Advanced Practice Registered Nurse (APRN) Roles and Population Focus

This report delves into the multifaceted roles and population focuses of Advanced Practice Registered Nurses (APRNs). It outlines the four primary APRN roles: Certified Nurse Midwife, Certified Registered Nurse Anesthetist, Clinical Nurse Specialist, and Clinical Nurse Practitioner, while also identifying the six key population focuses, including adult gerontology. The report highlights the scope of practice for APRNs, emphasizing the crucial role of the Gerontology Nurse Practitioner and the Adult-Gerontology Acute Care Nurse Practitioner (AG-ACNP). It further explores essential competencies, the healthcare delivery system, scientific foundations, leadership, practice inquiry, and technology integration. The challenges faced by APRNs, such as state practice regulations, physician opposition, and payer policies, are discussed, along with insights into the future of the APRN role, including implications for healthcare access. The report concludes by emphasizing the evolving scope and responsibilities of APRNs as healthcare providers, and the need for nurses to meet increasing demands.

Advanced Practice Register Nurse

Introduction
Advanced Practice Register Nurse is basically the nurse who has attained a Master’s Degree
in Science Nursing or a Doctor’s Degree in Nursing Practice at graduate level and has been
trained in one among the four chief APRN roles. Likewise, this particular paper attempts to
identify the four chief roles as well as the population focus of an Advanced Practice Register
Nurse. The paper describes the scope of practice for this role and recognizes the population
focus elected to study. Lastly, the paper highlights the implication of an APRN Adult-
Gerontology Certified Nurse Practitioner in Adult/ Gerontology.
APRN Roles
 Certified Nurse Midwife – They specialize in labor as well as delivery while
executing different health medical services for women.
 Certified Registered Nurse Anesthetist - RN’s expert in handling anesthesia for
patients going for surgery or any other medical processes and ensures patient’s well-
being.
 Clinical Nurse Specialist- These RN practice leadership and hold high degree of
clinical proficiency within several specialties spheres of medicine.
 Clinical Nurse Practitioner- These RN offer progressive extensive care to patients
encompassing the caregiver. The majority of NPs prefer specializing in one among
the population focus.
APRN Population Focus
There are several population focus an APRN can get specialized after completed education in
one of the four roles. The six population focus includes family/individual across the lifespan,
neonatal, adult gerontology, pediatrics, women’s gender/health associated or psych/mental
health. People would be licensed as autonomous practitioners for practice at one among the
four levels of APRN roles in a minimum of one among the six recognized population foci.
Moreover, certification, education as well as licensure of the individual need to be congruent
with respect to the role along with population focus. APRNs might specialize nevertheless

they could not be licensed exclusively in any specialty segment. Specialties could offer depth
within one’s practice in the established population focus.
Gerontology Nurse Practitioner
The Gerontology Nurse Practitioner has an impact upon the older adults and influences the
cognitive, physical, psychological and social functions. They are capable of diagnosing,
treating and managing acute as well as chronic illnesses, witnessed frequently amongst older
adults and illnesses related to aging resulting in functional decay requiring treatment for
preserving an optimum functional level (American Nurse Association, 2010).
Certified Nurse Practitioner in Adult/ Gerontology
AG-ACNP offers care to older adults and adults facing acute, complex and critical chronic
physical as well as mental disorders. The practice scope of any AG-ACNP basically revolves
around the requirement of patient care. The AG-ACNP also organizes prevalent care in and
around the care setting for ensuring that the chronic and acute disorder among patients are
properly managed all through the care transition (AACN, 2012). Moreover, the Nurse
Practitioner needs to be proficient of treating chronic illness and acute and also, the geriatric
syndromes evident among older adults. Additionally, the education program for an APRN
involves a minimum three individual all-inclusive graduate-level courses called the APRN
core i.e. the progressive physiology/pathophysiology (general values are applicable
throughout the lifespan); Progressive health assessment (evaluation of all human systems,
progressive assessment methods, conceptions and strategies); Progressive pharmacology
(pharmacodynamics, pharmacokinetics and pharmacotherapeutics of all wide segments of
agents). Each NP must satisfy both the NP core abilities along with the population- focused
abilities within the region of educational preparation.
Competencies and standard of care
Coaching

This involves the capability of imparting knowledge and related psychomotor and dealing
with people, family as well as other caregivers. They also must understand along with
individualize therapies by means of advocacy modelling and teaching practices. Professional
role includes several roles of adult-gerontology acute care NP include progressing the
profession and improving direct care and administration; demonstrating a commitment
towards execution and evolution of NP role.
Healthcare Delivery System
This involves describing adult- gerontology acute care NP function in accomplishing
enhanced health results for people, societies and systems directing and overseeing the
delivery of clinical provisions. It also describes adult- gerontology acute care NP role in
making sure care quality by means of consultation, continuing education, collaboration,
certification and lastly, evaluation.
Scientific Foundation
This involves critically analysing information and evidence for enhancing ANP. It requires
integrating knowledge from the science and humanities with respect to nursing science. It
requires translating research as well as other knowledge forms for improving practice
procedures and results. It builds new practice strategies grounded upon the incorporation of
research, practice knowledge and theory.
Provide leadership
Leadership chiefly assumes advanced and complex leadership roles for initiating and guiding
change. This involves offering leadership for nurturing collaboration with several
stakeholders (including patients, integrated health team care, community and policy makers)
for improving health care. It also encompasses demonstrating leadership, which employs
critical thinking.
Practice inquiry
This involves integrating leadership in translation of new understanding into practice. This
builds understanding from clinical practice for improving practice and patient outputs. It
applies clinical investigative values for improving health outputs.
Technology and information literacy

This involves integrating suitable technologies for the purpose of knowledge management for
improving health care. This also requires translating scientific and technical health data as
and when needed. Evaluates the caregiver’s and patient’s educational requirements for
providing sound and personalized health care.
AG-APRN Issues and Challenges
The State Practice and Licensure regulates NP practice
The barrier for NP to practice at the fullest extends to training and education. The regulations
differ from state to state in spite of the chief objective of full practice authority. The NP holds
the ability of engaging practice in a minimum one aspect of the NP practice and is controlled
by means of a collaborative contract with an external health discipline for providing patient
care. NP holds the capability of engaging practice in a minimum of one aspect of NP practice
and calls for supervision, team-management and delegation from an outside health discipline
for practice.
Full practice authority
This implies towards independent practice under complete practice authority, NP, must by
their licensing state satisfy the educational as well as practice necessities for licensing and
maintaining national certificate (AANP 2016).
Physician opposition
They classify their training and education been more professional than that of the NPs
grounded upon the time-period of education they endure. There also prevails concern in case
if a NP holds the capability of safety prescribing controlled substances along with narcotics.
Payer Policy is frequently associated with states practice licensure and regulation. Restrictive
practice scope regulation might result in stricter payer policies.
Future of the APRN Role
The segment of APRN is continuously developing and thus, there prevails a higher need for
expert nurses and practitioners. Restricted admittance to health care system involves

restricted health provisions for the poor, restricted sources for offering care and Certified
Nurse Practitioner in Adult/ Gerontology.
Summary and Conclusion
The Nurse completes education in one among the four stated roles and could specialize in any
one among the six stated population focus. The NP could change the population focus
however would require attaining certificate within the new scope. The NPs are progressing in
terms of their scope of practice chiefly because of decline in the primary providers. Further,
as the practice scope expands further, the higher regulations along with laws and
accountabilities of the NPs will be there for the nurses.

References:
American Association of College Nursing (2008). Consensus Model for APRN Regulation.
AACN: Washington, DC
American Nurse Association (2010). Nursing Scope and standards of practice (2nd Ed.).
Practice registered nurse: Washington, DC
Adult-Gerontology Acute Care and Primary Care NP Competencies (2016). [Online]
Graduatenursingedu.org. Date Accessed: 19/12/2019
Hamric, A., Hanson, C., Tracy, M. and O’Grady, E. (2013). Advanced practice nursing: An
integrative approach. St. Louis, MO: Elsevier