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Roles of advanced practice nurse
Healthy People 2020 goal/objective
Healthy People 2020 goal/objective
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Healthy People 2020 have a number of goals such as having the community attaining high-quality, longer lives free of preventable disease, disability, injury, and premature death to all health groups with equality and without disparities; Advanced Practice Nurses (APN) is contributing to these goals through community medicine. Access to primary health care is getting harder every day (epically with low income populations) due to a number of reasons including; a decreasing number of physicians choosing primary care as their specialty and the cost of care. Without access to primary care the community cannot achieve the Health People 2020 goals, APN’s fills this void through a number of avenues from the private sector to the public sector while providing affordable healthcare.
There is growing trend where physicians are choosing different specialties instead of choosing primary care, primarily due to low reimbursement rate in
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The Bureau of Labor and Statistics 2010 indicates that a family practice physician wage is twice as much as a APN, an hourly rate of 108.67 versus 51.14 respectively. The reports, even though the cost is less APNs provide similar or greater level of care to the community (Allen, Dennison Himmelfarb, Frick, & Szanton, 2014). This cost savings can be passed to the community or double the number of providers allowing greater access to that community while still providing quality care.
Advanced Nurse Practitioners are contributing to the goals of Healthy People 2020 tby providing affordable community primary health care; accessing all groups with equality. Nurse practitioners are filling a gap in care at an affordable rate while providing exceptional
In 2011, Barbara Safriet published an article “Federal options for maximizing the value of Advanced Practice Nurses in providing quality, cost-effective health care” from a legal perspective. The article focused on the benefits of utilizing Advance Practice Nurses to the full extent of their abilities as well as the current barriers that APNs encounter in their practice. The aim of this paper is to discuss two regulatory provisions to full deployment of APNs in current health care system, as well as three principle causes of current barriers to removal of the restrictive provisions for the APN. Furthermore, I will discuss the critical knowledge presented in the article and how it relates the APN practice. This article was incorporated into a two-year initiative was launched Institute of Medicine (IOM) and by the Robert Wood Johnson Foundation (RWJF) in 2008 which addressed the urgency to assess and transform the nursing profession.
The Affordable Care Act (ACA) was passed in 2010 with the goal of expanding healthcare coverage to all Americans by reforming insurance policies and practices (Tillett, 2011). The ACA upsurges the demand for an increase in primary care providers in order to supply quality care to the much larger population that will have coverage and therefore acquiring healthcare. The Institute of Medicine (IOM) through its report The Future of Nursing: Leading Change, Advancing Health has generated a solution to the shortage of primary care providers by promoting a transformation of the nursing profession to fill the gap.
My vision for the Family Nurse Practitioner in a primary healthcare setting is to bring health care to small communities, comprised of predominately poor working class people, who are classified as underprivileged. Performing exams on the sick, providing immunizations to the young, educating all, and assisting the elderly with chronic illness and disease management, while providing preventative care and education on wellness. The Family Nurse Practitioner sees patients from young to old in need of a wide variety of care. As a Family Nurse Practitioner I will provide education and holistically meet the health care and wellness needs of my community, and others like it, by providing critical access to health care for the most vulnerable
Nurse practitioners (NPs), one type of advanced practice nurses, are licensed by the states where they practice and certified by private boards. Nurse practitioners hold advanced degrees in clinical practice and function in a wide variety of settings and across the life span. They provide a broad array of healthcare services ranging from managing treatment plans, to prescribing medications, to implementing health promotion services. As of 2014, 205,000 NPs were licensed in the United States with 86% of those prepared to deliver care to patients in primary care settings (NP Facts, 2015). The progression of the Nurse Practitioner movement that occurred in the 1960 and 1970s emerged as a creative and
The advanced practice nurse (APN) and a registered nurses (RNs) are both involved in the primary care of patients, and provide health care services for acute and chronic illness, but in different work settings and responsibilities (Pennbrant, Nilsson, Öhlén & Rudman, 2013). One of the major differences between the APN and the RN is education, although both the APN and the RN started out with the basic nursing education from an Associate or Bachelor’s degree program, becoming an APN requires a Master’s degree and a specialty track (Stanley, 2011). Another significant difference between the APN and RN is the working environment, APNs mainly practice in the private care settings and community clinics, while most RNs work in hospitals and surgical
Advanced practice registered nurses play a significant part in extending access to health care by providing primary care and specialty care services to clients. Advanced practices registered are mentors, educators, researchers, and administrators. According to Health Resources and Services Administration, “Ninety-six percent of the NP workforce reported being in clinical practice, providing direct patient care” (Health Resources and Services Administration 2016). Furthermore, “Nearly three percentages were in faculty positions and approximately one percent was in administrative positions”(Health Resources and Services Administration 2016).
Physician salary is affected by a variety of factors, which are correlated to the method of payment. In a medical practice physicians are often paid based on fee-for-service, in which compensation is directly tied into the number of patients or services rendered by the physician. However, with changes brought upon by new government regulations, payment is linked to performance. Moreover, the type of practice may directly affect physician compensation. For example, in a single-specialty practice group practice the mean compensation for internal medicine physicians in 2015 is estimated to be $195,000; however, in a multispecialty group the average is $200,000 (Rappleye, 2015). The practice has to first calculate the amount of funds that will be available for physician income after taking operating costs and non-physician salaries into consideration.
It is no secret that the current healthcare reformation is a contentious matter that promises to transform the way Americans view an already complex healthcare system. The newly insured population is expected to increase by an estimated 32 million while facing an expected shortage of up to 44,000 primary care physicians within the next 12 years (Doherty, 2010). Amidst these already overwhelming challenges, healthcare systems are becoming increasingly scrutinized to identify a way to improve cost containment and patient access (Curits & Netten, 2007). “Growing awareness of the importance of health promotion and disease prevention, the increased complexity of community-based care, and the need to use scarce human healthcare resources, especially family physicians, far more efficiently and effectively, have resulted in increased emphasis on primary healthcare renewal…” (Bailey, Jones & Way, 2006, p. 381). The key to a successful healthcare reformation is interdisciplinary collaboration between Family Nurse Practitioners (FNPs) and physicians. The purpose of this paper is to review the established role of the FNP, appreciate the anticipated paradigm shift in healthcare between FNPs and primary care physicians, and recognize the potential associated benefits and complications that may ensue.
Educational preparation for the advanced practice public health nurse includes at least a Master’s degree and is based on an integration of current knowledge and research in public health, nursing, and other scientific preparations. In addition to executing the functions of the generalist in population-focused nursing, the specialist retains clinical experience in political and legislative activities, delivering and evaluating service, organizing, interdisciplinary planning, community empowerment, and assuming a leadership role in interventions that have a positive effect on the health of the community. Certification examinations for advanced practice nurses are rewarded by the American Nurses Credentialing Center (ANCC).
Social determinants of health has been a large topic for many years and can have a positive and negative effect on individuals, families and communities. (World Health Organisation, 2009) The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. Social determinants have many factors and in this essay education will be the main social determinant of health discussed and how this could have an impact on the physical and mental sides of health.
Healthy People 2020 is a program for the promotion of health and the prevention of diseases, launched by the Department of Health and Human Services in December 2010. According to healthypeople.gov, this program has four overarching goals which are first to achieve healthy, longer lives free of preventable diseases, injuries, and premature deaths; to achieve health fairness, eliminate differences, and improve all groups’ health; also to produce social and physical environments that encourage good health; and last but not least to promote life’s quality, healthy development, and healthy behaviors through all life stages. This program has a vision of a community where people live long, healthy lives. Healthy People 2020 offers a comprehensive set of 10 years of nationwide goals and objectives that is meant to improve the health of the American population. Healthy People 2020 covers 42 topic areas with approximately 600 objectives, which include 1,200 measures. A smaller set of Healthy People 2020 objectives, has been designated to communicate high-priority health issues and actions that can be taken to address them, this objectives are called Leading Health Indicators. The program goes above and beyond these health indicators in order to provide the best care for the people of this country. These indictors cover from the access of health service, nutrition, physical activity, and obesity to substance abuse, environmental quality, injury and violence.
In consequence, this will limit poor adults finding the proper treatment since many doctors do not accept Medicaid patients. High rates of uninsured populations were associated with lower primary care capacity (Ku et al., 2011). Thus, expanding insurance coverage can support more primary care practices in rural areas and can help equal the gap in primary care positions. The impact of not expanding affects APRN practice by limiting them to practice in areas where they are needed the most. This not only affects APRNs from practicing without a physician supervision but also limit those that need coverage for basic preventive measures to reduce non-paying visits to the emergency room. Ensuring access to care will be contingent upon the ability to attain progress from insurance coverage and primary
Health care spending consumes a significant proportion of the national budget. As a result, good management practices should be part of providing cost-effective care to the community. The nursing profession is effective in providing primary care to the community. Even though the practice dates to the 19th century, its significance emerged in the previous decade as a result of changing demographics and global environment. It compliments health care policies through comprehensive nursing assessment, monitoring progress and early intervention. Additionally, it facilitates referrals and social support services such as education to promote self-reliance among people at risk. It combines biophysical, psychological, social knowledge and experience to develop capacity in health care provision. Therefore, the role of public health nursing is changing from contemporary generalist services to specialized and advanced roles in dealing with shifts in demographics, sociological and cultural factors that affect the health of the community.
With my academic, professional and volunteer experience, I have reached a point in my career where I am fully equipped to enter the advanced curriculum of the Doctor of Nursing practice, Family Nurse Practitioner program. Working in the nursing profession for the past three years has shown me that there is an increasing need for research to improve health care delivery and access to vulnerable populations. It is rewarding to be a nurse; however there are limitations in my current scope of practice that prevents me to go beyond my job requirements. Through advanced education, my aim is to provide quality patient-family
There has been a drastic cut in both the Medicare and Medicaid reimbursement rates. According to Robert (2012), “cuts of more than $360 billion to Medicare and Medicaid will be made over the next 10 years. The focus of nursing needs to emphasize more on wellness care and prevention rather than acute care” (McNeal, G., 2012). Nursing practice will need to shift more towards community and population focused nursing. Baccalaureate prepared nurses are provided with a curriculum that includes both community health and leadership skills that are not included in the associate program. By encouraging associate’s degree nurses to obtain a bachelor’s degree in nursing, an increase in the awareness of the needs of the community and population may be seen. The IOM report has outlined the anticipated obstacles that healthcare will face if changes are not made. By allowing nurses to provide care within their full scope of practice, quality care may be provided at an affordable cost to the population. The use of advanced practice nurses in primary care may provide quality, access, and cost efficient healthcare to high-risk populations and possibly decrease hospital admission rates, thus lowering the overall cost of healthcare. If nurses partner with doctors and other healthcare providers, it may improve healthcare by providing seamless transitions (Institute of Medicine,