Nurse Practitioner Competencies
Nurse Practitioner Competencies
Seynor Massalee Kennedy
South University
Compared and contrasted the roles of the NP, nurse educator, nurse informaticist, and nurse administrator in advanced practice nursing pertaining to clinical practice, primary care, education, administration, and research.
Advanced practice of nursing (APN) is a direct/indirect care individual who cares for patients and manages individuals and the community, nursing and health care organizations, administrations, and the growth and application of health policy by using various forms of nursing intervention to change the outcome of health care (AACN, 2006).
APN is a patient-focused range of competencies …show more content…
that improve health outcomes for patients and populations in specialized clinical areas within the larger profession of nursing. Critical to this competencies is collaboration and leadership. In this field research based evidence is being expanded to inform practice (Hamric, Hanson, O’Grady, 2014).
A nurse working in the role as an APN has completed a graduate level education from an accredited program; passed a national certification examination measuring the role of an APN with skills that focus on the populace; has acquired a license as an APN and maintains competencies through recertification. The APN provides direct individual care, and a portion of indirect care by achieving advanced clinical knowledge and skills (Thompson, 2011).
The Nurse Practitioner (NP) NP often performs direct and indirect functions and activities with patients, their families and other healthcare members depending on the focus of practice by forming a therapeutic partnership with the patient and their families; use effective communication to gather and understand health issues, establish health and recovery goals while exploring management and treatment plans; performing assessment, diagnosis, planning, implementation pharmacologic and nonpharmacological treatment and evaluation; teaching, coaching, counselling, supporting and comforting while planning future decisions. Additionally,, the NP does researches, provide guidance for bedside nurses, communicate with insurance agencies, consult and coordinates care with other healthcare provider (Hamric, Hanson, Tracy, & O’Grady, 2014),
Nurse Informatics (NI)
Whereas, the speciality of a nurse informatics (NI) comprises of the sciences of nursing, information, computer, management and communication of data and information knowledge on the nursing practice supports the decision making of patients and healthcare providers through the use of information technology, process and structures. As the healthcare setting becomes more complex, all advanced practice nurses, no matter the specialty should have competencies in informatics.
Advance practice nurses that have specialized in informatics has the responsibility of system implementation, workflow analysis, educating and supporting other users through the combination of health care professional workflow and the information technology system. (Troseth, 2012). An advance practice nurse informatic education requirements include a post graduate education and completion of American Association of Colleges of Nursing certification test. Employment of a NI includes hospitals, healthcare organizations, consulting firms and universities.
With the implementation of electronic medical record (EMR) and it’s use for the documentation and communication of patient’s health records, the NI collaborates with information services and systems analysts while advocating for other healthcare members about documentation issues pertaining to the application of EMR to nursing care ( Kirchner, 2014).
Nurse educators
Nurse educators are advanced practice nurses with certification in academic education serving as a clinical speciality, researcher and educator. The role of a nurse educator is primarily indirect patient care (Booth, Emerson, Hackney & Souter, 2016). To encourage distinction in the role of advance speciality, nurse educator faculty should address these seven competencies which include creating a learning environment for the attainment of psychomotor, affective and cognitive results, facilitate development of nursing skills combine with behaviors and values, evaluate the learning of students in various settings, prepare graduates to perform effectively by formulating and designing curricula and programs for health care,create a future for the education and practice of nursing leadership, continue enhancement of growth and competencies, participate in scholarship and scholarly activities and acknowledge the impact of social, political, economic and institutional on their role (NLN, 2016).
Nurse Administrator/Executive
The delivery of organized, secure, convenient and impartial patient focused care is the goal of a nurse executive while working in collaboration and an interprofessional setting. The nurse executive influence the improvement of patient care experience, population health while lowering the cost of healthcare. Moreover, the nurse executive competencies is the knowledge and abilities that directs the nurse executive practice nevertheless of their education, title or the environment they work in. Communication, leadership, knowledge, leadership, professionalism and business skills are core competencies of a nurse executives (AONE, 2015).
The nurse executive uses effective communication for presentation to other health team members, manage professional and academic relationships, influences other team members behaviors, promote diversity and for involvement in the community.
Knowledge for the nurse executive includes clinical, evidence based practice, knowledge, delivery models, economics and policy of healthcare, governance, promote patient safety, evaluate performance and improvement and provide risk management. In Leadership, the nurse executive provides foundational and systematic knowledge, development of the leadership succession plan, and adjust leadership style to the situation. The nurse executive uses business skills for financial management, human resource, strategic and information and technology management. While, professionalism for a nurse executive includes self-accountability, career planning ethics and advocacy (AONE, …show more content…
2015).
Regulatory And Legal Requirements In Michigan
Regulatory and legal requirements for a NP practicing in the State of Michigan include acquiring a registered nurse license in the State of Michigan and a graduate level education in addition to acquiring a specialty certification from the Michigan Department of Licensing and Regulatory Affairs (LARA). Before acquiring a registered nurse license in Michigan, the candidate goes through background check and screening. The State of Michigan certification is constructed on the standards of national certification. Michigan Council of Nurse Practitioners (MICNP) is a professional organizations available for NP membership in Michigan (Nursing Licensure.org, 2016).
MICNP uses members engagement, advocacy and education to enhance the practice of a NP in Michigan by creating a message that is clear and consistent in addressing the role of MICNP and stae innovative models, promoting the balance of work/life, fostering strategic relationships and data collection about the NP Michigan community (Michigan Council of Nurse Practitioners, 2013).
The core competencies of a nurse practitioner (NP) is use as a guideline for educational institutions used in addition to the core competencies of master’s and doctorate of nursing practice (DNP) in the preparation of the NPs, for the implementation of the scope of practice as a licensed independent practitioner. Upon graduation, all NPs, regardless of the program population focus should be able to demonstrate the below competencies to succeed in a complex and changing health system. These core competencies through independent and interprofessional practice can be acquired through experiences of mentored patient care, analytical skills for the evaluation and implementation of evidence-based practice, patient focused care, and advance knowledge of the health care system. Knowledge of scientific foundation, technology and information literacy skills and engagement in practice inquiry, policy, and health delivery system are core competencies of a NP in addition to complicated decision making, leadership, business skills, collaboration and improved communication are advanced skills, knowledge and expertise (National organization of nurse practitioner faculties (NONPF, 2012).
Scientific Foundation Competencies
The NP uses the confirmation of data analysis to improve advance practice nursing by integrating acquired information humanities and sciences, translating research for the improvement of practice and outcomes and for the development of different approaches to practice through practiced knowledge, theory and research (NONPF, 2012).
Leadership Competencies
Is a guide to initiate change, maintain diversity, share values and mutual respect while working with other healthcare professionals for the enhancement of the performance of the team through interprofessional development and leadership to develop, implement and evaluate care to meet the need of specific patients.
Quality Competencies
NP uses key evidence for the quality improvement of clinical practice for research, monitoring, accountability, self-evaluation, peer review, and maintaining professional competence and credential through professional development(NONPF, 2012).
Practice Competencies
The NP alters healthcare delivery affirmatively through the provision of leadership that applies a patient focused research using an approach that is evidence based (NONPF, 2012).
Technology and Information Literacy Competencies
NP monitor the outcomes of health status by enhancing patient safety through evaluation of the educational needs of the patient and caregiver and coaching when necessary.
In addition, assessment of nursing care data on variables can also be captured in the technological system (NONPF, 2012). Policy Competencies
The NP assesses the connection between issues affecting community health, literacy, poverty, violence and advocates for health and the improvement of healthcare delivery, individually or collaboratively by forming strategies to influence legislation(NONPF, 2012).
Health Delivery System Competencies
Health and delivery is enhanced by the NP use of organizational practices and complex systems knowledge to effect changes in healthcare through negotiating, partnership and consensus. Patient and providers risks are reduced at the system and individual level while facilitating healthcare system development addressing providers, population, diverse cultural and stakeholders needs. Furthermore, the NP forms collaboration for transitions over care continuum(NONPF, 2012).
Ethics Competencies
The NP uses ethical principles while making decisions to complicated individual, community and systems of care issues while evaluating the ethical repercussion of the decision(NONPF, 2012).
Independent Practice
Competencies
The NP role as a licensed independent practitioner is the most advanced level in the professional practice of accountability, managing independently patients that were diagnosed and undiagnosed formerly, in addition to providing the promotion and protection of health, preventing and managing diseases, anticipatory guidance, counseling, palliative, and hospice care. Advanced health assessment is utilized by the NP to distinguish the variation of findings that are normal or abnormal, use screening in diagnoses, use SOP for medication prescription, and management of health of the patient and their families. Furthermore, the NP identifies the patient’s or their designated health proxy cultural diversity in decision making(NONPF, 2012).
Hospitals, subacute care facilities, clinics and nursing homes are organizations/setting NP typically works in and these organizations policies defines the scope of practice of an NP. However, the Consensus Model of the advance practice registered nurse (APRN) clarifies that the SOP of a NP is determined based on patient's needs rather than the setting. Moreover, NP provides curative, rehabilitation, maintenance and palliative care for the acutely or critically ill patients (Hamric et al., 2014).
Nurse Practitioner Leadership Attributes
My style of leadership, according to the leadership quiz is democratic or participative leader. With this style of leadership, I often collaborate with my team members during conflict to give their input during decision making although, I always make the final decision. A weakness of mine, I would say is being a team player who always tried to make a decision that will satisfy everyone or majority of the people involved which is often difficult to accomplish thereby, causing unnecessary delay. Therefore, to become a better leader in the world of NP with my democratic style of leadership, I would need to be more decisive and make decision that would better the care of my patient and organization. This can be done through using evidence based practice.
According to Hamric et al.( 2014), a NP leadership should focus on the needs of patient and staff members while providing quality patient care. Moreover, a NP can use role modelling and mentoring as empowerment of colleagues and means to instill confidence in their patients. NP can master leadership competency through mental models, personal mastery, shared vision, team learning and system thinking.
Nurse Practitioner And Health Policy Issues
Nurse practitioners (NPs) practices are regulated by their state licensure through legal, regulatory, and policy and 31 out of 52 states has yet to allow complete autonomy for the NP practice. This health policy issue of full practice law is a barrier to improving health care in the United States.
In the article by Hassmiller (2015), the purpose was to discuss the five ways in which nurses, no matter their educational level can improve the conditions of pregnancies among teenagers and sexually transmitted diseases, low birth weight and mortalities among infants, obesity and diabetes, death related to drugs, injuries and homicides, disabilities, chronic lung and heart diseases. A NP can help build a healthy culture promoting health through wellness and prevention; increase healthcare access, make healthcare accessible, safe and cost effective; improve care through interprofessional collaboration; and educational advancement.
Therefore, to make these changes, a NP has to get other health care workers, the patients and their families, the community, state policy and decision makers involve. Additionally, through leadership and involvement in professional organizations, boards and committees (Hassmiller, 2015).
Conclusion
With all 52 states adopting the implementation of full practice law which, allows NP to practice to the full extent of the education and training, there would be more primary care practitioners to counteract the increase necessitated for care due to the affordable care act and the ability for more people to acquire health insurance (Hassmiller, 2015).
Seynor Massalee Kennedy
South University
Compared and contrasted the roles of the NP, nurse educator, nurse informaticist, and nurse administrator in advanced practice nursing pertaining to clinical practice, primary care, education, administration, and research.
Advanced practice of nursing (APN) is a direct/indirect care individual who cares for patients and manages individuals and the community, nursing and health care organizations, administrations, and the growth and application of health policy by using various forms of nursing intervention to change the outcome of health care (AACN, 2006).
APN is a patient-focused range of competencies …show more content…
that improve health outcomes for patients and populations in specialized clinical areas within the larger profession of nursing. Critical to this competencies is collaboration and leadership. In this field research based evidence is being expanded to inform practice (Hamric, Hanson, O’Grady, 2014).
A nurse working in the role as an APN has completed a graduate level education from an accredited program; passed a national certification examination measuring the role of an APN with skills that focus on the populace; has acquired a license as an APN and maintains competencies through recertification. The APN provides direct individual care, and a portion of indirect care by achieving advanced clinical knowledge and skills (Thompson, 2011).
The Nurse Practitioner (NP) NP often performs direct and indirect functions and activities with patients, their families and other healthcare members depending on the focus of practice by forming a therapeutic partnership with the patient and their families; use effective communication to gather and understand health issues, establish health and recovery goals while exploring management and treatment plans; performing assessment, diagnosis, planning, implementation pharmacologic and nonpharmacological treatment and evaluation; teaching, coaching, counselling, supporting and comforting while planning future decisions. Additionally,, the NP does researches, provide guidance for bedside nurses, communicate with insurance agencies, consult and coordinates care with other healthcare provider (Hamric, Hanson, Tracy, & O’Grady, 2014),
Nurse Informatics (NI)
Whereas, the speciality of a nurse informatics (NI) comprises of the sciences of nursing, information, computer, management and communication of data and information knowledge on the nursing practice supports the decision making of patients and healthcare providers through the use of information technology, process and structures. As the healthcare setting becomes more complex, all advanced practice nurses, no matter the specialty should have competencies in informatics.
Advance practice nurses that have specialized in informatics has the responsibility of system implementation, workflow analysis, educating and supporting other users through the combination of health care professional workflow and the information technology system. (Troseth, 2012). An advance practice nurse informatic education requirements include a post graduate education and completion of American Association of Colleges of Nursing certification test. Employment of a NI includes hospitals, healthcare organizations, consulting firms and universities.
With the implementation of electronic medical record (EMR) and it’s use for the documentation and communication of patient’s health records, the NI collaborates with information services and systems analysts while advocating for other healthcare members about documentation issues pertaining to the application of EMR to nursing care ( Kirchner, 2014).
Nurse educators
Nurse educators are advanced practice nurses with certification in academic education serving as a clinical speciality, researcher and educator. The role of a nurse educator is primarily indirect patient care (Booth, Emerson, Hackney & Souter, 2016). To encourage distinction in the role of advance speciality, nurse educator faculty should address these seven competencies which include creating a learning environment for the attainment of psychomotor, affective and cognitive results, facilitate development of nursing skills combine with behaviors and values, evaluate the learning of students in various settings, prepare graduates to perform effectively by formulating and designing curricula and programs for health care,create a future for the education and practice of nursing leadership, continue enhancement of growth and competencies, participate in scholarship and scholarly activities and acknowledge the impact of social, political, economic and institutional on their role (NLN, 2016).
Nurse Administrator/Executive
The delivery of organized, secure, convenient and impartial patient focused care is the goal of a nurse executive while working in collaboration and an interprofessional setting. The nurse executive influence the improvement of patient care experience, population health while lowering the cost of healthcare. Moreover, the nurse executive competencies is the knowledge and abilities that directs the nurse executive practice nevertheless of their education, title or the environment they work in. Communication, leadership, knowledge, leadership, professionalism and business skills are core competencies of a nurse executives (AONE, 2015).
The nurse executive uses effective communication for presentation to other health team members, manage professional and academic relationships, influences other team members behaviors, promote diversity and for involvement in the community.
Knowledge for the nurse executive includes clinical, evidence based practice, knowledge, delivery models, economics and policy of healthcare, governance, promote patient safety, evaluate performance and improvement and provide risk management. In Leadership, the nurse executive provides foundational and systematic knowledge, development of the leadership succession plan, and adjust leadership style to the situation. The nurse executive uses business skills for financial management, human resource, strategic and information and technology management. While, professionalism for a nurse executive includes self-accountability, career planning ethics and advocacy (AONE, …show more content…
2015).
Regulatory And Legal Requirements In Michigan
Regulatory and legal requirements for a NP practicing in the State of Michigan include acquiring a registered nurse license in the State of Michigan and a graduate level education in addition to acquiring a specialty certification from the Michigan Department of Licensing and Regulatory Affairs (LARA). Before acquiring a registered nurse license in Michigan, the candidate goes through background check and screening. The State of Michigan certification is constructed on the standards of national certification. Michigan Council of Nurse Practitioners (MICNP) is a professional organizations available for NP membership in Michigan (Nursing Licensure.org, 2016).
MICNP uses members engagement, advocacy and education to enhance the practice of a NP in Michigan by creating a message that is clear and consistent in addressing the role of MICNP and stae innovative models, promoting the balance of work/life, fostering strategic relationships and data collection about the NP Michigan community (Michigan Council of Nurse Practitioners, 2013).
The core competencies of a nurse practitioner (NP) is use as a guideline for educational institutions used in addition to the core competencies of master’s and doctorate of nursing practice (DNP) in the preparation of the NPs, for the implementation of the scope of practice as a licensed independent practitioner. Upon graduation, all NPs, regardless of the program population focus should be able to demonstrate the below competencies to succeed in a complex and changing health system. These core competencies through independent and interprofessional practice can be acquired through experiences of mentored patient care, analytical skills for the evaluation and implementation of evidence-based practice, patient focused care, and advance knowledge of the health care system. Knowledge of scientific foundation, technology and information literacy skills and engagement in practice inquiry, policy, and health delivery system are core competencies of a NP in addition to complicated decision making, leadership, business skills, collaboration and improved communication are advanced skills, knowledge and expertise (National organization of nurse practitioner faculties (NONPF, 2012).
Scientific Foundation Competencies
The NP uses the confirmation of data analysis to improve advance practice nursing by integrating acquired information humanities and sciences, translating research for the improvement of practice and outcomes and for the development of different approaches to practice through practiced knowledge, theory and research (NONPF, 2012).
Leadership Competencies
Is a guide to initiate change, maintain diversity, share values and mutual respect while working with other healthcare professionals for the enhancement of the performance of the team through interprofessional development and leadership to develop, implement and evaluate care to meet the need of specific patients.
Quality Competencies
NP uses key evidence for the quality improvement of clinical practice for research, monitoring, accountability, self-evaluation, peer review, and maintaining professional competence and credential through professional development(NONPF, 2012).
Practice Competencies
The NP alters healthcare delivery affirmatively through the provision of leadership that applies a patient focused research using an approach that is evidence based (NONPF, 2012).
Technology and Information Literacy Competencies
NP monitor the outcomes of health status by enhancing patient safety through evaluation of the educational needs of the patient and caregiver and coaching when necessary.
In addition, assessment of nursing care data on variables can also be captured in the technological system (NONPF, 2012). Policy Competencies
The NP assesses the connection between issues affecting community health, literacy, poverty, violence and advocates for health and the improvement of healthcare delivery, individually or collaboratively by forming strategies to influence legislation(NONPF, 2012).
Health Delivery System Competencies
Health and delivery is enhanced by the NP use of organizational practices and complex systems knowledge to effect changes in healthcare through negotiating, partnership and consensus. Patient and providers risks are reduced at the system and individual level while facilitating healthcare system development addressing providers, population, diverse cultural and stakeholders needs. Furthermore, the NP forms collaboration for transitions over care continuum(NONPF, 2012).
Ethics Competencies
The NP uses ethical principles while making decisions to complicated individual, community and systems of care issues while evaluating the ethical repercussion of the decision(NONPF, 2012).
Independent Practice
Competencies
The NP role as a licensed independent practitioner is the most advanced level in the professional practice of accountability, managing independently patients that were diagnosed and undiagnosed formerly, in addition to providing the promotion and protection of health, preventing and managing diseases, anticipatory guidance, counseling, palliative, and hospice care. Advanced health assessment is utilized by the NP to distinguish the variation of findings that are normal or abnormal, use screening in diagnoses, use SOP for medication prescription, and management of health of the patient and their families. Furthermore, the NP identifies the patient’s or their designated health proxy cultural diversity in decision making(NONPF, 2012).
Hospitals, subacute care facilities, clinics and nursing homes are organizations/setting NP typically works in and these organizations policies defines the scope of practice of an NP. However, the Consensus Model of the advance practice registered nurse (APRN) clarifies that the SOP of a NP is determined based on patient's needs rather than the setting. Moreover, NP provides curative, rehabilitation, maintenance and palliative care for the acutely or critically ill patients (Hamric et al., 2014).
Nurse Practitioner Leadership Attributes
My style of leadership, according to the leadership quiz is democratic or participative leader. With this style of leadership, I often collaborate with my team members during conflict to give their input during decision making although, I always make the final decision. A weakness of mine, I would say is being a team player who always tried to make a decision that will satisfy everyone or majority of the people involved which is often difficult to accomplish thereby, causing unnecessary delay. Therefore, to become a better leader in the world of NP with my democratic style of leadership, I would need to be more decisive and make decision that would better the care of my patient and organization. This can be done through using evidence based practice.
According to Hamric et al.( 2014), a NP leadership should focus on the needs of patient and staff members while providing quality patient care. Moreover, a NP can use role modelling and mentoring as empowerment of colleagues and means to instill confidence in their patients. NP can master leadership competency through mental models, personal mastery, shared vision, team learning and system thinking.
Nurse Practitioner And Health Policy Issues
Nurse practitioners (NPs) practices are regulated by their state licensure through legal, regulatory, and policy and 31 out of 52 states has yet to allow complete autonomy for the NP practice. This health policy issue of full practice law is a barrier to improving health care in the United States.
In the article by Hassmiller (2015), the purpose was to discuss the five ways in which nurses, no matter their educational level can improve the conditions of pregnancies among teenagers and sexually transmitted diseases, low birth weight and mortalities among infants, obesity and diabetes, death related to drugs, injuries and homicides, disabilities, chronic lung and heart diseases. A NP can help build a healthy culture promoting health through wellness and prevention; increase healthcare access, make healthcare accessible, safe and cost effective; improve care through interprofessional collaboration; and educational advancement.
Therefore, to make these changes, a NP has to get other health care workers, the patients and their families, the community, state policy and decision makers involve. Additionally, through leadership and involvement in professional organizations, boards and committees (Hassmiller, 2015).
Conclusion
With all 52 states adopting the implementation of full practice law which, allows NP to practice to the full extent of the education and training, there would be more primary care practitioners to counteract the increase necessitated for care due to the affordable care act and the ability for more people to acquire health insurance (Hassmiller, 2015).