treating acute illness in primary care settings. According to Woo et al. (2017), the ACNP was involved in assessing, diagnosing, and documenting patient care in the primary care setting. ACNP was also involved in weaning and extubations of patients in the inpatients. Therefore, a significant increase in acute and chronic healthcare services, especially during and after COVID-19, has led to the high demand for APRNs.

The Significance of APRNs Incorporating Nursing Theory in their Clinical Practice

            Incorporating nursing theory into nursing practice has become a common practice since the 1990s. Integrating nursing theories in advanced nursing practice has various benefits. First, nursing theories have been derived from various paradigmatic assumptions (McCarthy & Jeffrey, 2019). Thus, theories guide APRNs in providing quality, efficient, and safe care to various patient populations, meeting all their healthcare needs. Secondly, theories present nursing as a broad profession focusing on various factors that affect patients’ health, resulting in holistic health outcomes (McCarthy & Jeffrey, 2019). Furthermore, theories emphasize all areas of patient care, including disease prevention, illness treatment, and management of one’s health, resulting in optimum health outcomes. Nursing theories also inform APRNs’ thinking and reflection, resulting in reflective practice, which enables APRNs to transform reality in a way that leads to positive health outcomes. Therefore, nursing theories have impacted advanced nursing practice positively. The Role of Advanced Nurse Practitioner In Healthcare Discussion

How Can APRNs Practice Move Nursing Value if they fail to Provide Patient-Centered Care?

APRNs should focus on providing patient-centred care to individual clients to meet one’s healthcare needs. Patient-centred care recognizes and respects patients’ unique healthcare needs, preferences, interests and values (Kuipers et al., 2019). In patient-centred care, healthcare providers respect and consider patients’ values, interests, preferences, and goals while making significant clinical decision-making and assessing outcomes (Kuipers et al., 2019). Patient-centeredness is the foundation of providing quality health care and achieving holistic health outcomes. Thus, nursing practice can move APRNs from the nursing value if they fail to provide patient-centred care to their patients. In such cases, APRNs cannot provide holistic patient care, thus failing to address their physical, emotional, spiritual, and psychological healthcare needs. The Role of Advanced Nurse Practitioner In Healthcare Discussion

Interventions to be implemented in Classroom and Workplace to enhance Integration of Nursing Theory into Advanced Nursing Practice

Educating nursing learners and APRNs on the benefits of incorporating nursing theories into their clinical practice is the most effective intervention for enhancing the integration of nursing theories into advanced nursing practice. First, nursing learners and APRNs will be informed about the role of nursing theories in advocating for caring in nursing. Theories present caring as the centre of nursing care, which promotes respect for the integrity of the individuals in a dynamic relationship, resulting in quality care and positive health outcomes. Secondly, nursing students and APRNs should be informed about the contribution of theories in restructuring the entire nursing profession. Theories present nursing as a body of knowledge focusing on holistic care rather than identifying and treating a particular illness. Consequently, APRNs integrate nursing theories into their clinical practices, resulting in high-quality patient care and optimum health outcomes.

Conclusion

Nursing theory positively impacts clinical practices at all levels of nursing practice. Theories guide nurses in providing patient-centred care in which patients’ preferences, interests, values, and goals are integrated into clinical decision-making and outcome assessment. Additionally, theories guide APRNs in providing holistic care to their patients, addressing their physical, spiritual, emotional, and psychological healthcare needs. Nursing theories also consider other factors that influence one’s health, including the environment. Furthermore, nursing theories present caring as the foundation of quality and safe patient care. Nurses provide quality care to their patients if they are caring and compassionate. Lastly, theories present nursing as a unique profession based on a broad perspective, including preventing illness and self-management of one’s health, resulting in positive health outcomes. The Role of Advanced Nurse Practitioner In Healthcare Discussion

References

Coates, V. (2017). Role of nurses in supporting patients to self-manage chronic conditions. Nursing Standard31(38). https://academyhealth.org/sites/default/files/VA_FORUM_Fall_2017.pdf

Fraze, T. K., Briggs, A. D., Whitcomb, E. K., Peck, K. A., & Meara, E. (2020). Role of nurse practitioners in caring for patients with complex health needs. Medical care58(10), 853. doi: 10.1097/MLR.0000000000001364

Hajat, C., & Stein, E. (2018). The global burden of multiple chronic conditions: a narrative review. Preventive medicine reports12, 284-293. Doi: 10.1016/j.pmedr.2018.10.008

Kuipers, S. J., Cramm, J. M., & Nieboer, A. P. (2019). The importance of patient-centered care and co-creation of care for satisfaction with care and physical and social well-being of patients with multi-morbidity in the primary care setting. BMC Health Services Research19(1), 1-9. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3818-y

McCarthy, M. P., & Jones, J. S. (2019). The Medicalization of Nursing: The Loss of a Discipline’s Unique Identity. International Journal for Human Caring23(1). http://dx.doi.org/10.20467/1091-5710.2 . 3 1.101

Poghosyan, L., Norful, A. A., Liu, J., & Friedberg, M. W. (2018). Nurse practitioner practice environments in primary care and quality of care for chronic diseases. Medical care56(9), 791. Doi: 10.1097/MLR.0000000000000961

Raghupathi, W., & Raghupathi, V. (2018). An empirical study of chronic diseases in the United States: a visual analytics approach to public health. International journal of environmental research and public health15(3), 431. Doi: 10.3390/ijerph15030431.

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Woo, B. F. Y., Lee, J. X. Y., & Tam, W. W. S. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human resources for health15(1), 1-22. Doi: 10.1186/s12960-017-0237-9. The Role of Advanced Nurse Practitioner In Healthcare Discussion

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