Advanced Practice Roles in Nursing
•Advanced Practice Roles in Nursing (____/35)
- Compare and contrast the roles of the Nurse Practitioner, Nurse Educator, Nurse Informaticist and Nurse Administrator in advanced practice nursing pertaining to clinical practice, primary care, education, administration and research.
•Selected Advanced Practice Role (____/20)
- Examines regulatory and legal requirements for the state in which you plan to practice.
- Describe the professional organizations available for membership based on your selected role.
- Identify required competencies including certification requirements for your selected role.
- Predict the organization and setting, population and colleagues with whom you plan to work.
•Leadership Attributes of the Advanced Practice Role (____ /15)
- Determine your leadership style: http://psychology.about.com/library/quiz/bl-leadershipquiz.htm
- Identifies leadership attributes you currently possess, and attributes you may need to develop.
- Determine how to attain and evaluate those missing attributes.
•Health Policy and the Advanced Practice Role (____/20)
Visit the Robert Wood Johnson Foundation http://www.rwjf.org/en/topics/rwjf-topic-areas/health-policy.html and identify a health policy issue. Conduct a review of literature and address the following: ◾Describe the current policy and what needs to change; justify your conclusions with citations from the literature.
- Provide the process required to make the change with key players and parties of interest.
- Explain how you could lead the effort to make or influence the change in policy.
- Predict the effect on health care quality if the change in policy is implemented
Overall scholastic quality (____/10)
- Writing style
- Additional Deductions ______ (Turn-It-In >20%)
Advanced Practice Roles in Nursing
The unique roles of nurse practitioners include; diagnosing, treating and assisting patients in managing both chronic and acute illnesses (Iglehart, 2013). These individuals are charged with the responsibility of executing physical examinations as well as interpreting medical history. The Nurse practitioners have the role of ordering and conducting diagnostic procedures. These professionals can perform minor surgeries and procedures, as well as prescribing age-based physical therapy and rehabilitation. However, the role of recommending pharmacologic treatments varies with states.
The nursing educators are responsible for scheming, implementing, assessing and reviewing academic and continuing educational programs for nurses (Joel, 2013). The educators play a major role in conducting research and outlining the existing trends. Through these researches, new techniques and procedures are developed. The nursing educators integrate the nursing ideologies with multiple information handling and analysis to define, identify, manage and implement the knowledge, ideologies, and information in the healthcare practice (Joel, 2013). The educators, similar to nurse practitioners may offer counseling and education to individuals about the preventive measures to reduce the prevalence of diseases.
Nursing administrators are in charge of large-scale policy establishment. The administrators review the current policies and imitate the process of developing new ones or improving the current ones based on their effectively. The nursing administrators are in charge of workers management (Joel, 2013). They have the responsibility of recruiting new workers as well as relieving the current ones. They develop the working relationship as well as the engagement contract with individual workers. They manage the welfare of the workers. They also manage the business side of the healthcare facilities; like managing the accounts, developing investment plans, developing financial projections, and analysis the performance of the health care facilities among others.
The nursing informaticists are charged with the responsibility of integrating nursing science through multiple management and analytical science to determine, manage, define and share knowledge, data, and wisdom I the nursing practice. As the technology is improving, new systems are finding their way in the healthcare sector. The nursing informaticists are in charge of developing and handling of these technologies in the healthcare facilities.
The main role shared by all the above professions is the responsibility of ensuring the quality of delivery of service. These professionals must always conduct themselves in a manner that would promote healthcare service quality. They have the responsibility of assessing the current practices in each field and coming up with new and novel ways of delivering services. Another shared responsibility is the promotion of health awareness. All the practitioners in the healthcare sector have a role to play when it comes to conducting awareness campaigns. The nursing educators, as well as the nursing practitioners, share the responsibility of conducting or facilitating research on healthcare related topics. The educators may need the input of the practitioners when conducting research. The nursing administrators, as well as the nursing informaticists, have a role to play in handling and storage of clients’ information. The two institutions usually work together to implement systems that best store client information. It is only the nursing practitioners who handle patients both in diagnosis and administration of treatment. Of the four professionals, only the practitioners are allowed to give prescriptions to the patients.
Selected Advanced Practice Role
Regulatory and legal requirements
An Advanced Registered Nurse Practitioner (ARNP) in Florida is defined by s.464.003 as per the Florida Statutes as any individual that is licensed in the state to exercise professional nursing, and they can also have advanced or specialized certifications in the practice of nursing. These certifications may include registered nurse anesthetists, nursing practitioners, and certified nurse-midwives. As per Rule 64B9-4.010(1), of the Florida Administrative Code, “An Advanced Registered Nurse Practitioner shall only perform medical acts of diagnosis, treatment, and operation under a protocol between the ARNP and a Florida-licensed medical doctor, osteopathic physician, or dentist.”
A written procedure that is signed by all the parties involved that represent the agreement of the medical practitioner, and the ARNP should include and not limited to:
(a) General Data.
Signatures of every party to the procedure (At practice places that have many dentists or physicians administering the same ARNPs, the process may grant the authority of signing the protocol for the dentists or the physicians who are listed in the process to one of the physician or dentists who is playing the supervisory role in a health care facility); the data captured here includes name, address, ARNP certificate number, ARNP DEA number, license number of the dentist or physician.
Nature of practice is also captured; practice location that may include the primary as well as the satellite sites and the date the protocols were made or amended with all the signatures of all the parties.
(b) Collaborative Practice Agreement
It entails the description of the responsibilities of ARNP, explanations of what the physician or the dentist should do, and this may include all the supervisory and consultative plans and what should be done if a dentist or the physician is not available. The agreement should also describe the management areas that ARNP should handle, in terms of the conditions that calls for the initiation of therapies, the treatments that can be started by ARNP, in regards to the condition of a patient and the conclusions from the ARNP and the kind of drug therapies that can be prescribed, initiated, altered, ordered or monitored by the ARNP.
There should also be a provision of yearly review by all the parties involved. Also, there should be specific conditions as well as a procedure that can help in the identification of conditions that may call for direct evaluation or consultation by a dentist or physician.
The Professional organizations available for membership
There are some professional organizations available for membership in Florida in the medical field. They include; Florida Association of Nursing Practitioners (FLANP); this is a proactive group of nursing practitioners as well as health care advocates working together to improve access to healthcare services to the citizens of Florida.
Florida Nurses Association (FNA); an association that always represents the all the nurses in Florida. It aims at ensuring that the nurses work together and have one voice to protect the nurses together with the people they serve. It also aims at supporting all the registered nurses regarding professional development, promotion of excellence as well as advocacy.
Another professional organization is the Florida Coalition of Advanced Practice Nurses (FLCAPN): that aims at building a cohesive base for all APN members. The coalition promotes creative approaches to solving problems by the use of advanced practice nursing models for addressing healthcare problems in Florida.
For one to be certified and registered in Advanced Registered Nurse Practitioner, the requirements as per section 464.012.F.S. are as follows:
The person must be a holder of a valid Registered Nurse License recognized in the State of Florida. Other requirements include education which requires an applicant who graduated on or after October 1, 1998, to complete a master degree program or a post-master degree. Any Certified Registered Nurse Anesthetist applicant that graduated on or after October 1, 2001; must have a complete degree program, all the applicants who graduated before the applicable dates do not have to follow this requirement, all the graduates from either certificate or the closed program are supposed to provide supporting documents to prove that their program complies with the guidelines of the Board.
After July 1, 2006, the applicants for ARNP certification as per section 464.012(1), F.S, are required to provide evidence of national advanced practice certification from a recognized nursing specialty Board. All the applicants should also provide a proof of malpractice insurance or an exemption if applicable.
Predict the organization and setting, population and colleagues
The organization may be Mayo Clinic in Jacksonville; the setting should public healthcare sector handling a population of about 40,000 patients annually, in the sense that, the clinic handles about 5,853 annual inpatient and 6,505 outpatient surgeries. Its emergency room had 27,500 visits. And the colleagues will be other nurses, surgeons, doctors, and pharmacists.
Leadership Attributes of the Advanced Practice Role
Determination of the leadership skill:
From the activity taken, it was obtained that my leadership style is the democratic model.
This type of leadership model focusses on redistribution of authority and power between leaders and juniors to give them an opportunity to be involved in decision making. This model tries to lead with the principles of deliberation, equal participation, inclusiveness, and self-determination. The following are the outstanding attributes of my leadership model:
- Empowering colleagues: I emphasize on empowering others so that they can execute their responsibilities. This empowerment entails offering training and education necessary for delegated task handling.
- Distribution of task: As a leader, I would distribute responsibilities to individuals and ensure that each and every one of them is acknowledged when making decisions.
- Facilitating group decision-making process: the juniors are free to raise their views as well as propose their ideologies. In such a case I act as a mediator and a facilitating in the discussions of the group members. I would ensure that a healthy and respectful environment is maintained.
The attributes that need development are:
- Being proactive: As a leader, it would be critical of me to be proactive and reactive. Being proactive means, I should be in a position to detect occurrences before they happen. I should be able to tell how the current strategies will the impact the future. As such I should develop strategies for future integration.
- Maintaining open communication: As a democratic leader, I should put more effort in making everyone feel comfortable. When all the members are comfortable, they can easily put across their views. This can be achieved by laying out by all the considerations for every individual member to examine. When passing communications, it necessary to address everyone and not individual members.
- Respecting ideas of every individual: Since democracy is about allowing divergent views, it is critical that I improve the level of acknowledgment of other people’s contributions. As a leader, I should not get emotional or get annoyed when the juniors have divergent views from mine. I should be in a position to accommodate every ideology, even if I feel they are out of place. Acknowledging does not mean accepting, I should strive to dismiss the views of others respectfully. This would mean using evidence to refute the thoughts of others.
How to attain and evaluate the missing attributes
Keeping a journal: I should make a journal that is strictly about my career. I would then record the various instances that I feel I could have handled better. I would also record other controversial instances, where I was not sure of how to handle. I would then find time to revisit these instances and look for ways of improving going forward.
Taking leadership building courses: there are many rolled out leadership courses available online. These courses are helpful in developing leadership skills. I would also learn from the experiences of other leaders. There are various documentations available on how to handle different situations. I would make such pieces of literature to be my reference points.
Health Policy and the Advanced Practice Role
The policy of choice if the Price Transparency Policy
Understanding the cost of healthcare services us usually confusing. The rates of the services vary depending on where the services are provided, the kind of insurance cover the patient took, and other factors (Delgado et al., 2016). It is not easy, therefore, for patients to know the amount they will be required to pay for a given procedure or test. Many individuals have been calling for greater price transparency in the health sector, where the individuals can readily see the cost of a treatment and determine the amount they should pay before receiving the service (Delgado et al., 2016).
The stakeholders have long agreed that price transparency in the service has numerous positive effects. Price transparency is an important tool that can be used by clients to compare the prices so that they can make informed decisions on healthcare. Most people want the level of price transparency to be increased (Christensen, Floyd & Maffett, 2013). However, the policy does not only serve educational purposes; it also lowers the cost of health care. Through price transparency, the consumers can anticipate the amount they will be required to pay, and this has helped reduce the cost of healthcare in the long run. The previous opacity of health care prices is believed to have been the main inhibiting factor to the attainment of the efficient delivery system. The stakeholder holds that the substantial cost containment cannot happen without a widespread and sustained transparency in provider prices.
Despite the increased access to price information, the usefulness of the tool us limited by lack of integration with health plans (Christensen, Floyd & Maffett, 2013). The healthcare providers are thus not able to automatically customize their price quotations based on the benefit structure of a patient’s plan. This needs to change; the policy should be made comprehensive to cover all the dynamics, which still exist.
The process required to make the change begins with bringing together all the stakeholders in a roundtable forum to initiate the policy review process. The next phase is the public participation stage where the patients would also be allowed to provide their inputs. The views collected would then be collected and analyzed to determine existing trends. A team of multidisciplinary professionals would then be involved in creating a new policy. The proposed bill will then be taken through the legislative process and would be passed to become law. As a democratic leader, I would accommodate the divergent views of every person. I would also act as a mediator to ensure that any conflicts arising are addressed. Once this policy is reviewed, the initial objective of substantial reduction of healthcare cost will be achieved.
Christensen, H. B., Floyd, E., & Maffett, M. (2013). The effects of price transparency regulation on prices in the healthcare industry. SSRN Electron J.
Delgado, R. I., Elifnur Yay Donderici, M. S., & Swartz, M. D. (2016). Price Transparency and Healthcare Cost: An Evaluation of Commercial Price Variation for Obstetrical Services. Journal of Health Care Finance, 43(3).
Iglehart, J. K. (2013). Expanding the role of advanced nurse practitioners—risks and rewards.
Joel, L. A. (2013). Advanced Practice Nursing: Essentials of Role Development. FA Davis.
Yoder-Wise, P. S. (2014). Leading and managing in nursing. Elsevier Health Sciences.