Transforming Healthcare Services - An approach towards Independent Nursing Practitioners

Running head: Transforming Healthcare Services
Transforming Healthcare Services
-An approach towards Independent Nursing Practitioners
Name of the Student
Name of the University
Author Note

1Transforming Healthcare Services
Abstract:
Advanced nursing practice (APN) comprises of roles like nursing midwifery, clinical
nurse specialist, nurse anesthetist and nurse practitioners. Independent Nursing Practice (INP)
is a form of nursing practitioner profession, in which the nurses can work independently, but
with collaboration, with other healthcare professionals like general physicians,
pharmacologists, social care workers and other professionals from a multidisciplinary
healthcare team. The INP is required to be highly mobile, and deliver care in various setups
ranging from patient’s homes to various healthcare and daycare facilities. The profession
faces different challenges in its implementation, and the aim of this report is to analyze the
strengths and weaknesses of the model, and explore the opportunities for collaboration with
other healthcare professionals, keeping in mind that through effective collaborations, the
model can be further improved. The barriers and challenges towards the implementation of
change are also discussed in the report. The strengths of the model include flexibility of
practice, does not require physician supervision, can allow the nurses to act as teachers and
counselors for the patients. However several healthcare organizations do not have sufficient
trust on the competencies of independent nursing practice that can merit its utilization,
independent of general physicians. Provision for support is offered by Nursing and
Midwifery board though endorsements for advanced clinical nursing practice. Other strengths
include the ability of the practice being conducted in different settings, which increases
accessibility to healthcare services and increase the range of healthcare setups supported by
healthcare organizations. INP can also be effective model for the care of elderly patients,
considering how the practice can address the needs identified through the social determinants
of health. INP also fosters the development of active collaboration within a multidisciplinary
healthcare team and develops a culture where the quality of care can be constantly developed.

2Transforming Healthcare Services
The strategies of improvement in the existing model can be implemented at two levels:
patient experience and strategic cultural alignment. The steps can be divided into four stages:
complex care, development of partnership network and value based care and incorporating
strategic enablers like branding of services, technology, facility planning, etc. However, the
different factors that affect services should also be considered. Strengths and weaknesses of
service can also be measured through the value of services, calculated by the equation device
by UK healthcare. INP also allows access to quality care in a coordinated and patient centric
manner, it fosters health promotion through health education and training, and it also
improves affordability of healthcare services, as well as improves the overall health
infrastructure. Collaboration of care can also be developed through leadership and
commitment, attributed in nursing profession, apart from fostering health literacy and
improving access to affordable and high quality care. Different barriers to the practice
includes the providence of adequate time, and time lost in the regular travelling, the cost of
care as well as resistance from general physicians in acknowledging INP as a credible
healthcare option. However an effective collaboration such barriers can be overcome, and
ensure that the nursing profession flourishes further.

3Transforming Healthcare Services
Contents
ABSTRACT:..............................................................................................................................1
Introduction:...............................................................................................................................4
Description of the current service:.............................................................................................4
Patient Demographics:...............................................................................................................5
Factors Influencing Consumer Care Provision or Access..........................................................5
Current Model of Care:..............................................................................................................8
Strengths and Weaknesses of Health Service:.........................................................................13
Proposed NP Model:................................................................................................................14
Conclusion:..............................................................................................................................15
Recommendations:...................................................................................................................16
References:...............................................................................................................................18

4Transforming Healthcare Services
Introduction:
Advanced Practice Registered Nursing (APRN) comprises of four roles which are
nurse mid-wife, clinical nurse specialist, nurse anaesthetist and nurse practitioner. Nursing
practitioners are registered nurses with an accredited graduate degree and specialization
certifications reflecting the area of expertise (Nursing.upenn.edu, 2018). Independent Nursing
Practice allows the nurses to carryout work independent of other healthcare professionals,
and also allows collaboration whenever required. This means that the nursing practitioners
can practice and prescribe medications independently (Rigolosi & Salmond, 2014).The
Independent nursing practice model comprises of models that are small business or private
and are very mobile, which means that the nurses often have to travel to client’s locations.
This model combines the functions of a small business ownership and a professional practice,
which raises are significant challenge in respect to the combination of responsibilities
associated with each of these functions (Hamric et al., 2013).
In the current context, the Independent Nursing Practice model will be critically
analysed and evaluated to identify the strengths and weaknesses in the model. Opportunities
for collaboration with other professionals in order to support the service model shall also be
discussed, which can allow improvement in the model. Furthermore, the different barriers
and challenges for improvement will also be analysed which can help nib the development of
improvement strategies for the model.
The setup for the independent practice is setup in an aged residential care centre (Blue
Care) which houses about 100 residents of ages 70 to 100 years.
Description of the current service:

5Transforming Healthcare Services
Independent Nursing Practice involves the providence of differential services
depending upon the local demand as well as the scope of the nursing practitioner, showing a
lot of flexibility in practice. This entails the independent practice to be conducted at different
service environments. Independent NP can provide non acute care in a home setup (MacPhee
& Borram, 2012). The types of care provided can include: regular monitoring of blood
glucose, blood pressure, and blood clotting; regular health checkups; care for wound;
treatment for upper respiratory system, continence care, assessing the medication provided,
assessment for falls and also provide referral for other services.
Patient Demographics:
In the present scenario, the selected population comprises of elderly patients.
Factors Influencing Consumer Care Provision or Access
Independent NP enables the nursing practice to be conducted without the
supervision of a physician. This helps the nurses to gain independence and autonomy as they
are able to provide medical care without management or oversight of the physician (Antohe
et al., 2016). A ‘full practice’ status of an NP is a provision that enables independent
assessment, diagnosis, interpretation of diagnostic tests, and prescription of medicines
(Moran et al., 2016). Licensed Independent Nurse Practitioners can conduct their practice in
different setups like: ambulatory, acute, long term care and also function as primary or
speciality care providers. They can assess, diagnose, treat and manage both chronic
conditions as well as acute episodic conditions. Therefore the practitioners need to be adept
with health promotion and disease prevention. They can also order, conduct, supervise as
well as interpret laboratory and diagnostic results, provide prescriptions for pharmacological
substances and non-pharmacological therapies. Moreover, the independent nurses can also be
involved in teaching and counselling of the patients. Hain and Fleck (2014) however pointed