19 Sep Advanced Practice Nursing and advanced nursing pra
Advanced Practice Nursing and advanced nursing practiceAdvanced Practice Nursing (APN) and advanced nursing practice differ in the clinical aspect of continued education. Advanced nursing practice are those specialties that are not involved in providing direct patient care, and are associated with administration, informatics, policy, and public health (Tracy & O’Grady, 2019). According to the National Council of State Boards of Nursing (NCSBN), there are four APN roles who have received a Master’s or post Master’s degree in a specific role and provide care to a particular patient population. The four specialty roles include Certified Nurse Practitioners (CNP), Certified Registered Nurse Anesthetist (CRNA), Clinical Nurse Specialist (CNS), and Certified Nurse-Midwife (CNM) (APRNs in the U.S., n.d.). Tracy and O’Grady (2019) describe advanced nursing practice as any form of nursing that is influential in the outcomes for individuals or populations, including management, administration of organizations, and the expansion and application of healthcare policy. A few examples of advanced nursing practice include: Nurse Executives, Clinical Nurse Leaders, Nursing Administration, and Nursing Informatics. Family Nurse Practitioners are one of the four APN specialty roles and are armed with clinical expertise and advanced education to provide evidence-based care to their patients, as well advocate for health policies and provide a positive change for generations to come in the healthcare industry (Chilton, 2015).Advanced Practice Nurses versus Physician AssistantsPhysician assistants (PAs) and nurse practitioners (NPs) are highly educated advanced care providers that can sometimes compete for the same position. Both of these providers are able to assess patients, make diagnoses, and prescribe medications (What Is the Difference Between a Nurse Practitioner and a Physician Assistant?, n.d.). There are a few differences between the two care providers. These differences include practice authority and educational background. Buppert (2019) explained all physician assistants are required to have a written collaborative agreement with a physician. This PA practice agreement allows for one or more physicians to delegate medical tasks to the PA. Currently, 22 states allow nurse practitioners to practice with full authority and do not require physician supervision. There are 16 states that require NPs to have a collaboration with a physician, and 12 states that are restricted practice and require a career-long supervisory affiliation with a physician.Sugarbaker and Debakey (2019) explain PAs and NPs have similar roles in providing patient care. The biggest difference between the two advanced practice providers is education. APNs receive a Bachelor’s and Master’s degree in nursing and see the patient as a whole and provide a holistic approach to wellness. PAs typically have a Bachelor’s degree in science and a Master’s degree from a PA program. PA programs are structured much like medical school and these providers focus more on the pathology and biology of diseases processes. PA programs typically require 2000 clinical hours and APN programs usually involve close to 600 (What Is the Difference Between a Nurse Practitioner and a Physician Assistant?, n.d.). NPs have several specialty areas to chose from and the number of clinical hours will depend on which track is chosen. PAs have a more generalized education, but can also specialize in areas such as emergency medicine or surgery. Both PAs and NPs must hold a state license and be board certified by a national certification agency.Practice EnvironmentState practice laws vary by state and provide a clear understanding to APNs of how regulations and laws effect their practice authority. The latest report published by the American Association of Nurse Practitioners (AANP, 2018) shows 23 states, including the District of Columbia, allow APNs to practice within the full scope of practice, 16 states have reduced the scope of practice, and 12 states have restricted the practice of NPs. Perloff et al. (2019) states there is large shortage of physicians specializing in primary care. With this shortage, APNs are the best option for filling the void; however, the state scope of practice laws are curbing the efficiency capabilities of NPs and decreasing access to services that NPs are trained to perform. Unfortunately, none of my surrounding states allow NPs to practice with full authority. Georgia was the last state to allow NPs prescriptive privileges, and is still one of the most restrictive states for APNs. Ortiz et al. (2018) finds restricted practice states inhibit the ability of APNs to engage in one or more component of practice for which they are trained. These states also require supervision, allocation, and management by a physician in order for the APN to provide care to their patients. Expanding states’ scope of practice and allowing APNs to practice independently and to their full potential has been shown to improve patient safety, accessibility, and quality of care (Chattopadhyay & Zangaro, 2019).
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