Nursing Promotion: Advanced Practice Nurse

Nursing Promotion

Errors

The advanced practice nurse (APN) will join a workforce with many other health professionals. Educated and trained, the APN will contribute to current practice and that includes safety measures to prevent patient harm, and provide more effective work that is financially more soluble. The Institute of Medicine has developed six aims for nursing, and eight recommendations to assist nursing in reducing errors, and providing more educated quality care. These aims also pave the way for the future nursing work force.

Safety

This is a dual-purpose aim, as medical practice is supposed to be safe for the practitioner and patient both. Safety in regard to the patient is the ability to not be accidentally harmed while receiving

medical treatment (Institute of Medicine, 2001). In medical practice, errors can be made and safety is promoted through many aspects of the work that health care professionals do.
Another part of patient safety is to directly involve the patient in care that they receive, and to let them assist with the plan of care if they are willing and able (Institute of Medicine, 2001). Shielding patients and their family from treatment choices, or learning more about the diagnosis does not promote the patient safety and should be avoided. The APN can promote safety and independence developing a plan of care specific to that patient’s economic and functional status.
Effectiveness
Effectiveness is established when a treatment is utilizes evidence-based practice (EBP) to promote patient health. Effectiveness is strongly tied to EBP, as the promotion of effective treatment is the combination of patient values, the best research evidence and clinical expertise (Institute of Medicine, 2001). Treatment should help the patient, and then prove effectiveness through best practices as each APN assumes care for a patient.
Patient-Centeredness
This aim is patient focused, and takes the patients feelings about illness and health care and the ability of those to meet the needs of the patient (Institute of Medicine, 2001). As the patient assists the APN to plan care, technology can prove to be an asset as it assists the patient on education of health issues. Part of patient centeredness is the integration and cohesion of the patient’s needs, values and preferences and the understanding that the right health professionals are on the care team (Institute of Medicine, 2001). Communication with the patient and family/friends is also another hallmark of patient centered care, providing physical comfort and emotional support. In practice the APN will assist the patient in patient centered care as a member of the care team.
Timeliness
In a world that is so connected obtaining information takes time.

Each patient should experience the shortest wait possible for care with prompt sharing of test results. The inability to effectively manage time throughout the care experience reflects poorly on the one providing care, be it an individual or an institution. Timeliness also involves spending an appropriate amount of time with the patient (Institute of Medicine, 2001). The balance of time is difficult to spite current practices, and the APN will continue to face critique based on the timeliness of care.

Efficiency

Efficiency is also a part of timeliness, but is singular as well. Economically, the health care system needs to provide as much product or service for time or resources spent. Efficiency in the grand scheme means reducing waste, and reducing production costs. It is noted that some quality improvements do not result in fewer resources used, and can be applied to effectiveness in decreasing overuse (Institute of Medicine, 2001). The APN will be responsible for efficiency now and in the future.

Equity
The final aim of ensuring best patient practice involves equity. Equity is the provision of goods and services in healthcare for all the people of the United States (Institute of Medicine, 2001). Equity is provided with the population of people, and individually. When providing equity, each institution is responsible for treating the each patient of a population fairly. The patient is provided equitable services when free from judgment of health care professionals (Institute of Medicine, 2001).
Future of Nursing
The Institute of Medicine (IOM) with the help of the Robert Wood Johnson Foundation, published a report eight recommendations for the future of nursing to lead change and advance the profession.

These recommendations promote the function to the broadest scope of nursing as a profession in practice. This is in response to the fact that nursing has a larger role, and more demanding role in healthcare.

Remove Barriers

The role of the advance practice nurse is called to expand, and envelope practice to the fullest extent. It is recommended, by the IOM, that services provided by APNs be fully reimbursed under Medicare. While some APNs have greater freedom in practice with pay equal to the work they do (IOM, 2011). This will affect all areas of advance practice, and provide a more knowledgeable group of greater numbers.

Expanded Opportunities, Nurse Residency

Advance practice nurses should have collaborative relationships in research with physicians and other health professionals. This relationship, while providing care, will be mutually beneficial and promote best practice through research efforts. This is also a call for health care organizations to provide support to APNs wanting to implement newer care models and

practices.
The IOM recommends that each nurse, after completing required courses and clinical hours, should transition into the profession through a residency. I am very fond of this idea, as many novice nurses are thrown into practice with little actual experience in how to effectively care for patients. This recommendation also promotes retention of nursing staff in the profession.
Increase Learning
The IOM recommends that the number of nurses with a baccalaureate degree, by 2020, should be 80%. Part of the rationale for this is that better educated nurses will lead to better outcomes. It is further suggested that financial incentives are provided to encourage higher education. Further educational recommendations request that the number of doctorate prepared nurses double by 2020 to assist in promoting diversity and educators in practice. The sixth recommendation is provided for lifelong learning in nursing (IOM, 2011).
Advance Health and Connect
The seventh and eighth recommendations promote leadership and connectedness. The nursing work force should be prepared for leadership in all positions of nursing. The future work force should also have a way to share information easily to promote better practices, and to record research findings (IOM 2011).
Nursing in the Future
Each one of these aims is part of a multifaceted approach to provide better care and safer care for those who receive medicine in this country. With integration of the six aims the patient population will obtain better, safer and more scientific and personalized care. Additionally, when each of these aims are achieved, patient needs are met more effectively.
These recommendations are intended to make nursing practice safer, higher quality, and more efficient. They are also intended to promote nursing into the future through research and educational in nursing. Finally, they empower advance practice nurses laying a foundation to collaborative work through the full scope of nursing practice.