Discussion Question 1
Reply to Alissa Hall
Hello Alissa, one of the achievements of the consensus model was to establish standards of practice that APRN nurses all over the country adhere to. For nurses, professional standards describe the competency level required in their daily activities. The standards of practice provide nurses with the desired and achievable performance indicator, by which they can compare their performance (Charlotte, 2014). Furthermore, these Standards play numerous roles in the nursing profession, including acting as evaluation tools for nurses’ performance. Nurses are expected to compare the quality of the services provided with the minimums provided in the standards of practice. Additionally, the standards of practice ensure that the nurses attain and maintain the professional proficiency associated with APRNs (Willson & Angell, 2017). The standards provide a framework for establishing the professional proficiency of nurses and act as a checklist against which their performance is graded.
References
Charlotte, D. (2014). The importance of professional standards. Wolters Kluwer Health. Volume 12 – Issue 5 – p 4 doi: 10.1097/01.NME.0000452691.04516.96
Willson, G., & Angell, K. (2017). Mapping the Association of College and Research Libraries information literacy framework and nursing professional standards onto an assessment rubric. Journal of the Medical Library Association: JMLA, 105(2), 150.
Reply to Matthew Clark
Hello Matthew, the nursing profession is continuously undergoing reforms that aim, among other things, to eradicate the barriers that are present in the practice of APRNs. However, despite the landmarking efforts, including the publication from the Institute of Medicine (IOM), APRNs still face significant barriers to practice (Hain & Fleck, 2014). Barriers to APRN practice comes from different areas. The first and most common is the state practices and licensure requirements. Despite the high level of training, APRNs in many states across the US are still barred from independent practice y state rules. Another barrier relates to their relationship with physicians. To date, various physician associations believe that APRNs do not possess the necessary training to warrant their licensure for independent practice. These arguments have been their primary driving force in their campaigns against the licensure of APRNs, allowing independent practice (Peterson, 2017). However, regardless of the excuses given, APRNs have the necessary training as skills to practice independently.
References
Hain, D., & Fleck, L. (2014). Barriers to nurse practitioner practice that impact healthcare redesign. OJIN: The Online Journal of Issues in Nursing, 19(2), 2.
Peterson, M. E. (2017). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. Journal of the advanced practitioner in oncology, 8(1), 74.
Discussion Question 2
Reply to unread posts
Victor Gonzalez
Hello Victor, the practice environment color red illustrates states with restricted practice legislation, like the state of Texas, as you mentioned in your post. While states have varied reasons for restricting the practice, these regulations have been found to impact patient outcomes adversely. Many of the individuals and organizations advocating for restricted practice hold an unproven belief that if allowed to practice independently, APRNs would reduce the quality of healthcare (Grimes et al., 2018). However, contrary to this opinion, research indicates that allowing the independent practice of APRNs world translates to the opposite results. In addition to the increased patient outcome, the independent practice would reduce the physicians’ workload, contributing to an improvement in their quality of life. Furthermore, allowing APRNs independent practice would aid in providing healthcare services to patients in remote areas in the country (Fund, 2014).
References
Fund, C. (2014). What would happen if health care in the US improved? The Commonwealth Fund.
Grimes, D. E., Thomas, E. J., Padhye, N. S., Ottosen, M. J., & Grimes, R. M. (2018). Do State Restrictions on Advanced Practice Registered Nurses Impact Patient Outcomes for Hypertension and Diabetes Control?. The Journal for Nurse Practitioners, 14(8), 620-625.
Reply to unread posts
Ihuoma Agada
Hello Ihuoma, based on the level of training and knowledge that APRNs possess, they are given specific levels of prescriptive authority in different states across the United States. However, despite being granted this authority, nurses are expected to uphold ethical prescribing. For APRN nurses to undertake ethical prescribing, they need to consider patient examination as a fundamental component for determining patient needs (Ambrose & Tarlier, 2013). However, when conducting the patient examination, nurses may face numerous ethical issues. One such challenge relates to the prescription of medication to friends and family members. Generally, APRNs are advised against giving prescriptions to individuals with whom they hold close intimate relationships. Another common challenge with ethical prescription is managing medication prescription errors (Bruckenthal & Gilson, 2019). Following prescription errors, nurses are faced with the moral dilemma of either disclosing their mistakes, risking losing their license, withholding the mistake, and jeopardizing the patient’s health.
References
Ambrose, M. A., & Tarlier, D. S. (2013). Nurse practitioners and controlled substances prescriptive authority: improving access to care. Nursing Leadership, 26(1), 58-69.
Bruckenthal, P., & Gilson, A. M. (2019). Development and Validation of the Achieving Effective & Safe Opioid Prescribing–Advanced Practice Registered Nurse (AESOP-APRN) Survey: A Pilot Study. Pain Management Nursing, 20(3), 214-221.