Service Improvement Plan for Advanced Independent Nursing Practitioner

Running head: Service Improvement Plan
Service Improvement Plan
-Advanced Independent Nursing Practitioner
Name of the Student
Name of the University
Author Note

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Contents
Introduction:...............................................................................................................................2
Background:...............................................................................................................................2
Overview of the NP Model/ Service Improvement Plan:..........................................................4
Types of Care:........................................................................................................................4
Strategies for care:..................................................................................................................5
Key Enablers:.............................................................................................................................6
Key Barriers:..............................................................................................................................7
Implementation Strategy:...........................................................................................................9
Evaluation Strategy:.................................................................................................................10
Conclusion:..............................................................................................................................12
References:...............................................................................................................................14

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Introduction:
Advanced Nursing Practice includes various roles such as nursing practitioner, nurse
anesthetist, clinical nursing specialist, and nursing midwives. Nursing practitioner is a form
of registered nursing practice, which includes professionals with a nursing graduation
degree and a certification on a specialty subject which shows a specific expertise of the nurse.
Independent Nursing Practitioner is a type of Nursing Practitioner, who are capable of
conducting theory practice independent of the doctor’s and GP’s supervision (Rigolosi &
Salmond, 2014; Antohe et al., 2016). This is a rapidly growing profession, which allows the
providence of care for the patients across various care settings and can provide different types
of care for the patients (such as long term care, palliative care, acute care, chronic care,
specialty care, primary care and also provide referrals for other healthcare services (Hamric et
al., 2013; MacPhee & Borram, 2012). The functions of the INP are ever diversifying, and
require the nurses to have special skills and competencies in order to deal with them. This
profession can help to develop access to care for many individuals, and also through the
objectives of the profession focus on the overall health and well being of the patient. Models
on INP can inform how the care can be delivered by Independent nurses, and how they can be
implemented in real life to ensure the wellbeing of the clients and patients.
The purpose of this report is to discuss an improved model for Independent Nursing
hereby referred to as Advanced Independent Nursing AIN, identifying the various strategies
and types of care that is provided by the independent nurses and also to identify the specific
enablers and barriers faced by the profession in order to understand how they might be
overcome. Similarly, strategies for implementation of Advanced Independent Nursing
Practice and evaluation of the care provided are also outlined in the report.
Background:

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Independent Nursing Practice (INP) can be understood as a form of nursing, or a
speciality of registered nurses, where, the nurses are able to provide professional nursing
services as a business proprietor involving direct providence of care to the patients, and also
involve in research, education, consultation and administration (ipnig.ca, 2018; Rigolosi &
Salmond, 2014; Antohe et al., 2016). The practice allows the nurses to work independently of
general practitioners (GP), and also enable working in collaboration with them to provide
care for the patient. INP can independently (that is without the need of GP supervision)
prescribe medications (Rigolosi & Salmond, 2014). The INP can function as a small and
private business, and require the nurses to travel a lot, in order to provide care at different
client places and locations and in different types of care settings (Hamric et al., 2013). These
can include: like non aged care centre, home health care centre, primary care centres, long
term care centre, rehabilitation centre and counselling centre (ukhealthcare.uky.edu, 2018).
Due to this, Independent Nursing Professionals need to be highly mobile, and exhibit
significant amount of flexibility in order to provide care to patients across various locations
and different care settings, providing a range of care to different clients (Buppert, 2014). In
home setup, the INP can provide a range of non acute care such as monitoring of blood
pressure, blood glucose, blood clotting, physical and mental health status, regular health
checkups, wound care, continence care, helping with medications as well as providing
referrals to other services (nursingmidwiferyboard.gov.au, 2018; Nursing.upenn.edu, 2018).
AINP would have the same characteristics of the INP and incorporate improvements across
various aspects. First some of the aspects about the INP must be discussed, which shall be
incorporated in the AINP model.
The INP can be done independently of GP, they can provide medical care without the
physician’s oversight, and can perform health assessment, diagnosis and interpretation of the
diagnosis and prescribe medicines independently, which can be effective in various types of

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settings such as ambulatory care, acute care and long term care (Moran et al., 2016; Halcomb
et al. 2014). The specialities of the INP also helps them to function as providers of both
primary as well as speciality care, and enable them to teat both acute and chronic conditions
(Anderson, 2017; Kilpatrick et al. 2013). INP can also act as health educators, counsellors
and leaders in healthcare (Billings & Halstead, 2015). Clinical and Administrative leadership
allows the Independent Nursing Practitioners to develop plans and programs for care, as well
as influence other healthcare nurse in developing their skills and competencies (Grossman &
Valiga, 2016). As educators, the INP can also help to develop the understanding of the
disease, by educating the patients and their care givers, which can help to improve the care
(Billings & Halstead, 2015). As social support and advocates, the INP can also ensure the
overall wellbeing, and assist in the providence of uninterrupted care (especially for long term
and palliative care) and improve access to healthcare services (by providing care at client’s
home settings or providing referrals as and when needed) (Council, 2013). The aspects of the
INP will be incorporated in the proposed model of AINP.
Overview of the NP Model/ Service Improvement Plan:
The proposed model for AINP addresses the various types of care that can be
provided by an Advanced Independent Nursing Practitioner (AINP) as well as the different
strategies that can be used to improve care for the clients using the AINP care model:
Types of Care:
Primary Care: As primary care professional, AINP can function as a GP. This means, that
AINP can order and/or perform health assessment, diagnosis and interpretation of diagnostic
test or laboratory investigation reports, prescribe medications, provide treatment for acute and
chronic conditions, supervise other healthcare workers and provide referrals to hospital or
other medical services, which is the case with INP (Yee et al., 2013; Poghosyan et al. 2013).

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Speciality Care: As a speciality care provider, AINP is able to provide specialist medical
services, often with collaboration with other healthcare professionals and services. The
different types of services AINP can provide as a part of speciality care includes: perfusion,
Intraoperative care, neuromonitoring services, and deep brain stimulation. Sterile processing
of medical equipments, medical and clinical consultation, surgical assist service, and
support /assist clinical decision making, as is outlined in the functions of the INP (Raftery,
2013; Dougherty & Lister, 2015)
Home Health Care: In a residential care setup, the AINP can provide home nursing service,
sub acute care, home therapy, long term care, rehabilitation service, counselling service. This
can also help to improve access to care for many patients, who are unable to visit healthcare
centres (Yee et al., 2013; Nettina & Nettina, 2013).
Health Literacy: AINP can also support health literacy, by acting as Educators, improving
the understanding of the disease, and strategies of care for both the patients and their care
givers. This can also ensure the patients and their carers are able to make informed and
appropriate healthcare decisions and healthy lifestyle choices (Cafiero, 2013; Johnson, 2014).
Counselling: The AINP can also provide counselling service for different types of mental
health conditions (Dougherty & Lister, 2015).
Strategies for care:
The different strategies for providing and improving care in the AINP model include:
1. Ensuring that the nursing professional focuses on understanding the experiences of
the patient, as a central part of the care and foster the development of a therapeutic
relation between the nurse and the patient/client