Collaboration and Supervision in Advanced Practice Nursing

2014 ◽  
Vol 7 (1) ◽  
pp. 57-62
Author(s):  
Tracy Scott ◽  
Marie Lindsey
Keyword(s):  
Nurse Practitioners ◽  
Clinical Training ◽  
District Of Columbia ◽  
The United States ◽  
Current Data ◽  
Advanced Practice Nursing ◽  
Advanced Practice ◽  
Educational Preparation ◽  
Restrictive Practice ◽  
Collaborative Agreement

Mandated collaborative or supervisory agreements are a restriction to practice for nurse practitioners (NPs) in the United States. According to the Pearson Report (Pearson, 2012), 18 states and the District of Columbia allow NPs to practice without mandated agreements. Progress toward autonomy is being made as many states remove collaborative agreement requirements. These victories are significant but many NPs continue to work in restrictive practice environments. Stiff opposition from the American Medical Association (AMA) is one obstacle to removing these restrictions. Opponents to the removal of mandated agreements cite a concern for patient safety and the educational preparation NPs receive. The evidence regarding safety is not supported by current data and a comparison of the educational requirements for NPs to other providers reveals NPs have a strong background in science and clinical training. This article explores the issues surrounding mandatory practice agreements.

Building the Next Generation of Advanced Practice Nurses Through Clinical Education and Faculty Practice: Three International Perspectives

2015 ◽  
Vol 8 (2) ◽  
pp. 249-257 ◽  
Author(s):  
Andrew Scanlon ◽  
Janice Smolowitz ◽  
Judy Honig ◽  
Katie Barnes
Keyword(s):  
Nursing Education ◽  
Nurse Practitioners ◽  
Clinical Education ◽  
Clinical Excellence ◽  
Advanced Practice Nurses ◽  
The United States ◽  
Advanced Practice Nursing ◽  
Advanced Practice ◽  
Practice Nurses ◽  
The Ideal

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.

Blending Specialist and Practitioner Roles in Psychiatric Nursing: Experiences of Graduates

2003 ◽  
Vol 9 (4) ◽  
pp. 136-144 ◽  
Author(s):  
Kathleen Scharer ◽  
Mary Boyd ◽  
Carol A. Williams ◽  
Kathleen Head
Keyword(s):  
Nurse Practitioners ◽  
Psychiatric Patients ◽  
Advanced Practice Nurses ◽  
Advanced Practice Nursing ◽  
Advanced Practice ◽  
Practice Nurses ◽  
Master Of Science ◽  
Clinical Specialist ◽  
Primary Care Patients ◽  
Adult Nurse Practitioner

BACKGROUND: Blended roles in advanced practice nursing have generated much discussion but little study. As role modifications emerge in nursing, there is a need to explore their implementation. OBJECTIVE: This descriptive study examined the experiences of nurses who were implementing blended roles as psychiatric clinical specialists and adult nurse practitioners. DESIGN: Four master of science in nursing and 10 postmasters nurses who had been practicing in blended roles for 1 to 2 years were interviewed about their experiences in implementing their roles. Interviews were tape recorded, transcribed, and content analyzed. RESULTS: Respondents believed they were practicing holistically, were able to appropriately integrate physical and psychological care of the patient, and found chronic psychiatric patients to have more complex physical illnesses than they had anticipated. In addition, the advanced practice nurses were satisfied with their roles, felt supported by their physician preceptors, and described cross-consultation with physicians and nonpsychiatric nurse practitioners. CONCLUSIONS: There are roles for advanced practice nurses who blend clinical specialist and adult nurse practitioner skills in the care of psychiatric and primary care patients.

scholarly journals Psychiatric-mental health nurse practitioner student preceptorship: Perspectives on the clinical training

2018 ◽  
Vol 8 (12) ◽  
pp. 82
Author(s):  
Horace Ellis
Keyword(s):  
Mental Health ◽  
Nurse Practitioners ◽  
Clinical Training ◽  
Cost Effective ◽  
Health Service Delivery ◽  
The United States ◽  
Clinical Practicum ◽  
Mental Health Nurse ◽  
Course Work ◽  
Health Nurse

As today’s health-service delivery continues to evolve and transform, keeping pace with the training needs of professionals entrusted to deliver quality, competent care is itself an evolutionary and multifaceted academic undertaking. In the United States, psychiatric mental health nurse practitioners (PMHNPs) have been evidenced as formative, effective, and necessary contributors to quality, cost- effective patient, family, and community-based mental health care across the lifespan. The education and certification processes for PMHNPs involve a comprehensive and rigorous combination of theoretical course-work and clinical practicum guided by the concepts and principles of the preceptorship model. The purpose of this paper is to use the available literature to discuss and gain insights into some clinical and educational perspectives influencing PMHNP students’ practice preparations within the context of the preceptorship-paradigmatic relationship. Along with adding to the literature, this paper could have important implications from the standpoint of the PMHNP student-faculty-preceptor model.

Yet Another Degree for the Nursing Profession

2005 ◽  
Vol 24 (4) ◽  
pp. 7-7
Author(s):  
Gail McCain
Keyword(s):  
Nurse Practitioners ◽  
Position Statement ◽  
Nurse Anesthetists ◽  
Advanced Practice Nursing ◽  
Advanced Practice ◽  
Doctor Of Nursing Practice ◽  
Clinical Nurse Specialists ◽  
Neonatal Nurse Practitioners ◽  
Professional Degree ◽  
Practice Doctorate

THE AMERICAN ASSOCIATION OF COLLEGES OF NURSING (AACN) issued a position statement on the practice doctorate in nursing in October of 2004.1 It proposes a terminal professional degree, doctor of nursing practice (DNP), to replace the master’s degree in nursing as preparation for advanced practice nursing. Advanced practice nursing refers to certified nurse practitioners (e.g., neonatal nurse practitioners), certified nurse midwives, certified nurse anesthetists, and clinical nurse specialists.

scholarly journals Understanding the Role of Advanced Practice Providers in Oncology in the United States

2018 ◽  
Vol 14 (9) ◽  
pp. e518-e532 ◽  
Author(s):  
Suanna S. Bruinooge ◽  
Todd A. Pickard ◽  
Wendy Vogel ◽  
Amy Hanley ◽  
Caroline Schenkel ◽  
...  
Keyword(s):  
Patient Care ◽  
Nurse Practitioners ◽  
Clinical Care ◽  
Gynecologic Oncology ◽  
Physician Assistants ◽  
The United States ◽  
Direct Patient Care ◽  
Advanced Practice ◽  
Patient Counseling ◽  
Number Of Patients

Purpose: Advanced practice providers (APPs, which include nurse practitioners [NPs] and physician assistants [PAs]) are integral members of oncology teams. This study aims first to identify all oncology APPs and, second, to understand personal and practice characteristics (including compensation) of those APPs. Methods: We identified APPs who practice oncology from membership and claims data. We surveyed 3,055 APPs about their roles in clinical care. Results: We identified at least 5,350 APPs in oncology and an additional 5,400 who might practice oncology. Survey respondents totaled 577, which provided a 19% response rate. Results focused on 540 NPs and PAs. Greater than 90% reported satisfaction with career choice. Respondents identified predominately as white (89%) and female (94%). NPs and PAs spent the majority (80%) of time in direct patient care. The top four patient care activities were patient counseling (NPs, 94%; PAs, 98%), prescribing (NPs, 93%; PAs, 97%), treatment management (NPs, 89%; PAs, 93%), and follow-up visits (NPs, 81%; PAs, 86%). A majority of all APPs reported both independent and shared visits (65% hematology/oncology/survivorship/prevention/pediatric hematology/oncology; 85% surgical/gynecologic oncology; 78% radiation oncology). A minority of APPs reported that they conducted only shared visits. Average annual compensation was between $113,000 and $115,000, which is approximately $10,000 higher than average pay for nononcology APPs. Conclusion: We identified 5,350 oncology APPs and conclude that number may be as high as 7,000. Survey results suggest that practices that incorporate APPs routinely rely on them for patient care. Given the increasing number of patients with and survivors of cancer, APPs are important to ensure access to quality cancer care now and in the future.

Monitoring and Investigating Certified Registered Nurse Practitioners in Pain Management

2003 ◽  
Vol 31 (1) ◽  
pp. 101-118 ◽  
Author(s):  
Jean B. Lazarus ◽  
Belinda (Wendy) Downing
Keyword(s):  
Pain Management ◽  
Nurse Practitioners ◽  
Registered Nurse ◽  
Advanced Practice Nurses ◽  
Advanced Practice Nursing ◽  
Advanced Practice ◽  
Prescribing Practices ◽  
Practice Nurses ◽  
Prescription Practices ◽  
Certified Registered Nurse

The Mayday Scholars Program for 2001-2002 provided an opportunity to boards of nursing to present their experiences in monitoring the prescribing practices of advanced practice nurses and to research ways for improving their own investigation processes as professional disciplinary agencies for prescribing practices related to pain management. The Alabama Board of Nursing was interested in participating in the program based on its commitment to accountability for public protection. A gradual increase in disciplinary cases involving violations of prescribing practices by certified registered nurse practitioners (CRNPs) prompted our inquiry as to whether a proactive monitoring system was needed to determine compliance with regulations for advanced practice nurses in collaborative practice.In this article, we discuss selected elements related to pain management and regulatory factors, including nursing, that affect the treatment of pain. We present a brief overview of the evolution of advanced practice nursing, with an emphasis on the nurse practitioners movement, and prescription practices and pain management by nurse practitioners.

scholarly journals Bone-Active Medication Utilization from 2013-2017 Amid Beneficiaries Aged 65+ with Medicare Part D by Provider Type

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 608-608
Author(s):  
Jennifer Kirk ◽  
Sean Fleming ◽  
Denise Orwig
Keyword(s):  
Older Adults ◽  
Nurse Practitioners ◽  
Clinical Training ◽  
Medicare Part D ◽  
The United States ◽  
Geographic Region ◽  
Medicare Part ◽  
Provider Type ◽  
Related Factors ◽  
Part D

Abstract As the United States’ population increasingly consists of older adults aged 65+, an increase is expected in the prevalence of osteoporosis and the number of osteoporotic fractures. Bone-active medications (BAM) delay osteoporosis progression and prevent fragility fractures, but historically low treatment persistence rates and drug utilization for BAM exist among at-risk older adults. This research assessed for differences in the BAM utilization rates over five-years in Medicare Part D by provider type: geriatric specialists (GERO), generalists, specialists, nurse practitioners (NP), and physicians’ assistants (PA). This longitudinal retrospective analysis included providers with at least one BAM prescription among beneficiaries aged 65+. An analysis of response profiles was used to model the mean BAM utilization rates overall and by provider group. Of the 50,249 providers included in this analysis, 88.15% were generalists, 5.76% specialists, 1.48% GERO, 2.73% NP, and 1.87% PA. From 2013-2017, the prevalence of BAM utilization was 6%. Over the five years, BAM utilization rates did not change significantly, but provider-specific rates were significantly different (F=12.53, p<.001). Provider-specific utilization rates were inconsistent with the highest utilization rates and most considerable variation observed among specialists (14.95%). PAs and NPs’ BAM utilization rates were stable at around 9.02% and 9.20%, but GERO and generalists exhibited the lowest utilization rates, 4.86% and 5.79%, respectively. While specialists had the higher-than-expected utilization rates, the overall and provider-specific BAM utilization rates were low and did not increase over time. Further research is needed to identify how provider-related factors, like geographic region and clinical training, influence underutilization.

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