Consensus Model Integration
Advanced Practice Registered Nurse (APRN) assumes an integral part in the delivery of healthcare to patients across the lifespan. The recent healthcare reform and the national shortage of health care providers in the rural and underserved areas caused a tremendous growth of APRNs. Thus, APRNs evolved as highly valued members in the delivery of healthcare. The purpose of this paper is to consider the various barriers that affect the delivery of affective healthcare by Advanced Practice Registered Nurses.
Practice Barriers
Each state regulates APRN licensure defining the full extent of the education and training. These laws and regulations vary from state to state creating an issue in the evaluation, diagnosis and
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Despite accepting advanced roles and responsibilities APRNs have often encountered various barriers in the delivery of effective health care based on the variability in the legislative requirements endorsed by various states. To overcome these barriers and improve the delivery of healthcare the Consensus Model for APRNs has been endorsed by 41 various nursing organizations focusing on defining the roles, population foci and implementation strategies across the nation (American Nurses Association [ANA], 2017). Creating a standard expectation regarding the practice of APRNs will help to foster more consistent, quality education APRN programs nationwide (Rounds, Zych, & Mallary, …show more content…
The model includes the following key elements to ensure the uniformity of state laws: title of APRN, licensure, graduate or postgraduate education, certification, independent practice and independent prescribing (National Council of State Board of Nursing [NCBON], 2017). North Carolina Board of Nursing has targeted some of the major elements of the Consensus Model, while independent practice and independent prescribing remained unaffected.
APRN titles and educational requirements
Currently, the North Carolina Board of Nursing (NCBON) uses the following titles for APRNs: Nurse Practitioner, Nurse-Midwife, Nurse Anesthetist, Clinical Nurse Specialist. According to the NCBON a candidate for APRN has to complete a graduate degree and pass a national certification examination to be able to practice in one of the APRN roles.
APRN Licensure
While some states use the term “licensure,” the NCBON uses the term “approval to practice” for the APRN roles. The national certification is required in the state of North Carolina.
Independent Practice and independent
Hi Freylen, as you discussed the Consensus Model allow APRNs to practice to the full scope of their education, able to move to different states, providing quality care. My new role as a primary care NP I agree with the continuity of care and follow patients into acute or long-term care facility to help them through their ongoing health issues and managing their chronic diseases(Stanley,2012).
Disciplinary Defense Insurance- If a case where a complaint is filed and you have to appear before the board, you have the right legal assistance. What are the ANA’s standards of practice and how do they differ from the state laws?
According to the BON, the scope of practice for the RN is defined as, “the legal scope of practice for professional registered nurses (RNs). “Professional nursing” means the performance of an act that requires substantial specialized judgment and skill, the proper performance of which is based on knowledge and application of the principles of biological, physical, and social science as acquired by a completed course in an approved school of professional nursing. The term does not include acts of medical diagnosis or the prescription of therapeutic or corrective measures.” (bon.texas.gov,
Conclusion In conclusion, APNs are equipped to deliver the same safe, efficient, and high- quality care as physicians. The clinical and professional background of nurses gives them an extraordinary opportunity to change the healthcare landscape and promote cost-effective, compassionate, and patient-centered care for people. In a study performed by Dill, Pankow, Erikson, & Shipman (2013), the patient preferred the APN to physicians due to greater accessibility, more personalized and compassionate care, increased comfort with communication, and past positive
Scope of Practice NP’s scope of practice can vary depending on which state they are licensed in. It is extremely important that the NP is aware of the laws and regulations that their state has implemented. Understanding the scope of practice allows you to understand what you can and cannot do as an NP. In Arizona, NP’s are board certified and are now required to take a national certifying exam (Buppert, 2015). NP’s in Arizona have an expanded scope of practice, they can assess, manage, diagnose, and prescribe medications to patients.
Advanced practice nurses (APN) have a vital role in the future of health care, especially since the enactment of the Affordable Health Care Act. With more citizens having health insurance coverage they will be seeking health care providers, and there are not enough physicians to care for them all. According to Letiziam (2014), advance practice nurses are licensed autonomous health care providers that have been trained to evaluate, diagnose, and treat patients and their conditions. Advanced practice nursing is an umbrella that covers four separate roles of nurses, this includes: the certified nurse midwife (CNM), certified registered nurse anesthetist (CRNA), certified nurse practitioner (CNP), and certified nurse specialist (CNS).
These studies illustrates that NPs can play a key role in providing services to health care market. NPs provide a full range of high quality care to patients of all ages. These services include primary care, acute care, special health care services such as oncology, gerontology health, or women’s health to name a few (American Association of Nurse Practitioners (AANP), 2015). NPs practice in many health settings, including private physician office, hospital, urgent care site, emergency room, community health center, school, and others. Family Nurse Practitioners (FNPs) are NPs are primary care providers who focus on
Nurse practitioners play an important role in healthcare in every state. However, each state has specific regulations pertaining to state regulations that guide prescriptive practice related to educational requirements, advance practice licensure requirements, and prescriptive authority (specifically controlled substances) of nurse practitioners. This paper will analyze the governing regulations of nurse practitioners in three states with full practice authority, reduced practice authority, and restricted practice authority. It will compare and contrast Washington D.C., New York, and Georgia, which have similar educational and licensure requirements, but vastly different approaches to the scope of practice in their respective states.
Retrieved from: http://www.in.gov/legislative/iac/T08480/A00040.PDF Pediatric Nurse Practitioner Certification Board (2015). Steps to CPNP-AC Certification. Retrieved from:
Working with state office leadership to develop policies and procedures based on evidenced based practices is crucial to the health of the public. The director attends county board of health meetings to professionally represent nursing and converse with board members to identify interventions to assist with addressing the needs of their community. These responsibilities highlight the need for all public health nurses, especially those in leadership roles, to have a BSN degree. As pointed out, the opportunities for a nurse transitioning from an AD position to a BSN position are diverse and endless. Patients, healthcare facilities and the nursing profession benefit from advanced degree nurses.
Retrieved from: https://www.aanp.org/legislation-regulation/state-legislation/state-practice-environment. Villegas, W.J. & Allen, P.E. (2012). Barriers to advanced practice registered nurse scope of practice: Issue analysis. The Journal of Continuing Education in Nursing, 43(9), 403-9. DOI:
While the main focus of APNs is clinical practice and direct patient care,
With the ongoing healthcare demands and shortages, the appropriate role and responsibilities of the advanced practice registered nurse (APRN) will continue to be a controversial debate. There were many points addressed in your post that I agree and don’t agree with. It is most certainly not arguable that physicians do endure a longer, more intense education. I personally believe their role as a hospitalist is valuable and should never be discredited for their knowledge and expertise. However, I also believe that they are doing their patients a disservice if they are being overworked due to provider shortages.
The Affordable Care Act has shifted focus on health and wellness of patient populations urging hospitals to do a community needs assessment and come up with a strategy to address these needs. Hospitals most often partner with community and professional organizations to address the health need (Stempniak, 2014). This is an example of how the four spheres are all interrelated. Nurses are at the heart of this movement, providing the necessary skills, experience and expertise to address the needs of the population being served (Shamian,
In the clinical setting, the nurses’ expertise can be used to make clinical assessments and recommendations for routine care at a lower cost than a physician visit. This would increase the number of patients seen and increase the quality of the care provided. The advance practice nurse would be able to hone in on preventative measures and increase patient education. The advance practice nurse can also make recommendations about practice changes needed to facilitate better health outcomes through the use of evidence-based practice. Nursing leaders are aware of how important nursing science is to provide needed evidence to transform practice, even though, finding the time and resources to support any research activity is often challenging (Stone, 2017).