Introduction
Advanced Practice Nursing refers to improved and broadened healthcare interventions and services offered by nurses who, in an advanced capacity, affect clinical health outcomes and provide direct medical services to individuals, communities, and families. An Advanced Practice Nurse (APN) is a nurse who has obtained the expert knowledge base, multifaceted decision-making skills, and clinical proficiencies for expanded nursing practice through additional education. While advanced nursing knowledge and education are at the heart of APN practice, there may be some competence overlap with other healthcare professions. In community-based activities such as primary healthcare, ambulatory services, and out-of-hospital settings, the breadth and depth of autonomy associated with the APN frequently develop within a more extensive range. The Clinical Nurse Specialist (CNS) and Nurse Practitioner (NP) are the two most common forms of APNs worldwide. APN practice has portrayed diverse impacts in providing patient’s health care services in hospitals across the globe in different ways.
APN Practice Effect on Healthcare Services
Demonstration of APN Practice on Cost-Effectiveness
Nurse practitioners (NPs) are a well-established response to the consumer-driven movement toward well-being and preventive health care. A substantial number of statistics reveals that NPs have steadily demonstrated their ability to provide cost-effective, high-quality therapy for nearly 50 years (Schober et al., 2020). From the time they finish their academic training, NPs are cost-effective. “The American Association of Colleges of Nursing” has long argued that nurse practitioner education costs 20% to 25% less than physician education (Lopes-Júnior, 2021). In 2009, the total tuition fees for NP training were less than one year of medical school (Lopes-Júnior, 2021). Numerous studies have shown that nurse practitioners (NPs) are cost-effective in maintaining the health of older persons.
When compared to physician-only groups, the cost of a physician-NP team in a long-term treatment center is 42% lower for intermediate and skilled care residents and 26% lower for long-term care residents (Lopes-Júnior, 2021). Moreover, the physician-NP groups undergo less emergency room handovers, fewer field visits, and shorter clinic stays. Moreover, NP-management care in acute-care settings has been linked to cost reductions. According to research, when NPs and physicians control hypercholesterolemia after revascularization, the NP-manage group spends less on drugs, and it is more likely to achieve their goals and stick to the advised regimen (Schober et al., 2020). In addition to the total cost, other factors influence the cost-effectiveness of health care. These include, among other things, illness prevention, health outcomes, and promotion.
Influence of APN Practice on Reduction in Errors
Registered nurses (RNs) have several responsibilities, but the most important is keeping patients safe. Unfortunately, medical errors occur; thus, APN practices can take specific precautions to reduce the likelihood of errors. The most common medical mistakes involve falls, documentation, infections, equipment injuries, and medicines (Lopes-Júnior, 2021). Nurses gain knowledge of techniques and methods as students and through years of practice. Furthermore, coworkers, bosses, and other healthcare experts can assist nurses by providing advice and direction. Nurses can decrease coincidental errors through doing the following: “Stop medication mix-ups by establishing the six ‘rights’ of medicine administration: right patient, right medication, right dose, right route, right time, and right documentation (Zaccagnini & Pechacek, 2019).” They keep patients from falling by urging them to ask for help getting out of bed if in need. They remove barriers that may cause patients to trip, make rounds to check on patients, and are mindful of drugs that may produce dizziness or drowsiness.
Furthermore, APN practice assures infection prevention by washing hands, using an antiseptic for skin preparation, and practicing sterile techniques. In addition, nurses follow central line placement and removal rules to avoid bloodstream infections (Schober et al., 2020). They also ensure that urinary catheters are adequately cleaned and are not left in for an extended period. Training nurses and patients on how to handle and use equipment correctly helps prevent equipment injuries (Zaccagnini & Pechacek, 2019). Before using a piece of equipment, nurses inspect it for signs of damage, ensure its functionality, and report any flaws.
Furthermore, APNs pay attention to minutiae to reduce documentation errors. NP should document all changes in a patient’s medical state as soon as possible. Moreover, all therapies, signs, symptoms of discomfort, and adverse events should also be accurately documented (Schober et al., 2020). They record the timing and content of notifications and the physician’s orders. Nurses also record when they conduct a patient training session and how well patients and their family members understand the material (Lopes-Júnior, 2021). This helps reduce errors that can arise during patient management.
Effects of APN Practice on Misuse or Overuse of Services
The APN movement’s rapid development and success have been regarded as a radical innovation in that APNs may deliver the same or better treatment than physicians at a cheaper cost and in a more convenient environment. This interruption has exacerbated professional turf fights that are detrimental to quality and patient safety. Strong leadership is essential to investigate creative models of multidisciplinary team approaches that promote patient safety, including how to remove barriers to interprofessional education and practice (Zaccagnini & Pechacek, 2019). As these professions expand, comparing APN outcomes to physician outcomes is a crucial validation of APN practice. Given the current demand for fundamental system transformation, new research questions regarding APN practice and patient safety have developed (Schober et al., 2020). To date, most outcome studies have concentrated on acute care nursing management and nursing-sensitive outcomes such as decubitus ulcers. Proper tools for measuring APN outcomes are yet to be discovered.
While the review of research on APN quality and safety certifies them as proficient and comparable to physicians in several ways, additional study is needed to eliminate errors and improve patient safety (Schober et al., 2020). Threshold enhancement cannot be attained without inter-profession practice tactics, necessitating radical change to break down the cultural and educational walls between nursing and medicine education. APNs must be identified as different provider types in all inter-profession research, organizational, and clinical datasets (Schober et al., 2020). It has taken decades for the nursing profession to dissociate licensed professional nursing from the ‘hotel costs of a hospital stay and unravel nursing’s unique position and usefulness within the hospital (Lopes-Júnior, 2021). Registered Nurses have always been viewed as a cost center rather than a valuable income stream within hospitals. Nursing’s value would not have to be argued if all professional nursing practice was billed individually, as is done with physician care. APNs must not be inconspicuous on the health care team as the evidence basis on interdisciplinary teams grows.
Conclusion
Since its inception in general care, advanced nursing practice has expanded to other hospital environments, such as acute care. Acute care supports patients with chronic unstable disorders and complex acute and catastrophic illnesses with short-term restorative stabilization. Emergency and critical care are included in acute care. Although both emergency and primary care advanced nurse practice offer first-contact access to medical care, understanding the patient presentations distinguishes the two. Unlike general care, emergency NP/APNs are trained to care for patients in life-threatening or limb-threatening situations. NP/APNs in emergency and critical care have gained more practice autonomy during the last decade. This extended practice permits nurses to handle some medical functions generally performed by physicians, intending to boost access to healthcare and service effectiveness and potentially lowering healthcare costs.
References
Lopes-Júnior, L. C. (2021). Advanced practice nursing and the expansion of the role of nurses in primary health care in the Americas. SAGE open nursing, 7, 23779608211019491. Web.
Schober, M., Lehwaldt, D., Rogers, M., Steinke, M., Turale, S., Pulcini, J.,… & Stewart, D. (2020). Guidelines on advanced practice nursing. Web.
Zaccagnini, M., & Pechacek, J. M. (2019). The doctor of nursing practice essentials: A new model for advanced practice nursing. Jones & Bartlett Learning. (4th ed.)