Advanced practice registered nurses (APRNs) can be defined as registered nurses with advanced knowledge and skills required for nursing practice as outlined within the country that they operate in, and they play a critical role in the US healthcare (Dubree, Jones, Kapu, & Parmley, 2015). Unfortunately, the barriers to their practice and education limit their contribution to US healthcare (Altman, Butler, & Shern, 2016). As a result, the tools that can bring down the barriers require examination, which might offer a plan of action for the improvement of the situation. The Essentials of Master’s Education in Nursing by the American Association of Colleges of Nursing [AACN] (2011) are among these tools. The proposed study aims to find out how the AACN (2011) Essentials of Master’s Education in Nursing can contribute to the eradication of the barriers that exist for the APRN roles in the United States.
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A Brief Literature Review
The Essentials of Master’s Education in Nursing
AACN (2011) is a champion in nursing quality improvement that promotes education and the application of scientific evidence to nursing practice (Peterson et al., 2014, p. 59). AACN (2011) offers a continually updated set of Master’s Education essentials for nursing. The main aim of the document is to enable nurses to meaningfully contribute to health care after completing their Master’s education; as a result, the essentials constitute the core of the US Master in Nursing programs (AACN, 2011, p. 3). The current version of the document includes a detailed discussion of nine essentials. In short, they cover the theoretical background required for a nurse (including a variety of health-related sciences and humanities as well as healthcare technologies), leadership and other interpersonal skills, the knowledge of quality and safety standards, methods, and tools, and several practice-related competencies. Thus, the essentials constitute a very comprehensive framework that modern educational institutions regard as central to their Master’s in Nursing programs.
The Barriers to APRN Practice and Education and the Essentials Bringing Them Down
The barriers to APRN role in the US are multiple, and they include those related to education and practice. Gerard, Kazer, Babington, and Quell (2014) point out that as the Doctorate programs in Nursing become more widespread, questions are raised about the effectiveness of a Master’s education. As emphasized by Peterson et al. (2014), education needs to be evidence-based and grounded in scientific research. Apart from that, Gerard et al. (2014) suggest ensuring the reexamination of the Master’s requirements to provide a continuous update, which should enable nurses to proceed to receive an appropriate, high-quality education.
The education issue is directly connected to the essentials, which Gerard et al. (2014) and Peterson et al. (2014) explicitly point out. Therefore, the essentials can be regarded as a tool for the removal of this barrier, which will be further examined in the proposed study. It is also noteworthy that the design of the essentials does not guarantee success in practice since their implementation can be lacking (Gerard et al., 2014). As a result, it may be necessary to consider the applicability of the essentials to the US realia and to determine if anything can be done to make them easier to implement.
Other barriers to APRN roles have been defined by-laws, policies, and established institutional practices, some of which have been criticized as unreasonable because they do not permit APRNs to practice “to the full extent of their education and training” (Altman et al., 2016, p. 39). Altman et al. (2016), as well as Dubree et al. (2015), Gerard et al. (2014), and Kung and Lugo (2014), unanimously agree on the Patient Protection and Affordable Care Act has resulted in the increased need for quality care. As a result, the ineffective use of APRNs needs to be improved. Altman et al. (2016) and Dubree et al. (2015) also admit that certain improvements in the removal of the barriers to APRN practice are visible since the permissible activities have been extended in the past and proceed to expand. Altman et al. (2016) suppose that it is the result of the work of a variety of nursing organizations, including AACN (p. 47).
As pointed out by Dubree et al. (2015), some of the state regulations are also harmful in promoting competition. Dubree et al. (2015), as well as Altman et al. (2016), insist that the collaboration between healthcare professionals is essential. The seventh essential in the AACN (2011) list is phrased as “interprofessional collaboration for improving patient and population health outcomes” (p. 22). Therefore, it can be suggested that the education which is aligned with the AACN’s (2011) essentials is likely to counter the negative effects of the regulations. To sum up, the essentials prove to be a useful tool removing barriers to APRNs’ practice and education, and the mechanisms of its work can be examined in detail with the help of a literature review.
The proposed study is going to employ the methodology of a literature review (LR). As a result, the research is likely to be mixed methods since, as pointed out by Booth, Papaioannou, and Sutton (2016), the specific approach to the analysis depends on the type of the data provided by the sources. The authors describe a systematic LR as a flexible method from the data that it can incorporate, which allows determining appropriate approaches depending on the final sample.
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It can be suggested that the topic is relatively unlikely to produce quantitative data. Indeed, the analysis of the essentials would be expected to use the narrative or thematic approach, and the barriers are also more likely to be described with the help of qualitative data. However, the definite conclusion on the type of data and relevant tools will only be available after the final sample is confirmed. Some of the possible tools are presented in Figure 1.
There are multiple limitations to LRs. In particular, Booth et al. (2016) emphasize that the available time and resources significantly affect the scale and complexity of LR. The authors suggest labeling a time- and resources-constrained LR as non-systematic, which is a rather undesirable outcome for the proposed study since it undermines the relevance of its findings.
One of the ways of improving the rigor of research is the use of multiple databases (Burns, Grove, & Gray, 2016, p. 168). Apart from that, LR is improved if the strengths and weaknesses of the sources are taken into account and summarized (Booth et al., 2016; Burns et al., 2016). These guidelines will be considered in the future LR and mentioned in the final report.
Another way of improving an LR is by limiting the scope of the sources. Apart from the topic-related constraints, it appears appropriate to limit the LR to relevant and current research, which implies that no older sources will be accepted. According to Burns et al. (2016), sources that were published within five years of the review can be termed as “current” ones, and they reflect the state-of-the-art literature on the topic. Also, the authors consider the ten-year mark as appropriate as long as a percentage of five-year-old sources is also present (Burns et al., 2016, p. 168). A quick search on the topic with year filters shows that there are some works related to AACN (2011) and its older essentials, but they will not be included due to their decreased relevance for modern-day problems, which will limit the scope of the research, improving its chances of being more thorough. As a result, the final LR is likely to be called a state-of-the-art LR (Booth et al., 2016).
Concerning the tools that are likely to be required by the study, search engines, a word processing program, and computing software are going to be necessary. The engines will be used to customize the search, which may require studying the tools that belong to different databases and libraries to achieve the best results. The software is going to be needed for the final reports and the collection and analysis of the results as well as their arrangement into tables and graphs. The statistical software may or may not be required depending on the final data, but it is relatively unlikely to be employed due to the specifics of the topic, which does not seem to produce quantitative data. The proposed methodology might be modified depending on the characteristics of the final sample.
Altman, S., Butler, A., & Shern, L. (2016). Assessing progress on the Institute of Medicine report “The future of nursing.” Washington, US: National Academies Press.
American Association of Colleges of Nursing. (2011). The essentials of Master’s education in nursing. Web.
Booth, A., Papaioannou, D., & Sutton, A. (2016). Systematic approaches to a successful literature review (2nd ed.). New York, NY: SAGE.
Burns, N., Grove, S., & Gray, J. (2016). Understanding nursing research (6th ed.). Amsterdam, Netherlands: Elsevier.
Dubree, M., Jones, P., Kapu, A., & Parmley, C. (2015). APRN practice: Challenges, empowerment, and outcomes. Nurse Leader, 13(2), 43-49.
Gerard, S., Kazer, M., Babington, L., & Quell, T. (2014). Past, present, and future trends of Master’s education in nursing. Journal of Professional Nursing, 30(4), 326-332.
Kung, Y., & Lugo, N. (2014). Political advocacy and practice barriers: A survey of Florida APRNs. Journal of the American Association of Nurse Practitioners, 27(3), 145-151.
Peterson, M., Barnason, S., Donnelly, B., Hill, K., Miley, H., Riggs, L., & Whiteman, K. (2014). Choosing the best evidence to guide clinical practice: Application of AACN levels of evidence. Critical Care Nurse, 34(2), 58-68.