Journal articles: 'Advanced practice nursing role' – Grafiati (2024)

Abstract:

In the last few decades, all the countries aim to combine the improvement of the quality of health care with the reduction of health costs. In order to harmonize the above-mentioned contradictory goals, newly enhanced roles, as in the case of Advanced Nursing Practice, have been introduced, initially in the private sector and more recently in the public hospital setting. The orthogeriatric advanced nursing practitioners’ role is valuable for providing pain relief, diagnosing and treating postoperative delirium, deep vein thrombosis, and secondary infections, preventing subsequent injuries and pressure sores, helping patients deal with postoperative constipation, and assist them in early mobilizing. After patients’ discharge from the hospital, their role is essential for ensuring the patients are adhering to their osteoporotic treatment and have the adequate skills to prevent falls. Their role is significant for older adults living in nursing homes or long-term care facilities. Their care is cost-effective compared to regular care.

Abstract:

The advanced nurse practitioner (ANP) role was established in Ireland in 2001 and represents an important nursing role development within Irish healthcare. Currently there are 336 ANPs registered with the Nursing and Midwifery Board of Ireland, working across 40 specialties. This number is increasing exponentially in response to emerging and anticipated future service needs and population demand projecting to a critical mass of 750 by 2021. Health service provision is enhanced by advanced practice performance outcomes. This article explores nurse to advanced nurse practitioner transitional journeys, a concept that has not previously been researched in depth from an Irish perspective. The theories of Benner, Woods, and Bourdieu are reviewed to explore whether an advance practice career trajectory results in unique nurse-to-ANP role transitioning. Contextualising possible personal, professional and educational transitions may enable the promotion of effective career ‘scaffolding’ to enhance a smooth transition for aspiring ANPs into advanced nursing practice roles.

Abstract:

Nurses around the world are increasingly prescribing and managing pharmaceutical agents. Prescribing by nurses is currently based on varying nursing roles, depending on national and regional norms and practices. Prescribing occurs within the advance practice, advanced level, and task-sharing roles, depending on the country. It is evolving both within and outside of traditional regulatory frameworks. Therefore, the purpose of this article is to describe the nurse prescribing globally among various nursing roles that support and facilitate the practice. We gathered practice, statutory, and regulatory information from gray and peer-reviewed literature, Google search and Google scholar, government websites, PubMed, and CINAHL electronic databases. In contrast to previous global policy reviews that focus primarily on high-income nations, our findings suggest that nurse prescribing occurs extensively in all six continents. Nurse prescribing within the context of advanced practice nursing occurs mostly in high-income countries. However, the predominant model of nurse prescribing from the global context occurs within the advanced level role by postbasic or postprofessional nurses. Additional nurse prescribing occurs through less formal task-sharing arrangements, primarily in low- to middle-income countries. In general, nurse prescribing is evolving rapidly around the world but within highly variable roles and regulatory frameworks. Codifying these roles by strengthening of educational and regulatory standards may serve to enhance the health system capacity, especially in low- to middle-income countries.

Abstract:

In the UK, transformation of the nursing workforce, including development of the role of the advanced nurse practitioner within general practice, is essential to meet healthcare demands. This article presents the results of a small, qualitative study conducted among students at one university in Scotland, describing their experiences of participation in advanced practice education. Data were collected through semi-structured interviews to generate in-depth descriptions and to identify the facilitators and barriers to learning. The study identified that a shared responsibility for patient care creates opportunities for learning. The facilitators to learning were identified as foundation level education in history taking and clinical examination, finance, having a supportive network and mentorship. Barriers included pressure of work and a lack of clarity about roles and training needs. Given the key role that these nurses will have in future healthcare models, there is a requirement for a national education standard. It is recommended that the Nursing and Midwifery Council leads on defining advanced nurse practitioner in general practice programme learning outcomes. The overall aim of such courses is to enhance the experience for future nurses to encourage recruitment and transform the nursing workforce.

Abstract:

ABSTRACT Objective: Reflect on the role of advanced practice nursing (APN) in the context of Brazilian primary health care. Method: analysis of the main scientific productions and of the discussion on the implementation of APN. Results: there are favorable areas for the work of APN in primary health care, especially in the family health strategy. Professional master’s degree and nurse residency programs constitute powerful training spaces. As a challenge, standardized definition of the roles of advanced practice nurses and of minimum training for work are necessary. Final considerations: researches that contribute to understanding the perspectives, facilitators, and barriers for APN are necessary, as well as determining the population’s health needs and expectations concerning the role of these professionals.

Abstract:

Advanced Practice Nursing (APN) emerged as a response to the need for professionals capable of giving care to patients, thereby improving the quality of healthcare; the results obtained by implementing APNs in healthcare teams confirm that APNs can be implemented in the healthcare of patients of all ages and with varied health situations (1). Levels of development in APN are very diverse in distinct countries, in the legal aspect as well as in the roles that a nurse with this level of training can fulfill. The International Council of Nurses (ICN) counts around seventy countries as being preoccupied with introducing clear function for APNs (20); nonetheless, literature describes the main progress in this sense occurring in Canada, Australia, Ireland, Finland, the United Kingdom, and the United States, although in the last ten years significant advances have been identifies in Belgium, Germany, Switzerland, Thailand, Singapore, Korea, and Africa (3, 4). In Latin-American, progress in this initiative is embryonic: the role that a APN can fulfill has not been sufficiently disseminated and the implementation of this strategy has been limited by healthcare policies in many countries or by the opposition to APNs by professionals in other areas who are reacting to misinformation or to fear of usurpation of certain functions by APNs. However, in primary care, APNs have been incorporated into healthcare teams, and research shows positive results for the expansion of coverage and reduction of healthcare costs, in both rural areas and urban centers (1, 5). Thanks to these advances, in 2000 the ICN supported the creation of the International Nurse Practitioner/Advanced Practice Nursing Network (INP/APNN) with the objective of favoring dialogue, advancing the installation of APNs in the countries, facilitating the interchange of knowledge, determining the limits in the expansion of the role of nurses, and defining the guidelines for the formation of human resources at this level. Likewise, the World Health Organization and the Pan-American Health Organization (PAHO) have worked with universities and nursing associations in Latin America and the Caribbean to, through context analyses, propose implementation of APNs (5). During August 2018, the 10th Conference of the International Nursing Council convened in Rotterdam with the goal of exploring the role of APNs in the transformation of healthcare (6). With the participation of more than fifty countries, the council established a global panorama of the situation and of the challenges nursing faces as an active participant and agent for achieving universal health coverage. An important conclusion drawn from the event is the recognition given by all participating countries to APNs for allowing significant advancement of strategies for primary healthcare and the achievement of goals related with universal health coverage and sustainable development: the guarantee of a healthy life and the promotion of wellness for everyone at every age (4, 5). These propositions imply a process and the need for countries to work towards the expansion of nursing roles, which requires the promotion of a collective project that unites different sectors involved in the formation of human talent, on one hand, that the offering of health services on the other. Likewise, administrators of education and health policy along with associations involved in the nursing discipline need to contribute to the analyses of strategies for implementing a sustainable and efficient health system that allows universal access to health (1, 4, 7). In this context, APNs are understood to have undergone master or doctorate level training that develops scientific knowledge, clinical expertise, leadership, political formation, communicational capacity, and education for the patient, family, and community groups. Therefore, the professional is enabled to take ethical decisions, work autonomously, interact in intra- and interdisciplinary groups, and understand that ANP’s work will be determined by the unique environment, healthcare structure, and legislation of different countries. In accord with Morán-Peña (8), the International Nursing Council states that APNs are characterized by an autonomous practice that allows the implementation of tools like: valuation, diagnostic reasoning, decision making for the handling of cases, plan development, implementation and evaluation of programs as part of consultation services, and being the first point of contact in the healthcare system. This implies that an ANP will have competencies to participate in the elaboration of public policy as well as on teams dedicated to care for individuals, families, groups, and communities in disease prevention, health promotion, treatment, recuperation, and palliative care (7, 9, 10). Consequently, working on the implementation of the EPA can possibly lead to transformation of healthcare systems in the clinical area, improvement in the access to primary healthcare, and in the design and development of investigation projects whose results can be applied in practice; in short, it would affect the quality and effectiveness of healthcare at different levels and allow the urgent and much needed evolution of healthcare systems (11). With this perspective, the fundamental question is whether sufficient political interest exist for the development of APN’s roles, the definition of APN’s limits, the adaption of the existing structure, the establishment of guidelines for educational programs, and the application of expert knowledge, among other aspects, in benefit of health coverage, healthcare quality, and the establishment of a sustainable healthcare system.

Abstract:

This six-paper series in the International Year of the Nurse and Midwife aims to draw together two important themes: celebrating the role of nursing in advancing care in cardiac surgery and providing an international perspective of cardiac surgery nursing.

Abstract:

Oncology care is becoming increasingly complex. The interprofessional team concept of care is necessary to meet projected oncology professional shortages, as well as to provide superior oncology care. The oncology advanced practitioner (AP) is a licensed health care professional who has completed advanced training in nursing or pharmacy or has completed training as a physician assistant. Oncology APs increase practice productivity and efficiency. Proven to be cost effective, APs may perform varied roles in an oncology practice. Integrating an AP into an oncology practice requires forethought given to the type of collaborative model desired, role expectations, scheduling, training, and mentoring.

Abstract:

This paper compares the results of studies of ophthalmic advanced practice in two similar but distinct health economies and integrates the effects of the setting, health policy and professional regulation on such roles. A mixed method questionnaire design was used, distributed at national ophthalmic nursing conferences in the UK and in New Zealand. Participants were nurses undertaking advanced practice who opted to return the questionnaire. Data were analysed separately, and are compared here, integrated with national health policy and role regulation to provide commentary on the findings. The findings suggest that health policy priorities stimulate the areas in which advanced practice roles in ophthalmic nursing emerge. The drivers of role development appear similar and include a lack of experienced doctors and an unmanageable rise in healthcare demand. Titles and remuneration are different in the two health economies, reflecting the organisation and regulation of nursing. In clinical terms, there are few differences between practice in the two settings and it appears that the distinct systems of regulation have minimal effect on role development. Ophthalmic nursing, as a reactive, needs based profession and in common with nursing in general, evolves in order that practice reflects what is needed by patients and services.

Abstract:

Aims and Objectives: This article aims to provide an overview of the history of advanced practice nursing, including regulation, education, and faculty practice of nurse practitioners/advanced practice nurses from Australia, the United Kingdom, and the United States. Background: Clinical nursing education has evolved from the apprenticeship model to the multiple learning methods that are employed today. The faculty practice model has the most promise and maybe the new frontier to achieve excellence in clinical education. Design: Discursive paper. Methods: Advanced practice nursing clinical education will be discussed, current trends presented, and future educational directions considered. The essential characteristics of an effective clinical educator and the ideal context for clinical education will be highlighted with the goal of educating for clinical excellence. Contemporary practices of a nurse practitioner regulation and education will be examined. Conclusions: Faculty practice in advanced practice nursing requires critical elements, which include role modeling, financial sustainability, teaching credibility, translation of research to practice, and clinical expertise. Challenges to a functional context include conflicting regulatory issues, limited scope of practice, external agency restrictions, and lack of institutional support. Relevance to clinical practice: It is essential to understand the ideal characteristics and context for effective advanced practice clinical education and identify specific challenges within each country’s functional contexts that prevent effective advanced practice clinical education. Strategies to address these current challenges and to enhance clinical excellence to maximize the effectiveness of advanced practice nursing education.

Abstract:

In this quantitative study, Sarah Barea analyses the current advanced practice roles in primary care in Cornwall Aim: To analyse current primary care advanced practice roles in Cornwall, measured against Health Education England's Multi-Professional Framework for Advanced Clinical Practice. Method: A quantitative questionnaire was sent to all primary care practitioners in the county practicing with an advanced title. Findings: In total, 34 respondents (approximately 60% of those invited) took part. Practitioners have a broad spectrum of experience and education and varied scope of clinical practice. The grading of roles does not compare with educational level, experience or scope of practice. This is consistent with current literature which explores the need to regulate the role. Conclusion: If the Advanced Practice Framework is implemented as planned, then there are gaps in current practice that need to be addressed in order to ensure practitioners have the competencies to provide safe, autonomous practice.

Abstract:

Background: Cardiovascular diseases (CVDs) are the number one cause of death globally. Most can be prevented by addressing behavioral risk factors, where advanced practice nurses- clinical specialists in cardiovascular nursing play a fundamental role. This modern and effective role is based on advanced activities, knowledge, skills, and experience in a specialized field, which can make a significant contribution to solving the problems of these civilization diseases. The aim of this work is to explore the self-perception of advanced-practice nurses (APNs) working in cardiology and vascular medicine departments within the context of advanced-practice nursing. Methods: This quantitative exploratory study included 103 APNs working in cardiology and vascular diseases departments of specialized hospitals in Slovakia. A validated instrument was used. Results: The overall perception was at the level of 68.01%. The highest-rated domain was the outcomes for patients/clients, and subdomains were meeting the needs, education of healthcare workers, and quality in relation to management. There was a significant difference found among hospitals with a better scoring of specialized institutions. Conclusion: There have been promising advances due to the current legislation in Slovakia defining APNs and specialists’ competencies. However, the practice in nursing for CVD patients remains fragmented, uncategorized and less valued by stakeholders and the public. According to the results, nurses have the potential and preparedness for this role in the context of their knowledge and skills in general. The Authors conclude that there is a need of such specialization of APNs in Slovakia.

Abstract:

Multiple sclerosis (MS) is a complex neurological disease that often requires a multidisciplinary approach to its management. The health care team treating MS patients is comprised of nurses, physicians, and therapists, many of whom are specialists in MS. As members of the MS care team, advanced practice nurses are prime candidates for addressing both MS-specific concerns and unmet primary care needs of their patients. Current discussion in the health care community has focused on the doctor of nursing practice (DNP). This article discusses the potential role of the DNP in caring for the MS patient.

Abstract:

This literature review was done to explore the use of master's-prepared nurse practitioners to manage critically ill patients. Data-based, anecdotal, clinical, analytic, and position papers published over the past 10 years in the medical and nursing literature were reviewed. This article synthesizes findings on the use of nurse practitioners in clinical settings including primary and specialty care settings, describes favorable outcomes of advanced practice nurses, and identifies factors that must be addressed as these roles increase in use in critical care settings. Nurse practitioners' movement into critical care settings should be undertaken. Additional federal support to ensure the preparation of these practitioners in adequate numbers is needed. Attention to issues of direct reimbursem*nt, salaries, impact of changing role boundaries, malpractice coverage, and prescription privileges must be addressed. Research programs to examine the effect of nurse practitioners in specialized care should continue.