Pros and cons of Doctor of Nursing Practice
Pros
In the article written by Ford, (2009), the doctorate of nursing practice (DNP) has an important role to play in the current health care system which is constantly changing. As healthcare around the world is transforming, the Institute of Medicine (IOM) 2011 report mentioned that in the United States, Advanced practice nurses play a vital role in the rapid complex changes based on the full extent of their education and training. This article describes some of the positive role of the advance practice Nurse as a facilitator in the regulatory and policy developments. The Advance practice nurse participates and provide cost-effective care models that will improve the access and quality of care of the population. Another positive area for the APN in this current healthcare system is health promotion, health maintenance, and prevention. In this evolving health care system, it gives the Advance practice nurse the opportunity to set up acute and primary care settings that will positively impact health care delivery as they meet the needs of an expanding, aging, and chronically ill population. All over the world, the NP’s role has developed and is beneficial to health care systems and health care consumers. As Advance practice nurses we must use this great opportunity to advance our role and work with others to improve and transform health care globally. DNP graduate 's role is include leadership, research, practice, education, and
In addition, a DNP degree will help me better serve my community by advocating for quality and safety healthcare system. Once attained, I would seek employment at either a school or university with the mission of educating nursing students to practice the highest quality of patient care. One of the major issues facing the nursing profession today is the lack of advance nursing practices. The medical field is in crisis. Doctors are stretched to the limits, and patients are demanding more advanced care. To alleviate some of the concerns facing medicine in the 21st century, advance nursing practices is a vital area in the contribution of understanding and working within the bounds of a team structure, and the promotion of communication between the interdisciplinary health team. The mission of the advance nursing practice is to help individual patients, and their families, determine and achieve optimum physical, mental and social potential, and to do so within the challenging context of the environment in which they live and work Nurses are among the largest professional care group within the healthcare service industry. We are responsible for providing quality care and assisting patients towards independent and healthy living. Considering the changing working environment, health care practitioners like nurses are
The health care industry is experiencing a surge in the number of baby-boomers needing health care and increased demands on the physicians providing the care. This trend has made the role of Advanced practice providers more important (cite). It is imperative to understand the differences and similarities in the advanced practice provider roles as it pertains to healthcare. This paper will identify specialty nursing roles including advanced practice registered nurses (APRN). It will further compare and contrast the advanced practice nurse (APN) and physician assistant (PA) roles in practice.
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
The American Association of Colleges for Nurses [AACN], (2006) in 'The Essentials of Doctoral Education for Advanced Nursing Practice ' Essential II: Organizational and Systems Leadership for Quality Improvement and Systems Thinking, affirms "advanced nursing practice (APN) includes an organizational and systems leadership component that emphasizes practice, ongoing improvement of health outcomes, and ensuring patient safety. APNs should be prepared with sophisticated expertise in assessing organizations, identifying systems’ issues, and facilitating organization-wide changes in practice delivery". (p.10) Hameric, Hanson, and Tracy ( 2014) indicates that APN must assess the clinical microsystems in which they perform nursing practices, have knowledge of the medical organizations that impact their specialties, assist with establishing patient centered care reforms to enhance quality of nursing care, improve patient safety, and provide nursing indicators that evaluates nursing performance. (p.266) APNs perform leadership capabilities in four chief areas including clinical practice settings, in the nursing career, within organizations, and in healthcare politics at regional and national levels. (Hameric et al, 2014, p. 266)
In 2008, the coalition of members from the Alliance for Advanced Practice Credentialing and the National Council of State Boards of Nursing (NCSBN) created the Consensus Model for Advanced Practicing Registered Nurses (APRN’s). This model creates a framework for APRN’s in licensing, accreditation, certification, and education in the United States (Alleman & Houle, 2013). The establishment of this Consensus Model has developed a bases for the ARNP’s comprehensive knowledge base, ability for clinical reasoning, cultural, and ethical competencies, establishing a model of practice for ARNPs in which to follow. These concepts will be further discussed in this paper.
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
The report shows that the part of nursing must be expanded so that nurses are able to practice to the fullest degree of their education and training. Currently, advanced practice nurses (APRNs) work according to the scope of practice guidelines set forth by their individual state, meaning these highly educated nurses may not be working to the extent of their training but to the individual state laws. The report offers recommendations to streamline these idiosyncrasies and get rid of the red tape so that nurses can work in their appropriate manner and deliver safe quality care to some 32 million Americans who will before long gain access to health care services (American Association of Colleges of Nursing [AACN], 2012). The report correspondingly finds that nurses need to attain advanced levels of education and training through an enhanced education structure which encourages a cohesive academic progression as to safeguard the delivery of quality health care services. Patients are becoming progressively more complex and nurses need to attain the proper skills to care for these persons. Nursing education must embrace the continuous move towards a streamline approach to higher degree programs (Institute of Medicine [IOM], 2010, p. 2). Nurse residency programs
The historic article by Safriet (1992) fully lists and analyzes the major challenges facing the advanced practice nurse (APN). At the time the article was written compared to now, a few aspects are changing. In areas where change has occurred, it has been an exceedingly slow process. Change for APNs is often dependent on legislation and regulatory authorities which receives half-hearted support, at best, from the medical establishment (Safriet, 1992). Since the first day nurses were given any authority to practice outside of regular practice, physicians only objected when it began to encroach upon their perceived hierarchal status or potential for compensation (Hamric, Hanson, Tracy, & O’Grady, 2014). The concern that this
As the young and rapidly-aging population continues to increase, the demands of primary, acute and chronic disease management will also increase. As a result, more health care professionals who provide primary care will be needed to meet these demands. Thus, the emergence of Advanced Practice Registered Nurse (APRN) evolve. APRN is a nurse who has completed a graduate degree and has acquired advanced knowledge and skills. APRNs are grounded with theory, concepts and principles that enable them to assess, diagnose, treat and manage their patients. APRNs can work in conjunction with other health care professionals or independently. APRNs improve access to health care by providing care in the rural and underserved areas. APRNs also reduce the cost to health care (Joel, 2013).
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.
For current and future needs we need to enable all healthcare professionals especially nurses to practice to the full level of their education and training. Advanced practice nurses can fulfill the primary care needs. This will free up physicians to address more complex cases which needs their expertise. Current practice focus on specialty and acute care only and a shift in practice to deliver more primary care and community care services is essential to improve the quality of nursing care and address the growing need of care in these areas.
The role of Advanced Practice Nursing (APN) has changed dramatically in recent years. Currently, the Unite States (U.S.) health care is focusing on delivering a cost -effective health care to all patients. In the last decades, there were many efforts to control health care over spending in the U.S. One of such efforts is to focus on applying proven principles of evidence-based practice and cost-effectiveness to find the least expensive way to produce a specific clinical service of acceptable quality (Bauer, 2010). The vast changes in health care system, such as cost, need for high productivity, limitation on reimbursement, and the inadequacy on access have made APNs to think in a way where they most fit to provide independent care for
The role of the Advanced Practice Nurse (APN) is expanding internationally throughout the healthcare system. Since the initiation of the Patient Protection and Affordable Care Act in 2010, there has been an increased need for APNs due to the growing demand for primary care services and increased population that have gained healthcare coverage (Lanthrop & Hodnicki, 2014). The purpose of this paper is to explore the role of APN and develop a professional development plan for my future career.
“Advanced nursing practice is the deliberative diagnosis and treatment of a full range of human responses to actual or potential health problems.” (Calkin, 1984). Advanced nurse practitioners attempt to maximize the use of knowledge and skills and improve the delivery of nursing and health care services. The field of advanced nursing practice differs from basic practice as the former requires clinical specialization at the master’s level. At this level, nurses become expert practitioners whose work includes direct and indirect patient care. Direct patient care involves caring for patients and their families; this is the focus of my section on nurse clinicians. Indirect patient care includes work as an educator, researcher, and a
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