Advance Nursing Practice: Roles, Credentials, and Regulatory Issues

Advance Nursing Practice is one of the renowned and reliable
post graduation program which is an initiative taken by the American
Nursing Association for the education of future nurses. Advance practice
Registered Nurses provides appropriate care to the patients in terms of
primary and speciality health care.
American Association college of Nursing with National Council of
State Board of Nursing advanced nursing practice should be added to the
doctorate level from entry level practice in 2015. DNP(Doctor of Nursing
Practice) degree is needed to become a nurse from 2015 as most of the
nursing training centres are associated with the allied health
centres(Mancuso, Udlis, & Anbari, 2017)
).
• Advanced practices registered nurses are eligible for education, title
maintenance of patient care and licensure to nursing practise.
• They are supposed to protect, promote, and optimize health and ability
for prevention of illness and injury. They are facilitated to healing and
relief of sufferings through proper diagnosis and treatment with quick
response to increase the range of facilities from the medical institution.
Credentials
There are two steps of state legislature for
the license which are actually passes by
the law –“Nurse Practice Act”
The institutional and the regulatory bodies
are created by implemented rules and
regulations of the institutional bodies. The
licensures are to protect the patients from
wrong diagnosis(Petersen et al.,2015)
Health care licensure
Role of APN in the institutions
Advance practise nurses are expected to practise intervention and proper
decision making , managing care of individual or group of people(Popejoy
et al.,2017). They are supposed to engage with a collaborative practice for
the patients in the respected organisations. The institutions are suspecting
that within 20 years in the future number of nurses will be decreased by
30% to 50% so the AANC has decided to enhance the level of APN
programs in a compulsory level(Education,2016).
The nurses of APN education can be categorised in four form of recognised
general areas for certain specialisation such as :
• Clinical nursing specialists
• Nursing anaesthetist
• Nurse midwife
• Nursing practitioner
Majority of the nursing programs are related to the Doctor of Nursing
Practices as the most of the anaesthetist are trained from allied health
centres(Griffith et al.,2015). The roles of APRN or registered nurses are
different with respect to their specialisation,
• NP provides acute and primary treatment for patients and health care
regarding diagnosis, assessment, treatment of life long illness and
injuries.
• Certified nursing anaesthetists provide a full-scale pain relief
management by anaesthesia.
• The nursing midwife are mainly engaged with gynaecological, primary
paediatrics and reproductive health care.• Clinical Nurse Specialists support in the diagnosis , treatment ,
assessment, ,management of the client or patients, provide proficiency
and supports in care of nurses; help in continuation of the practice
changes through entire organization; and assure the best facility and
evidence-based care to achieve the highest potential of patient care as
outcomes.
Background
Regulatory issues
Consensus Model For APRN Regulation was released in July 2008. The
critical elements of licensure, accreditation, certification, and education
(LACE) are the primary supports of regulatory model. The assistances
of executing the national standards related to the Consensus Model also
embrace promising public safety through the standardization of
licensure. APRN will practice according to the model of consensus(Xue
et al.,2016). From June ,2014 :11 states of USA and the Commonwealth
of Northern Mariana have entirely implemented at points of the APRN
Consensus Model. Dakota has fully implemented the legislative related
the consensus model from 2014.
Reimbursement policy
References
The hospitals or health care communities
directly pay APRNs. Medicare and
Medicaid reimburse them. Current federal
laws were applied on nurses free of costs.
Some states have elected to also cover
the services of certified registered nurse
anaesthetists and clinical nurse specialists
– primarily as these practitioners are
prepared to deliver required services in
physician scarcity area. Balanced Budget
Act of 1997 was used primary care case
managers in the fee for the service
program. The BBA granted the states the
option to identify paediatric nurse doctors,
family nurse , and specialized nurse
midwives as primary care case managers;
while also letting them the option to
decline these
providers(www.nursingworld.org 2019).
There are several changes in Federal
Medicaid law are still required that will:
• Free- for- service Medicaid in a direct
form of payments for the facilities
provided by the nurses and clinical
practitioners.
• Identify all of the nurses and clinical
practices in the form of care case
managers.
• Every specialists of the advanced
nursing practitioners require the
managed care panels for Medicaid
from the hospitals(Sabo et al.,2017).
Education, E. N. D. S. A. (2016). Advanced Practice Registered Nurse
Preceptors Expanding North Dakota’s APRN Education Capacity Policy
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strain.
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