Role of Advanced Practice Registered Nurses

Introduction

The nursing role has evolved to be at the forefront of primary and clinical care in the health care system. Advanced Practice Registered Nurses (APRNs) have roles in research, administration, and providing high-quality patient care. The advanced nursing role requires skilled and highly motivated individuals that influence the nursing profession and even health care reform. It is a role that is consistently evolving and developing to encompass all aspects of patient care and safety. This essay seeks to explore the role of nurse practitioners as APRN through relevant research.

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Description

Nurse practitioners are registered nurses who receive a master’s education and board certification in a specific specialty such as family practice or pediatrics. This allows the nurse to have more specific medical knowledge as well as administrative abilities. Duties of a nurse practitioner include acute illness and injury diagnosis and treatment. Other common responsibilities include immunizations, recording vital signs, physical exams, and managing chronic medical issues. Depending on state requirements, these nurses can prescribe medication. Nurse practitioners seek to collaborate with physicians on many things; however, state laws direct on whether an independent authority is practiced. This advanced role provides numerous opportunities for specialization and career advancement (Nurse Journal, 2017).

Role and the NPSG’s

Nurse practitioners thrive in situations of complex problem-solving and compassionate patient care. The focal focus of nurse practitioners is to provide preventative and holistic care, working individually with each patient, which is rewarding professionally and ethically. Nurse practitioners are considered clinical roles as their primary duty is to provide primary patient care as well as direct to any medical services necessary.

Besides, they provide treatment for acute illnesses and injuries along with specialized treatment. In a clinical setting, they are essential to the hospital operation. However, a nurse practitioner has non-clinical duties, including possible administrative tasks. Also, the primary factor of working with patients and their families to guide, consult, and educate them based on their treatment is considered non-clinical.

The National Patient Safety Goals (NPSGs) are released on an annual basis recommending improvements to ambulatory care where nurse practitioners are most common. These measures are meant to improve the health care system by prioritizing patient safety. One of the first goals is to improve patient identification before receiving treatment, medicine, or blood transfusions. Nurse practitioners are at the forefront of patient care. Improving and confirming information through electronic health records allows meeting this goal. It is also recommended to improve staff communication, specifically test result communication.

As nurse practitioners often delegate patient tests, they can take the initiative to communicate with other professionals so that test results are received at an appropriate time. Time spent with a patient allows meeting another goal of identifying the patient’s risk of self-harm. Through proper training, nurse practitioners can see observable signs of mental illness and as well as show compassion for a patient so that they feel safe. Finally, many goals related to preventing infection fall under nurse practitioner duties. They are responsible for upkeeping the department cleanliness as well as practice correct handwashing techniques. Also, proper procedures such as the timely removal of catheters and the utilization of medical supplies help ensure hygiene in medical care (The Joint Commission, 2017).

A nurse practitioner is a stressful profession requiring patience, focus, and perseverance. Long hours worked by health professionals often hurt their performance which can endanger patient safety. In a review of claims against nurse practitioners, most involve failure to diagnose correctly or improper treatment which is a core competency. It is recommended for nurse practitioners to be aware of their actions and keep records of any medical interventions or tests to confirm (Leigh & Flynn, 2013). As evident, there are numerous factors impacting nurse practitioners in their profession which exposes tremendous influence over patient safety.

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Research Articles

In a critical review, several professionals conducted an evidence-based assessment of patient safety strategies over four years. This was done due to the overwhelming public interest and followed policy change in patient safety. The publication focuses on the importance of theorizing, identifying context, and followed by practical implementation of safety guidelines. It is emphasized that not all issues have yet been addressed and this assessment analyzes the safety strategies for the most hazardous safety violations.

Some suggested changes include hand-hygiene, precautions to prevent infections prominent in health-care settings, and interventions to reduce falls (Shekelle et al., 2013). It is important to note that nurse practitioners are trained to practice the guidelines emphasized10.1002/jhrm.21124 by this research. The strategies that the article encourages to implement are directly related to the nursing department and many duties of the nurse practitioner. However, either legislation, hospital guidelines, and systems, or management do not allow for the improvement of these strategies to increase patient safety for which nurse practitioners are responsible.

A literature synthesis was conducted to evaluate the impact of nurse practitioners on cost, care quality, patient satisfaction, and waiting times in an adult emergency department. Emergency departments are considered the forefront of critical patient care with growing traffic, causing service expansion of active nurse practitioners.

The systematic review showed evidence of a positive influence of nurse practitioners on emergency departments. Specifically, quality of care and patient satisfaction increased, which was connected with decreased waiting times. No sufficient evidence was found to conduct a cost-benefit analysis. This evidence serves as a basis for hospitals to staff more nurse practitioners in the emergency department as the demand for faster and quality care increases in society. Nurse practitioners can provide effective service within professional and safety guidelines (Jennings, Clifford, Fox, O’Connell, & Gardner, 2015).

Expert Opinion

The expert opinion described is by Leigh Montejo MSN, FNP-BC who is a National Public Health Service Corp scholar. It begins with a report published by the Institute of Medicine which led to massive reforms on micro and macro levels of health care to prevent medical errors. This resulted in improved policies, guidelines, and continuing education. Nurses are a patient’s advocate and the last line of defense against possible medical errors in their treatment. In the education curriculum for nurses, it is important to emphasize constant awareness to reduce any possible incidents.

While severe medical mistakes are rare, seemingly innocent errors such as a wrong test have a possibility of erroneous results. Nurse practitioners have direct access to the patient, reviewing and conducting various procedures that a physician may recommend. With the introduction of electronic health records, it is crucial to review and constantly update the patient’s profile, as the system has flaws. When an error is detected, the process which led to it should be evaluated. Meanwhile, the nurse practitioner provided a high quality of care and protected the patient’s safety (Montejo, 2013).

References

Jennings, N., Clifford, S., Fox, A., O’Connell, J., & Gardner, G. (2015). The impact of nurse practitioner services on cost, quality of care, satisfaction and waiting times in the emergency department: A systematic review. International Journal of Nursing Science, 52(1), 421-435. doi: 10.1016/j.ijnurstu.2014.07.006

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The Joint Commission. (2017). Hospital National Patient Safety Goals.

Leigh, J., & Flynn, J. (2013). Enhance patient safety by identifying and minimizing risk exposures affecting nurse practitioner practice. Journal of Healthcare Risk Management, 33(2), 27-35. doi: 10.1002/jhrm.21124

Montejo, L. (2013). Nurse practitioners play an important role in preventing errors.

Nurse Journal (2017). What roles does a Nurse Practitioner have?

Shekelle, P. et al. (2013). The top patient safety strategies that can be encouraged for adoption now. Annals of Internal Medicine, 158(5), 365-369. doi:10.7326/0003-4819-158-5-201303051-00001

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