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Paola Vieira
YesterdayNov 1 at 10:48pm
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The Role of the APRN
The Role of the APRN, has emerged due to the changing environment of
healthcare. As the cost of healthcare rises, APRN's play an important role in cost
management and quality of care available to patients. From the Video sick around
the world, it is clear that other countries have achieved different ways to reduce cost
in healthcare. I'm wondering if APRNs in the USA can be a way to manage the cost
of primary care and preventive care. Challenging forces that may make it difficult for
APRN's to practice is the regulatory practices such as physician oversight. Does
working with a physician reduce overall cost? or does it increase the number of
patients that can be seen in an office at any given time? From this perspective, I
think that APRN's can offer great quality of care at a lesser cost but still be rewarded
for the work they do. Removing regulations that prevent NPs from practicing on their
own, can also benefit the cost on the health care system. " The Unites States has
regulated some of the scope of practice of the
APRN, The United Kingdom and Finland did not regulate the titles or the scope of pr
actice of advanced practice nurses, besides regulation of registered nurses and pres
criptive authority, but leaving the governance to individual settings and employers."
Maier, C. (2015).
In the USA, there are states that have allowed NPs to work without physician
oversight, allowing for NPs to own their own practice and serve a variety of patients
in the community. "The United States still faces variations across states. The
landmark Institute of Medicine (IOM) report on the future of nurses recommended
removing regulatory barriers to practice, so all NPs can work to their full extent of
training." Maier, C. (2015). Allowing NPs to practice to the full extent of their license
allows for healthcare to become more accessible and affordable. Primary care and
preventative care play a key role in reducing the extenuating burden of illness and
the price tag the comes along with it. Currently, Rhode Island allows APRN's to
practice independently. "State practice and licensure laws permit all NPs to evaluate
patients; diagnose, order and interpret diagnostic tests; and initiate and manage
treatments, including prescribing medications and controlled substances, under the
exclusive licensure authority of the state board of nursing." AANP, (2023).
Nurses will continue to play and integral role in health care and the role of the APRN
is one that will be needed even more as the needs of the populations continue to
evolve.
References
Maier, C. (2015). The role of governance in implementing task-shifting from
physicians to nurses in advanced roles in Europe, U.S., Canada, New Zealand and
Australia.
Health Policy, 119(12), 1627–
1635.
http://dx.doi.org/10.1016/j.healthpol.2015.09.002
American Association of Nurse Practitioners, (2023) State Practice
Environment.
State Practice Environment (aanp.org)
Links to an external site.
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Sydney Lavoie
Sydney Lavoie
YesterdayNov 1 at 10:50pm
Manage Discussion Entry
As per the International Council of Nurses, an Advanced Practice Nurse (APN) is
a highly-trained nurse who has pursued advanced education to acquire an extensive
knowledge base and refined clinical decision-making abilities. An APN uses a
complex skill set to care for patients with both acute and chronic conditions (Schober
et al., 2020). APNs have changed healthcare across the globe in a profound and
positive way. With the rising demand for healthcare services and a shortage of
physicians, the presence of advanced practice nurses is growing globally, leading to
improved health outcomes on a broader scale.
With escalating wait times, costs, and a shortage of medical professionals
straining healthcare systems worldwide, many countries are adopting a task-shifting
approach and granting increased autonomy to the nursing profession (Maier, 2015).
Allowing APRN to care for patients on a level comparable to their physician
counterparts has led to decreased wait times, which in turn led to greater patient
satisfaction.
In Brisbane Australia, a clinic run by NPs opened due to the demand on the
healthcare system and hospital waiting times for basic needs (Fagerström, 2012). As
APRNs are allowed to open practices and take on certain patient populations, it
lessens the strain on the healthcare system and allows for greater access to
healthcare. In countries such as Austria, Belgium, Canada, France, the US, and
others, the development of Advanced Practice Registered Nurses originated due to
the shortage of physicians in remote and rural areas, a desire to enhance the
continuity of care, and the growing prevalence of illnesses (Sánchez-Gómez, 2019).
As APRNs gained professional independence, they assumed responsibility for
managing acute and chronic conditions, with remarkable results. In a 2018 U.S.
study, primary care nurse practitioners had lower hospital admissions and ER visits
than primary care physicians (Joyce, 2021). Similarly, in Sweden and Finland,
advanced practice nurses improved care accessibility across both nations
(Fagerström, 2012). Globally, integrating APRNs into healthcare enhances primary
care access, promoting early healthcare issue detection.
The elderly population has reaped substantial benefits from the valuable
contributions made by APRNs. Worldwide, research has provided evidence of the
positive influence of APRNs on health outcomes across various domains, including
diabetes, hypertension, heart failure, as well as respiratory conditions among
geriatric patients. Given the unique and severe healthcare needs of the elderly, it has
been demonstrated that APRNs invest more time with each patient and prioritize
collaborative condition management involving both patients and their
families. (Sánchez-Gómez, 2019). With a nursing background, it comes natural to
nurses to care for patients both mentally and emotionally. In one study, it was proven
that patients who saw the APRN compared to the GP had lower anxiety levels
(Fagerström, 2012). Based on both research findings and my own firsthand
encounters, it is evident that a significant number of patients exhibit a preference for
the care provided by APRNs. This preference is rooted in the APRNs' ability to
thoroughly evaluate and attentively address patient concerns.
Across the globe, advanced practice registered nurses are on the rise to adapt to
evolving and high-demand healthcare systems. Nevertheless, the scope of practice
for APRNs can vary depending on factors such as a country's healthcare system,
population, and specific healthcare requirements. Interestingly, in a number of
European countries, nurses who pursue advanced education, like an APN/NP role,
may not receive official recognition, while physicians and various medical
professionals, including those with a standard RN qualification, enjoy
recognition (Maier, 2015) . This hinders the ability of physicians to task shift and
allow APRNs to practice their autonomy. In Canada for example, the Canadian Nurse
Protective Society and the Canadian Medical Protective Association worked together
in order to clearly define each role's scope of practice (Dalamaire et al., 2010). This
allows for a more cohesive partnership between APRNs and physicians.
From observing the "Sick Around the World” video, it was clear that healthcare
providers in many nations had to follow fixed healthcare service costs. GPs in many
other countries did not make as much as physicians in America do (PBS, 2020). This
appears to limit the scope of practice for both physicians and advanced practice
nurses in such nations. APRNs have more autonomy in America, compared to some
of these countries with fixed healthcare costs and shorter wait times, diminishing the
need for APNs. In America, the role of the APN stemmed from a dire need for more
healthcare providers aiding the physicians.
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References
Dalamaire, M.-L., & Lafortune, G. (2010). Nurses in Advanced Roles.
OECD Health
Working Papers
, 1–107.
https://doi.org/10.1787/5kmbrcfms5g7-en
Links to an
external site.
Fagerström, L. (2012).
The impact of advanced practice nursing in healthcare:
Recipe for developing countries
. Annals of Neurosciences, 19(1), 1–2.
https://doi.org/10.5214/ans.0972.7531.180401
Links to an external site.
Joyce, M. (2021, March 31).
Three ways nurse practitioners can improve healthcare
in your state
. National Nurse-Led Care Consortium.
https://nurseledcare.phmc.org/advocacy/policy-blog/item/1007-three-ways-nurse-
practitioners-can-improve-healthcare-in-your-
Links to an external site.
state.html#:~:text=The%20authors%20state%20that%20%E2%80%9Cthe,lower
%20hospital%20admissions%2C%20readmissions%2C%20inappropriate
Maier, C. (2015). The role of governance in implementing task-shifting from
physicians to nurses in advanced roles in Europe, U.S., Canada, New Zealand and
Australia.
Health Policy, 119(12), 1627–
1635.
http://dx.doi.org/10.1016/j.healthpol.2015.09.002
Links to an external site.
PBS. (2020).
Sick around the world
.
FRONTLINE.
https://www.pbs.org/wgbh/frontline/film/sickaroundtheworld/
Links to an
external site.
Sánchez-Gómez, M. B., Ramos-Santana, S., Gómez-Salgado, J., Sánchez-Nicolás,
F., Moreno-Garriga, C., & Duarte-Clíments, G. (2019, February 26).
Benefits of
advanced practice nursing for its expansion in the Spanish context
. International
journal of environmental research and public health.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6427304/
Links to an external site.
Schober, M., Lehwaldt, D., Rogers, M., Steinke, M., Turale, S., Pulcini, J., Rousse, J.,
& Stewart, D. (n.d.).
Guidelines on Advanced Practice Nursing 2020 -
International Council of ...
GUIDELINES ON ADVANCED PRACTICE NURSING.