Role and Setting: Advance Nursing Practice

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Advanced Practice Nursing Role in the South University

Clinical professionals play a critical role in ensuring high-quality healthcare delivery to patients across the world. They maintain high standards of primary care that entail physical, psychological, and emotional well-being of the patients. In various hospital setups, role and setting of the nurse practice ensure safe, complete, and in time service delivery based on the desired clinical standards (Mashiach-Eizenberg, 2011). Issues that surround the nursing workforce, cost reduction methods, and quality of the primary care among others have been a challenge to the delivery of healthcare services. This essay provides insight into various features of the role and setting in advanced nurse practice (NP) with respect to the delivery of clinical services.

Services delivered by the nurses in the NP fields were confirmed to be relatively low as compared to offered in the private and retail clinics. A study conducted by Naylor and Kurtzman (2010) indicated a low cost of service delivery offered by the NP in delivering primary care. The costs were also lower in the insurance claims offered by the NP to those of retail clinics and physicians. Naylor and Kurtzman (2010) further revealed that the costs incurred associated with nurse practitioner visits to a patient in delivering primary care were about 20-35 percent on average. These figures were lower than those of the physician visits. If a shift of visits to the patients in delivering primary care is given to the NP, a country such as the USA can save a lot. This scenario was confirmed in 2010 where the government realized that it stood a position to save approximately $4.2 to $8.4 billion in a decade (Naylor & Kurtzman, 2010).

How Clinical Practice promotes Patient Safety according to the NPSGs

Nurses and physicians promote the overall healthcare delivery, especially the primary care. Various benefits have been noted in patient outcomes, reduced mortality rates, and patient satisfaction due to the realization of their physical, emotional, psychological, and social wellbeing in the South University. Outcomes have been confirmed by a study conducted by the Congressional Office of Technology Assessment (OTA) where two independent reviews of non-physician providers were done in the USA. The OTA concluded that in the areas of competence, the nurses, physicians, and midwives delivered quality care to the patients whose satisfactions were also greater.

Summary of Two Research Articles

Article 1: Time to clarify– the Value of Advanced Practice Nursing Roles in Health Care by Lowe, Plummer, O’Brien, and Boyd

The article clearly elaborates role and setting as a challenge to nursing practice. Various developing nations and some parts of the developed countries have been experiencing challenges in hospitals, especially in the delivery of the primary care services. These challenges increase at the same rate as the numbers of patients in need of the healthcare services. Primary care has been identified to be important to the elderly, mentally disabled, and chronically ill patients among others (Lowe, Plummer, O’Brien, & Boyd, 2012). Such people require care in their various home compounds with proper and frequent visits by nurses who deliver clinical services at any given moment. Lowe et al. (2012) note that nurses have raised various issues concerning inadequate workforce, pathetic compounds, economic difficulties, numerous dimensions of patient experience, and overall low quality of service delivery.

Article 2: Broadening the Scope of Nursing Practice by Fairman, Rowe, Hassmiller, and Shalala

There has been an increase in the gap of quality of healthcare service delivery in various healthcare centers (Fairman, Rowe, Hassmiller, & Shalala, 2011). Such problems arise because most states experience low workforce in clinical setups with low nurse population ratio. In the United States, there have been lower numbers of students who join the medical fields of practice (Fairman et al., 2011). There are also low numbers of people admitted to the primary care systems. Such situations have also been noted in the enrollment of students who pursue careers in family practice internal medicine and pharmacy among others.

In contrast, different information was indicated in the primary care training programs for nurse practitioners whose numbers rose to about 61 percent (Naylor & Kurtzman, 2010). Currently, various challenges are faced in the development of advanced nursing practice due to insufficient capital to invest in the improvement of clinical courses. There is also a low supply of clinical preceptors. The challenges directly affect the nursing workforce in clinical settings. The government initiatives in various institutions have resulted in positive effects on the growth of the national nursing practice. Other problems include state laws and payment policies that are not impartial.

Summary of an Expert Opinion Article

Article 3: Facilitation as a Role and Process in Achieving Evidence‐Based Practice in Nursing: A Focused Review of Concept and Meaning by Dogherty, Harrison, and Graham

To comprehend and devise a solution to the challenges that face nursing practice, a clear understanding of the scope of healthcare delivery is required (Dogherty, Harrison, & Graham, 2010). The roles of a nurse practitioner in the delivery of primary healthcare include safe, effective, and patient-centered care that is timely and efficient. All services are conducted alongside other activities that are set to limit the ever-cropping barriers in the field. The first solution to various challenges is the effective provision of healthcare services at the lowest possible rates besides reaching a majority of the population. A well-established nurse practice Act should be in place to monitor the standards of delivery, reimbursement of funds in time, and reinforcement of reputable services amongst the practitioners (Dogherty et al., 2010). The public should also be made aware of various services and the results of performances of the different practitioners to ensure improved quality care in the field of nursing (Bodenheimer & Pham, 2010).

In conclusion, the roles of nurse practitioners are further expanding to meet the current international needs for primary care. Both the needs of the nursing workforce and patients must be met at all costs. For instance, in the United States of America, various challenges are faced in the clinical setups (Dogherty et al., 2010). These hurdles arise from aspects such as inadequate healthcare workforce and cost of care services. The low numbers of nurse practitioners together with policies that do not guarantee impartiality in payments are some of the problems highlighted. As a result, regulations governing the nursing practice should be put in place to address the ever-increasing issues through the reinforcement of the nurse practitioners’ Act. The government should also ensure that the clinical personnel is well-paid besides providing the necessary facilities to ensure that proper care is delivered to the patients. Finally, there is also a need to increase the number of schools offering medical courses with a view of increasing the clinical workforce to improve the patient-nurse ratio in healthcare environments.

Reference List

Bodenheimer, T., & Pham, H. (2010). Primary Care: Current Problems and Proposed Solutions. Health Affairs, 29(5), 799-805.

Dogherty, E., Harrison, M., & Graham, I. (2010). Facilitation as a Role and Process in Achieving Evidence‐Based Practice in Nursing: A Focused Review of Concept and Meaning. Worldviews on Evidence‐Based Nursing, 7(2), 76-89.

Fairman, J., Rowe, J., Hassmiller, S., & Shalala, D. (2011). Broadening the Scope of Nursing Practice. New England Journal of Medicine, 364(3), 193-196.

Lowe, G., Plummer, V., O’Brien, A., & Boyd, L. (2012). Time to clarify– the Value of Advanced Practice Nursing Roles in Health Care. Journal of Advanced Nursing, 68(3), 677-685.

Mashiach-Eizenberg, M. (2011). Implementation of Evidence‐Based Nursing Practice: Nurses’ Personal and Professional Factors. Journal of Advanced Nursing, 67(1), 33-42.

Naylor, M., & Kurtzman, E. (2010). The Role of Nurse Practitioners in Reinventing Primary Care. Health Affairs, 29(5), 893-899.

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