BOOK
Advanced Practice Nursing - E-Book
Ann B. Hamric | Charlene M. Hanson | Mary Fran Tracy | Eileen T. O'Grady
(2013)
Additional Information
Book Details
Abstract
Addressing all major advanced practice nursing competencies, roles, and issues, Advanced Practice Nursing: An Integrative Approach, 5th Edition provides a clear, comprehensive, and current introduction to APN today. It applies APN core competencies to the major APN roles — including the burgeoning Nurse Practitioner role — and covers topics ranging from the evolution of APN to evidence-based practice, leadership, ethical decision-making, and health policy. This edition includes a new chapter on the international development of APN, new and enhanced illustrations, and a colorful new reader-friendly format for improved readability. From internationally known APN experts Ann Hamric, Charlene Hanson, Mary Fran Tracy, and Eileen O'Grady, along with a host of internationally recognized APN contributors, Advanced Practice Nursing introduces you to APN and helps you identify an APN role, develop key competencies for that role, and succeed as an APN.
- Coverage of APN core competencies defines and describes all competencies, including direct clinical practice, guidance and coaching, consultation, evidence-based practice (EBP), leadership, collaboration, and ethical decision-making.
- Operationalizes and applies APN core competencies to the major APN specialties including the Clinical Nurse Specialist, the Primary Care Nurse Practitioner, the Acute Care Nurse Practitioner, the Certified Nurse-Midwife, and the Certified Registered Nurse Anesthetist.
- Content on managing APN environments addresses such factors as business planning and reimbursement; marketing, negotiating, and contracting; regulatory, legal, and credentialing requirements; health policy issues; and nursing outcomes and performance improvement research.
- Unique Exemplar boxes provide real-life scenarios, showing APN competencies in action.
- In-depth discussions of educational strategies show how nurses develop competencies as they progress into advanced practice.
- Discussions of APN role development clearly explain the career trajectory that you can anticipate as you transition to advanced practice.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| IFC_Contents | IFC2 | ||
| Advanced Practice Nursing, 5/e | i | ||
| Copyright Page | iv | ||
| Contributors | v | ||
| Reviewers | ix | ||
| Preface | xi | ||
| Purpose | xi | ||
| Underlying Premises | xi | ||
| Organization | xii | ||
| Audience | xiii | ||
| Approach | xiv | ||
| Transitions | xiv | ||
| References | xv | ||
| Table Of Contents | xvii | ||
| I Historical and Developmental Aspects of Advanced Practice Nursing | 1 | ||
| 1 A Brief History of Advanced Practice Nursing in the United States | 1 | ||
| Chapter Contents | 1 | ||
| Nurse Anesthetists | 2 | ||
| Anesthesia at Mayo Clinic | 3 | ||
| Wartime Opportunities | 3 | ||
| Education and Reimbursement | 6 | ||
| Nurse-Midwives | 7 | ||
| Nurse-Midwifery Education and Organization | 7 | ||
| Move Toward Natural Childbirth | 8 | ||
| Clinical Nurse Specialists | 10 | ||
| Coronary Care Unit: A New Era of Specialization | 11 | ||
| Defining the Clinical Nurse Specialist’s Role | 12 | ||
| Clinical Nurse Specialist Certification, Organization, and Prescriptive Authority | 14 | ||
| Nurse Practitioners | 14 | ||
| Early Public Health Nurses’ Role in Direct Care | 14 | ||
| Primary Care in Appalachia—the Frontier Nursing Service | 15 | ||
| Pediatric Nurse Practitioners Pave the Way | 17 | ||
| National Reports and Federal Funding | 17 | ||
| Controversy and Support for the Nurse Practitioner’s Role | 18 | ||
| Growth in Nurse Practitioner Numbers and Expanded Scope of Practice | 19 | ||
| Neonatal and Acute Care Nurse Practitioners | 20 | ||
| American Association of Colleges of Nursing and Doctor of Nursing Practice | 21 | ||
| Conclusion | 21 | ||
| References | 23 | ||
| 2 Conceptualizations of Advanced Practice Nursing | 27 | ||
| Chapter Contents | 27 | ||
| Nature, Purposes, and Components of Conceptual Models | 29 | ||
| Conceptualizations of Advanced Practice Nursing: Problems and Imperatives | 30 | ||
| Conceptualizations of Advanced Practice Nursing Roles: Organizational Perspectives | 32 | ||
| Consensus Model for Advanced Practice Registered Nurse Regulation | 34 | ||
| American Nurses Association | 36 | ||
| American Association of Colleges of Nursing | 37 | ||
| National Organization of Nurse Practitioner Faculties | 38 | ||
| National Association of Clinical Nurse Specialists | 38 | ||
| American Association of Nurse Anesthetists and American College of Nurse-Midwives | 40 | ||
| American Association of Nurse Anesthetists | 40 | ||
| American College of Nurse-Midwives | 41 | ||
| International Organizations and Conceptualizations of Advanced Practice Nursing | 41 | ||
| Section Summary: Implications for Advanced Practice Nursing Conceptualizations | 42 | ||
| Conceptualizations of the Nature of Advanced Practice Nursing | 43 | ||
| Hamric’s Integrative Model of Advanced Practice Nursing | 44 | ||
| Fenton’s and Brykczynski’s Expert Practice Domains of the Clinical Nurse Specialist and Nurse Practitioner | 45 | ||
| Calkin’s Model of Advanced Nursing Practice | 46 | ||
| Brown’s Framework for Advanced Practice Nursing | 49 | ||
| Strong Memorial Hospital’s Model of Advanced Practice Nursing | 50 | ||
| Oberle and Allen: The Nature of Advanced Practice Nursing | 51 | ||
| Shuler’s Model of Nurse Practitioner Practice | 52 | ||
| Ball and Cox: Restoring Patients to Health— A Theory of Legitimate Influence | 53 | ||
| Section Summary: Implications for Advanced Practice Nursing Conceptualizations | 53 | ||
| Models Useful for Advanced Practice Nurses in Their Practice | 55 | ||
| American Association of Critical-Care Nurses’ Synergy Model | 55 | ||
| Advanced Practice Nursing Transitional Care Models | 57 | ||
| Dunphy and Winland-Brown’s Circle of Caring: A Transformative, Collaborative Model | 57 | ||
| Recommendations and Future Directions | 59 | ||
| Conceptualizations of Advanced Practice Nursing | 59 | ||
| Consensus Building Around Advanced Practice Nursing | 60 | ||
| Consensus on Key Elements of Practice Doctorate Curricula | 60 | ||
| Research on Advanced Practice Nurses and Their Contributions to Patient, Team, and Systems Outcomes | 61 | ||
| Conclusion | 61 | ||
| References | 62 | ||
| 3 A Definition of Advanced Practice Nursing | 67 | ||
| Contents | 67 | ||
| Distinguishing Between Specialization and Advanced Practice Nursing | 68 | ||
| Distinguishing Between Advanced Nursing Practice and Advanced Practice Nursing | 69 | ||
| Defining Advanced Practice Nursing | 70 | ||
| Core Definition of Advanced Practice Nursing | 70 | ||
| Conceptual Definition | 71 | ||
| Primary Criteria | 71 | ||
| Graduate Education | 72 | ||
| Certification | 72 | ||
| Practice Focused on Patient and Family | 73 | ||
| Seven Core Competencies of Advanced Practice Nursing | 75 | ||
| Direct Clinical Practice: The Central Competency | 75 | ||
| Additional Advanced Practice Nurse Core Competencies | 76 | ||
| Scope of Practice | 77 | ||
| Differentiating Advanced Practice Roles: Operational Definitions of Advanced Practice Nursing | 78 | ||
| Workforce Data | 78 | ||
| Four Established Advanced Practice Nurse Roles | 78 | ||
| Critical Elements in Managing Advanced Practice Nursing Environments | 80 | ||
| Implications of the Definition of Advanced Practice Nursing | 81 | ||
| Implications for Advanced Practice Nursing Education | 82 | ||
| Implications for Regulation and Credentialing | 82 | ||
| Implications for Research | 82 | ||
| Implications for Practice Environments | 83 | ||
| Conclusion | 84 | ||
| References | 84 | ||
| 4 Role Development of the Advanced Practice Nurse | 86 | ||
| Chapter Contents | 86 | ||
| Perspectives on Advanced Practice Nurse Role Development | 86 | ||
| Novice to Expert Skill Acquisition Model | 87 | ||
| Role Concepts and Role Development Issues | 89 | ||
| Role Ambiguity | 90 | ||
| Role Incongruity | 90 | ||
| Role Conflict | 90 | ||
| Intraprofessional Role Conflict | 90 | ||
| Interprofessional Role Conflict | 91 | ||
| Role Transitions | 93 | ||
| Advanced Practice Nurse Role Acquisition in Graduate School | 93 | ||
| Strategies to Facilitate Role Acquisition | 95 | ||
| Advanced Practice Nursing Role Implementation at Work | 97 | ||
| Strategies to Facilitate Role Implementation | 101 | ||
| International Experiences with Advanced Practice Nurse Role Development and Implementation: Lessons Learned and A Proposed Model for Success | 103 | ||
| Facilitators and Barriers in the Work Setting | 103 | ||
| Continued Advanced Practice Nurse Role Evolution | 105 | ||
| Evaluation of Role Development | 106 | ||
| Conclusion | 106 | ||
| References | 107 | ||
| 5 Evolving and Innovative Opportunities for Advanced Practice Nursing | 112 | ||
| Chapter Contents | 112 | ||
| Patterns in the Evolution of Specialty to Advanced Practice Nursing | 112 | ||
| Innovative Practice Opportunities: Stage I | 115 | ||
| Hospitalist Practice | 115 | ||
| Commentary: Stage I | 117 | ||
| Specialties in Transition: Stage II | 117 | ||
| Clinical Transplant Coordination | 117 | ||
| Forensic Nursing | 118 | ||
| Commentary: Stage II | 120 | ||
| Emerging Advanced Practice Nursing Specialties: Stage III | 121 | ||
| Interventional Pain Practice | 121 | ||
| Wound, Ostomy, and Continence Nursing | 124 | ||
| Commentary: Stage III | 124 | ||
| Established Advanced Practice Nursing Roles: Stage IV | 125 | ||
| Advanced Diabetes Manager | 125 | ||
| Genetics Advanced Practice Nursing | 126 | ||
| Commentary: Stage IV | 128 | ||
| Conclusion | 128 | ||
| References | 130 | ||
| 6 International Development of Advanced Practice Nursing | 133 | ||
| Chapter Contents | 133 | ||
| Definitions | 136 | ||
| International Evolution of the Advanced Practice Nurse | 136 | ||
| Nurse Practitioner | 136 | ||
| Practice Settings | 138 | ||
| Nurse Midwifery | 138 | ||
| Nurse Anesthetist | 138 | ||
| Clinical Nurse Specialist | 138 | ||
| Advanced Practice Nurse Issues Worldwide | 139 | ||
| Titling | 139 | ||
| Power Differential Between Nursing and Medicine | 139 | ||
| Lack of Physician Support for Advanced Practice Nurse Roles | 140 | ||
| Level of Educational Preparation | 140 | ||
| Valuing Clinical Practice Expertise | 140 | ||
| Infusing Evidence into Role Development | 141 | ||
| Cultural Norms | 141 | ||
| Health Care Delivery System Values | 141 | ||
| Advanced Practice Nurse Payment | 142 | ||
| Advanced Practice Nurse Regulations and Standards | 142 | ||
| High-Quality, Interdisciplinary, Advanced Practice Nurse Education | 142 | ||
| Looking to the Future: What Do We Have To Learn From Each Other? | 143 | ||
| References | 144 | ||
| II Competencies of Advanced Practice Nursing | 147 | ||
| 7 Direct Clinical Practice | 147 | ||
| Chapter Contents | 147 | ||
| Direct Care Activities | 148 | ||
| Direct Care and Indirect Care | 148 | ||
| Six Characteristics of Direct Clinical Care Provided by Advanced Practice Nurses | 150 | ||
| Use of a Holistic Perspective | 151 | ||
| Holism Described | 151 | ||
| Holism and Health Assessment | 151 | ||
| Nursing Model or Medical Model | 151 | ||
| Formation of Therapeutic Partnerships with Patients | 153 | ||
| Shared Decision Making | 153 | ||
| Cultural Influences on Partnerships | 154 | ||
| Communication with Patients | 155 | ||
| Therapeutic Partnerships with Noncommunicative Patients | 155 | ||
| Expert Clinical Performance | 156 | ||
| Clinical Thinking | 156 | ||
| Thinking Errors | 158 | ||
| Time Pressures | 158 | ||
| Ethical Reasoning | 159 | ||
| Skillful Performance | 160 | ||
| Advanced Physical Assessment | 161 | ||
| Patient Education | 161 | ||
| Adverse Events and Performance Errors | 162 | ||
| Use of Reflective Practice | 162 | ||
| Use of Evidence as a Guide to Practice | 164 | ||
| Evidence-Based Practice | 164 | ||
| Clinical Guidelines | 165 | ||
| Theory-Based Practice | 165 | ||
| Diverse Approaches to Health and Illness Management | 166 | ||
| Interpersonal Interventions | 166 | ||
| Therapeutic Interventions | 166 | ||
| Individualized Interventions | 168 | ||
| Complementary and Alternative Medicine | 169 | ||
| Clinical Prevention | 170 | ||
| Population-Based Data to Inform Practice | 170 | ||
| Preventive Services in Primary Care | 171 | ||
| Preventive Services in Hospitals and Home Care | 171 | ||
| Management of Complex Situations | 172 | ||
| Helping Patients Manage Chronic Illnesses | 172 | ||
| Direct Care and Information Management | 175 | ||
| Conclusion | 176 | ||
| References | 176 | ||
| 8 Guidance and Coaching | 183 | ||
| Chapter Contents | 183 | ||
| Imperatives for Advanced Practice Nurse Guidance and Coaching | 184 | ||
| Burden of Chronic Illness | 184 | ||
| Health Care Policy Initiatives | 184 | ||
| Accountable Care Organizations and Patient-Centered Medical Homes | 184 | ||
| Patient-Centered Care, Culturally Competent and Safe Health Care, and Meaningful Provider-Patient Communication | 184 | ||
| Interprofessional Teams | 185 | ||
| Definitions: Teaching, Guidance, and Coaching | 185 | ||
| Patient Education | 185 | ||
| Guidance | 185 | ||
| Advanced Practice Nurse Guidance and Coaching Competency: Theoretical and Empirical Perspectives | 187 | ||
| Transitions in Health and Illness | 187 | ||
| Transtheoretical Model of Behavior Change | 188 | ||
| Stages of Change | 189 | ||
| Precontemplation | 189 | ||
| Contemplation | 189 | ||
| Preparation | 189 | ||
| Action | 189 | ||
| Maintenance | 190 | ||
| Evidence That Advanced Practice Nurses Guide and Coach | 190 | ||
| Advanced Practice Nurses and Models of Transitional Care | 190 | ||
| Transitional Care Model | 190 | ||
| Care Transitions Intervention Model | 192 | ||
| Model of Advanced Practice Nurse Guidance and Coaching | 193 | ||
| Assumptions | 193 | ||
| Overview of the Model | 193 | ||
| Self-Reflection | 193 | ||
| Clinical and Technical Competence | 194 | ||
| Interpersonal Competence | 195 | ||
| Ability to Create Therapeutic Partnerships | 195 | ||
| Person-Centered Approach | 195 | ||
| Knowing the Patient | 196 | ||
| Empathy | 197 | ||
| Cultural Competence and Cultural Safety | 197 | ||
| Other Advanced Communication Skills | 197 | ||
| Motivational Interviewing | 198 | ||
| Conflict Negotiation and Resolution | 199 | ||
| Individual and Contextual Factors That Influence Advanced Practice Nurse Guidance and Coaching | 202 | ||
| Advanced Practice Nurse Factors | 202 | ||
| Patient Factors | 202 | ||
| Contextual Factors | 202 | ||
| Coaching “Difficult” Patients | 202 | ||
| Guidance and Coaching Competency and Outcomes | 203 | ||
| Development of Advanced Practice Nurses’ Coaching Competence | 205 | ||
| Graduate Nursing Education: Influence of Faculty and Preceptors | 205 | ||
| Strategies for Developing and Applying the Coaching Competency | 206 | ||
| Professional Coaching and Health Care | 207 | ||
| Advanced Practice Nurse Guidance and Coaching and Coach Certification | 208 | ||
| Conclusion | 209 | ||
| References | 209 | ||
| 9 Consultation | 213 | ||
| Chapter Contents | 213 | ||
| Consultation and Advanced Practice Nursing | 214 | ||
| Defining Consultation | 215 | ||
| Distinguishing Consultation from Comanagement, Referral, and Collaboration* | 215 | ||
| Background | 216 | ||
| Types of Consultation | 216 | ||
| Consultation and Specific Advanced Practice Nurse Roles | 217 | ||
| Model of Advanced Practice Nursing Consultation | 218 | ||
| Ecologic Field of the Consultation Process | 219 | ||
| Purposes and Outcomes | 219 | ||
| Consultation Process for Formal Consultation | 220 | ||
| Characteristics of the Advanced Practice Nurse Consultant | 221 | ||
| Characteristics of the Consultee | 222 | ||
| Patient and Family Factors | 222 | ||
| Situational Factors | 222 | ||
| Common Advanced Practice Nurse Consultation Situations | 222 | ||
| Advanced Practice Nurse Consultation in Practice | 222 | ||
| Advanced Practice Nurse–Physician Consultation | 223 | ||
| Advanced Practice Nurse–Staff Nurse Consultation | 224 | ||
| Consultation in the International Community | 226 | ||
| Mechanisms to Facilitate Consultation | 226 | ||
| Issues in Advanced Practice Nurse Consultation | 228 | ||
| Developing Consultation Skills in Advanced Practice Nurse Students | 228 | ||
| Using Technology to Provide Consultation | 229 | ||
| Documentation and Legal Considerations | 230 | ||
| Discontinuing the Consultation Process | 231 | ||
| Developing the Practice of Other Nurses | 231 | ||
| Consultation Practice Over Time | 232 | ||
| Billing for Consultation | 233 | ||
| Evaluation of the Consultation Competency | 233 | ||
| Conclusion | 234 | ||
| Acknowledgment | 234 | ||
| References | 235 | ||
| 10 Evidence-Based Practice | 237 | ||
| Chapter Contents | 237 | ||
| Evidence and Current Best Evidence: Historical Perspective | 241 | ||
| Steps of the Evidence-Based Process | 242 | ||
| Step 1: Formulate a Measurable Clinical Question | 242 | ||
| Step 2: Search the Literature for Relevant Studies | 244 | ||
| MEDLINE and PubMed | 244 | ||
| Cumulative Index for Nursing and Allied Health Literature | 245 | ||
| Online Evidence-Based Resources | 245 | ||
| Clinical Practice Guidelines | 246 | ||
| Strategies for Searching Electronic Databases | 247 | ||
| Step 3: Critically Appraise and Extract Evidence | 248 | ||
| Evidence Pyramid | 248 | ||
| Systematic Reviews and Meta-Analyses | 250 | ||
| Critical Appraisal | 251 | ||
| Individual Studies | 251 | ||
| Systematic Reviews and Meta-Analyses | 251 | ||
| Data Extraction | 256 | ||
| Step 4: Implement Useful Findings in Clinical Decision Making | 257 | ||
| From Policy to Practice: Tips for Achieving Meaningful Changes in Practice Based on Current Best Evidence | 259 | ||
| Stakeholder Engagement | 261 | ||
| Organizational Support | 261 | ||
| Clinical Leadership Support | 261 | ||
| Evidence-Based Practice Innovation Feedback | 262 | ||
| Future Perspectives | 262 | ||
| Conclusion | 262 | ||
| References | 263 | ||
| 11 Leadership | 266 | ||
| Chapter Contents | 266 | ||
| Context in Which Advanced Practice Nurses Exercise Leadership Competency | 267 | ||
| Health Care System Transformation | 267 | ||
| Redesign of Health Professional Education | 268 | ||
| Interdisciplinary Competencies | 268 | ||
| Advanced Practice Nurse Competencies | 268 | ||
| Leadership Domains of Advanced Practice Nurses | 268 | ||
| Clinical Leadership | 269 | ||
| Professional Leadership | 269 | ||
| Systems Leadership | 270 | ||
| Willingness to Name Difficult Organizational Problems | 271 | ||
| Health Policy Leadership | 272 | ||
| Leadership: Definitions, Models, and Concepts | 272 | ||
| Definitions of Leadership | 272 | ||
| Leadership Models That Lead to Transformation | 273 | ||
| The Fifth Discipline | 273 | ||
| The Seven Habits of Highly Effective People | 275 | ||
| Leadership Models That Address Systems Change and Innovation | 275 | ||
| Microsystems in Health Care: High-Performing Clinical Units | 275 | ||
| Spread of Innovation | 275 | ||
| Appreciative Inquiry | 276 | ||
| Concepts Related to Change | 276 | ||
| Opinion Leadership | 276 | ||
| Driving and Restraining Forces | 277 | ||
| Pace of Change | 277 | ||
| Defining Characteristics of the Advanced Practice Nurse Leadership Competency | 278 | ||
| Mentoring | 278 | ||
| Empowering Others | 279 | ||
| Innovation | 280 | ||
| Political Activism | 280 | ||
| Attributes of Effective Advanced Practice Nurse Leaders | 281 | ||
| Vision | 281 | ||
| Timing | 281 | ||
| Self-Confidence and Risk Taking | 282 | ||
| Expert Communication and Relationship Building | 282 | ||
| Boundary Management | 283 | ||
| Respect for Cultural Diversity | 283 | ||
| Global Awareness | 283 | ||
| Balance in Personal and Professional Life | 284 | ||
| Developing Skills as Advanced Practice Nurse Leaders | 285 | ||
| Factors Influencing Leadership Development | 285 | ||
| Power Resources | 285 | ||
| Personal Characteristics and Experiences | 285 | ||
| Strategies for Acquiring Competency as a Leader | 286 | ||
| Developing Leadership in the Health Policy Arena | 287 | ||
| Becoming an Astute Political Activist: The Growth Process | 287 | ||
| Depth of Involvement | 287 | ||
| Using Professional Organizations to the Best Advantage | 288 | ||
| Political Action Committees | 288 | ||
| Internships and Fellowships | 288 | ||
| Raising Awareness Through Communication | 288 | ||
| General Political Strategies | 289 | ||
| Obstacles to Leadership Development and Effective Leadership | 289 | ||
| Professional and System Obstacles | 289 | ||
| Dysfunctional Leadership Styles | 289 | ||
| Horizontal Violence | 290 | ||
| Abandoning One’s Nursing Identity: Star Complex | 290 | ||
| Hoarding or Misusing Power: Queen Bee Syndrome | 291 | ||
| Failure to Mentor | 291 | ||
| Strategies for Implementing the Leadership Competency | 292 | ||
| Developing a Leadership Portfolio | 292 | ||
| Promoting Collaboration Among Advanced Practice Nursing Groups | 292 | ||
| Motivating and Empowering Others | 293 | ||
| Networking | 293 | ||
| Engaging Others in Planning and Implementing Change | 293 | ||
| Institutional Assessment Regarding Readiness for Change | 293 | ||
| Followship | 293 | ||
| Conclusion | 294 | ||
| References | 294 | ||
| 12 Collaboration | 299 | ||
| Chapter Contents | 299 | ||
| Definition of Collaboration | 299 | ||
| Collaboration: What It Is Not | 300 | ||
| Parallel Communication. | 300 | ||
| One-Sided Compromise. | 300 | ||
| Faux Collaboration. | 300 | ||
| Parallel Functioning. | 300 | ||
| Information Exchange. | 300 | ||
| Coordination. | 301 | ||
| Consultation. | 301 | ||
| Comanagement. | 301 | ||
| Referral. | 301 | ||
| Domains of Collaboration in Advanced Practice Nursing | 301 | ||
| Collaboration with Individuals | 301 | ||
| Collaboration with Teams and Groups | 301 | ||
| Collaboration in the Organizational and Policy Arenas | 301 | ||
| Collaboration in Global Arenas | 301 | ||
| Types of Collaboration | 302 | ||
| Interprofessional Collaboration | 302 | ||
| Characteristics of Effective Collaboration | 304 | ||
| Clinical Competence and Accountability | 305 | ||
| Common Purpose | 306 | ||
| Interpersonal Competence and Effective Communication | 306 | ||
| Trust and Mutual Respect | 306 | ||
| Recognizing and Valuing Diverse, Complementary Culture, Knowledge, and Skills | 307 | ||
| Humor | 307 | ||
| Impact of Collaboration on Patients and Clinicians | 307 | ||
| Evidence That Collaboration Works | 308 | ||
| Research Supporting Interprofessional Collaboration | 308 | ||
| Primary Care: Impact on Chronic Disease Management | 309 | ||
| Outcomes of Intensive Care Unit Stays | 310 | ||
| Effects of Physician and Advanced Practice Nurse Collaboration on Costs | 310 | ||
| Other Evidence | 310 | ||
| Effects of Failure to Collaborate | 311 | ||
| Effects on Organizations | 311 | ||
| Effects on Individuals | 311 | ||
| Imperatives for Collaboration | 312 | ||
| Ethical Imperative to Collaborate | 312 | ||
| Institutional Imperative to Collaborate | 312 | ||
| Research Imperative to Study Collaboration | 313 | ||
| Context of Collaboration in Contemporary Health Care | 313 | ||
| Incentives and Opportunities for Collaboration | 314 | ||
| Barriers to Collaboration | 314 | ||
| Disciplinary Barriers | 314 | ||
| Ineffective Communication and Team Dysfunction | 315 | ||
| Sociocultural Issues | 315 | ||
| Organizational Barriers | 316 | ||
| Regulatory Barriers | 316 | ||
| Processes Associated with Effective Collaboration | 317 | ||
| Recurring Interactions | 317 | ||
| Effective Conflict Negotiation and Resolution Skills | 318 | ||
| Bridging and Appreciative Inquiry | 318 | ||
| Partnering and Team Building | 318 | ||
| Implementing Collaboration | 318 | ||
| Assessment of Personal, Environmental, and Global Factors | 319 | ||
| Strategies for Successful Collaboration | 320 | ||
| Individual Strategies | 320 | ||
| Team Strategies | 320 | ||
| Organizational Strategies | 321 | ||
| Conclusion | 323 | ||
| References | 323 | ||
| 13 Ethical Decision Making | 328 | ||
| Chapter Contents | 328 | ||
| Characteristics of Ethical Dilemmas in Nursing | 328 | ||
| Communication Problems | 329 | ||
| Interdisciplinary Conflict | 329 | ||
| Multiple Commitments | 330 | ||
| Ethical Issues Affecting Advanced Practice Nurses | 330 | ||
| Primary Care Issues | 330 | ||
| Acute and Chronic Care | 330 | ||
| Societal Issues | 331 | ||
| Access to Resources and Issues of Justice | 332 | ||
| Legal Issues | 333 | ||
| Ethical Decision Making Competency of Advanced Practice Nurses | 333 | ||
| Phases of Core Competency Development | 333 | ||
| Phase 1: Knowledge Development | 334 | ||
| Developing an Educational Foundation | 336 | ||
| Overview of Ethical Theories | 336 | ||
| Principle-Based Model. | 336 | ||
| Casuistry. | 336 | ||
| Narrative Ethics. | 337 | ||
| Care-Based Ethics. | 338 | ||
| Professional Codes and Guidelines | 340 | ||
| Personal and Professional Values | 340 | ||
| Professional Boundaries | 340 | ||
| Phase 2: Knowledge Application | 341 | ||
| Ethical Decision Making Frameworks | 341 | ||
| Strategies for Resolution of Ethical Conflict | 342 | ||
| Phase 3: Creating an Ethical Environment | 344 | ||
| Preventive Ethics | 345 | ||
| Phase 4: Promoting Social Justice Within the Health Care System | 347 | ||
| Evaluation of the Ethical Decision Making Competency | 349 | ||
| Barriers to Ethical Practice and Potential Solutions | 350 | ||
| Barriers Internal to the Advanced Practice Nurse | 350 | ||
| Interprofessional Barriers | 351 | ||
| Patient-Provider Barriers | 351 | ||
| Organizational and Environmental Barriers | 352 | ||
| Conclusion | 354 | ||
| References | 355 | ||
| III Advanced Practice Roles: The Operational Definitions of Advanced Practice Nursing | 359 | ||
| 14 The Clinical Nurse Specialist | 359 | ||
| Chapter Contents | 359 | ||
| Overview and Definitions of the Clinical Nurse Specialist | 359 | ||
| Clinical Nurse Specialist Practice: Spheres of Influence and Advanced Practice Nursing Competencies | 362 | ||
| Direct Clinical Practice | 369 | ||
| Guidance and Coaching | 372 | ||
| Patients and Families | 373 | ||
| Nurses and Nursing Personnel | 374 | ||
| Students | 374 | ||
| Other Health Care Providers and the Public | 374 | ||
| Consultation | 375 | ||
| Internal Consultation | 375 | ||
| External Consultation | 375 | ||
| Evidence-Based Practice | 376 | ||
| Interpretation and Use of Research and Evidence in Practice | 376 | ||
| Evaluation of Practice | 377 | ||
| Participation in Collaborative Research | 378 | ||
| Leadership | 378 | ||
| Collaboration | 379 | ||
| Ethical Decision Making | 380 | ||
| Current Marketplace Forces and Concerns | 382 | ||
| Scope of Practice and Delegated Authority | 383 | ||
| Institute of Medicine Future of Nursing Report | 383 | ||
| Key Message 1 | 383 | ||
| Key Message 2 | 385 | ||
| Key Message 3 | 385 | ||
| Key Message 4 | 385 | ||
| NCSBN Consensus Model for Advanced Practice Registered Nurse Regulation and Implications for the Clinical Nurse Specialist | 386 | ||
| Regional and Local Variations in Clinical Nurse Specialist Regulation | 386 | ||
| Availability and Standardization of Educational Curricula for Clinical Nurse Specialists | 387 | ||
| National Certification for Clinical Nurse Specialists | 388 | ||
| Variability in Individual Clinical Nurse Specialist Practices and Prescriptive Authority | 388 | ||
| Understanding the Similarities and Differences Between Clinical Nurse Specialists and Nurse Practitioners | 388 | ||
| Future Directions | 390 | ||
| Conclusion | 391 | ||
| References | 392 | ||
| 15 The Primary Care Nurse Practitioner | 396 | ||
| Chapter Contents | 396 | ||
| Historical Roots of Primary Care in the United States | 396 | ||
| Federal Government and Primary Care | 397 | ||
| Health Resources and Services Administration | 397 | ||
| Health Professional Shortage Areas Designation | 398 | ||
| Centers for Medicare & Medicaid Innovation | 398 | ||
| Primary Care Workforce Composition | 398 | ||
| The Doctor of Nursing Practice | 400 | ||
| Nurse Practitioner Role and Competencies in Primary Care | 400 | ||
| Nurse Practitioners in Primary Care: A Role in Advanced Practice Nursing | 400 | ||
| Advanced Practice Nurse Core Competencies | 403 | ||
| Direct Clinical Practice | 403 | ||
| Reflective Practice: A Component of Direct Patient Care | 404 | ||
| Holistic Perspective | 404 | ||
| Coaching and Guidance | 404 | ||
| Consultation | 404 | ||
| Collaboration | 405 | ||
| Nurse Practitioner Core Competencies | 405 | ||
| Independent Practice Competencies | 405 | ||
| Scientific Foundation Competencies | 406 | ||
| Leadership Competencies | 406 | ||
| Quality Competencies | 406 | ||
| Practice Inquiry Competencies | 407 | ||
| Technology and Information Literacy Competencies | 407 | ||
| Policy Competencies | 407 | ||
| Health Delivery System Competencies | 408 | ||
| Ethics Competencies | 408 | ||
| Summary | 416 | ||
| Models of Primary Care and the Nurse Practitioner Role in Current Primary Care in the United States | 416 | ||
| Nurse Practitioners as a Disruptive Innovation | 417 | ||
| Patient-Centered Medical Home | 418 | ||
| Nurse-Managed Health Centers | 418 | ||
| School-Based Health Centers | 419 | ||
| Convenient Care Clinics | 419 | ||
| Care for Homeless and Vulnerable Populations | 419 | ||
| Veterans Administration | 420 | ||
| Aging Populations and Primary Care | 420 | ||
| Care Transitions and Primary Care | 421 | ||
| Quality of Care: Evidence-Based Care | 421 | ||
| Role of Electronic Health Records in Primary Care | 423 | ||
| Nurse Practitioners: Challenges and Opportunities | 423 | ||
| Regulatory Issues and Removing Barriers | 423 | ||
| Conclusion | 424 | ||
| References | 425 | ||
| 16 The Acute Care Nurse Practitioner | 429 | ||
| Chapter Contents | 429 | ||
| Emergence of the Acute Care Nurse Practitioner Role | 430 | ||
| Shaping the Scope of Practice for the Acute Care Nurse Practitioner | 431 | ||
| National Level (Professional Organizations) | 431 | ||
| State Level (Government) | 433 | ||
| Institutional Level | 433 | ||
| Service-Related Level | 434 | ||
| Individual Level | 435 | ||
| Competencies of the Acute Care Nurse Practitioner Role | 435 | ||
| Acute Care Nurse Practitioner Specialty Competencies | 435 | ||
| Advanced Practice Nurse Central Competencies of Adult Gerontology Acute Care Nurse Practitioners | 436 | ||
| Direct Clinical Practice | 436 | ||
| Diagnosing and Managing Disease | 436 | ||
| Promoting and Protecting Health and Preventing Disease | 438 | ||
| Advanced Practice Nurse Core Competencies of Adult Gerontology Acute Care Nurse Practitioners | 439 | ||
| Guidance and Coaching | 439 | ||
| Consultation and Evidence-Based Care | 439 | ||
| Leadership | 439 | ||
| Collaboration | 440 | ||
| Ethical Practice | 440 | ||
| Profiles of the Adult Gerontology Acute Care Nurse Practitioner Role | 440 | ||
| Comparison with Other Advanced Practice Nurse and Physician Assistant Roles | 443 | ||
| Adult Gerontology Acute Care Nurse Practitioners and Physician Hospitalists | 444 | ||
| Outcome Studies Related to Acute Care Nurse Practitioner Practice | 445 | ||
| Implementation of the Adult Gerontology Acute Care Nurse Practitioner Role in Other Clinical Practice Settings | 445 | ||
| Bone Marrow Transplantation Services | 445 | ||
| Diagnostic and Interventional Services | 447 | ||
| Heart Failure Services | 447 | ||
| Orthopedic Services | 447 | ||
| Rapid Response Team | 447 | ||
| Preparation of Adult Gerontology Acute Care Nurse Practitioners | 447 | ||
| Reimbursement for Acute Care Nurse Practitioners | 448 | ||
| Medicare Reimbursement for Acute Care Nurse Practitioners | 450 | ||
| Office and Nonhospital Clinic Setting | 450 | ||
| Hospital Inpatient, Hospital Outpatient, and Emergency Department Settings | 450 | ||
| Critical Care Reimbursement for Acute Care Nurse Practitioners | 451 | ||
| Challenges Specific to the Adult Gerontology Acute Care Nurse Practitioner Role | 451 | ||
| Conclusion | 452 | ||
| References | 453 | ||
| 17 The Certified Nurse-Midwife* | 456 | ||
| Chapter Contents | 456 | ||
| Historical Perspective | 458 | ||
| The Nurse-Midwifery Profession in the United States Today | 458 | ||
| Education and Accreditation | 458 | ||
| Certification and Certification Maintenance | 459 | ||
| Reentry to Practice | 459 | ||
| Regulation, Reimbursement, and Credentialing | 459 | ||
| American College of Nurse-Midwives | 461 | ||
| Implementing Advanced Practice Nursing Competencies | 462 | ||
| Overview of Advanced Practice Nurse and Certified Nurse-Midwife Competencies | 462 | ||
| Direct Clinical Practice | 463 | ||
| Guidance and Coaching of Patients, Families, and Other Care Providers | 465 | ||
| Consultation | 466 | ||
| Collaboration | 466 | ||
| Evidence-Based Practice | 467 | ||
| Leadership | 468 | ||
| Ethical Decision Making | 468 | ||
| Advocacy | 469 | ||
| Current Practice of Nurse-Midwifery | 469 | ||
| Scope of Practice | 469 | ||
| Practice Settings | 469 | ||
| Certified Nurse-Midwife Practice Summary | 470 | ||
| Exemplars of Nurse-Midwifery Practice | 470 | ||
| Professional Issues | 474 | ||
| Image | 474 | ||
| Work Life | 474 | ||
| Professional Liability | 475 | ||
| Quality and Safety | 475 | ||
| Conclusion | 475 | ||
| References | 476 | ||
| 18 The Certified Registered Nurse Anesthetist | 479 | ||
| Chapter Contents | 479 | ||
| Brief History of Certified Registered Nurse Anesthetist Education and Practice | 479 | ||
| Role Differentiation Between Certified Registered Nurse Anesthetists and Anesthesiologists | 481 | ||
| Profile of the Certified Registered Nurse Anesthetist | 481 | ||
| Scope and Standards of Practice | 482 | ||
| Education, Credentialing, and Certification | 483 | ||
| Programs of Study | 484 | ||
| Nurse Anesthesia Educational Funding | 485 | ||
| Practice Doctorate | 485 | ||
| Certification | 486 | ||
| Institutional Credentialing | 486 | ||
| Certified Registered Nurse Anesthetist Practice | 486 | ||
| Workforce Issues | 486 | ||
| Practice Settings | 488 | ||
| Access to Health Care | 488 | ||
| American Association of Nurse Anesthetists | 489 | ||
| Organization and Structure | 489 | ||
| Mission and Vision | 489 | ||
| Relationships within Nursing | 490 | ||
| International Practice Opportunities | 490 | ||
| Role Development and Measures of Clinical Competence | 491 | ||
| Direct Clinical Practice | 491 | ||
| Palliative Care | 493 | ||
| Collaboration | 493 | ||
| Guidance and Coaching | 494 | ||
| Consultation | 494 | ||
| Evidence-Based Practice | 494 | ||
| Accountability and Ethics | 495 | ||
| Leadership | 495 | ||
| Exemplars | 496 | ||
| Reimbursement | 496 | ||
| Future of Reimbursement | 500 | ||
| Continued Challenges | 500 | ||
| Conclusion | 501 | ||
| References | 501 | ||
| IV Critical Elements In Managing Advanced Practice Nursing Environments | 505 | ||
| 19 Business Planning and Reimbursement Mechanisms | 505 | ||
| Chapter Contents | 505 | ||
| Principles of Practice Management | 506 | ||
| Designing and Delivering Care to Patients | 506 | ||
| Entrepreneurs and Intrapreneurs | 507 | ||
| Inventory of Skills | 507 | ||
| Direct Processes of Care | 509 | ||
| Direct Patient Care | 509 | ||
| Mission, Vision, and Values | 509 | ||
| Informed Consent | 510 | ||
| Compliance with the Health Insurance Portability Accountability Act | 510 | ||
| Quality, Safety and Security | 510 | ||
| Risk Management | 511 | ||
| Resolution of Complaints | 511 | ||
| Clinical Relationships with Other Staff and Providers | 511 | ||
| Indirect Processes of Care | 512 | ||
| Business Relationships | 512 | ||
| Hiring Business Experts | 512 | ||
| Creating an Advisory Board | 513 | ||
| Community Outreach | 513 | ||
| Day to Day Administrative Support | 513 | ||
| Program and Business Structure | 513 | ||
| Titling the Practice | 514 | ||
| External Regulatory Bodies | 515 | ||
| Evaluation Processes That Ensure Quality and Safety | 515 | ||
| Diagnostic Services | 516 | ||
| Process Resources | 517 | ||
| Facility, Equipment, and Supplies | 517 | ||
| Managing Prescriptive Authority and Sample Medications | 519 | ||
| Business Plan Summary | 520 | ||
| Health Care Payment Mechanisms | 520 | ||
| Documentation of Services | 521 | ||
| Medical and Nursing Classification Systems | 523 | ||
| International Classification of Diseases | 523 | ||
| ICD-9-CM Codes | 523 | ||
| ICD-10 and ICD-10-PCS | 525 | ||
| Current Procedural Terminology Codes | 525 | ||
| E/M Services Guidelines | 525 | ||
| Nursing Classification Systems | 526 | ||
| Health Care Payment Mechanisms Summary | 527 | ||
| Reimbursement for Advanced Practice Nurses | 527 | ||
| Fostering Patient Responsibility | 529 | ||
| Financial Responsibility Statement | 529 | ||
| Installment Plans | 529 | ||
| Sliding Fee Scales | 529 | ||
| Failure to Pay | 529 | ||
| Reimbursement Mechanisms | 530 | ||
| Medicare | 530 | ||
| Medicaid | 531 | ||
| Federal Employee Health Benefit Program | 531 | ||
| Private Health Insurance—Fee-for-Service Plans | 531 | ||
| Managed Care Contracts | 532 | ||
| Cash and Credit Card | 532 | ||
| Reimbursement Summary | 532 | ||
| Value-Based Purchasing | 532 | ||
| Evaluation of Patient Care Services | 533 | ||
| Evolving Business Opportunities for Advanced Practice Nurses | 533 | ||
| Managed Care Organizations | 533 | ||
| Accountable Care Organizations | 533 | ||
| The Medical Home | 534 | ||
| Nurse-Managed Health Centers | 534 | ||
| Other Opportunities | 534 | ||
| Traveler Health Services | 534 | ||
| Pain Management Clinics | 534 | ||
| Retail Clinics | 534 | ||
| Hospitalist Services | 534 | ||
| Conclusion | 535 | ||
| References | 535 | ||
| 20 Marketing and Negotiation | 538 | ||
| Chapter Contents | 538 | ||
| Health Care Marketing: Yesterday and Today | 538 | ||
| Two Types of Advanced Practice Nurse Marketing | 539 | ||
| Definition of Marketing | 539 | ||
| Marketing Frameworks and Concepts | 539 | ||
| The Four Ps of Marketing | 539 | ||
| Product | 540 | ||
| Price | 540 | ||
| Place | 540 | ||
| Promotion | 540 | ||
| Marketing Influence | 540 | ||
| Preparing for an Advanced Practice Nurse Position | 541 | ||
| Resumé Versus the Curriculum Vitae | 541 | ||
| Query Letter | 542 | ||
| Interview Process | 542 | ||
| Health Care as a Business | 543 | ||
| Preparing to Market Advanced Practice Nurse Services | 543 | ||
| What is your Product? | 543 | ||
| Who is the Ideal Client/Patient? | 544 | ||
| Features Versus Benefits of Marketing | 545 | ||
| Message | 545 | ||
| Marketing Avenues, Media, and Technology | 546 | ||
| Offline Marketing | 546 | ||
| Written Word | 547 | ||
| Air Waves | 547 | ||
| Networking | 547 | ||
| Word of Mouth | 547 | ||
| Community Involvement | 548 | ||
| Online Marketing | 548 | ||
| Websites | 548 | ||
| Audio and Video | 548 | ||
| Advertising | 548 | ||
| Teleclasses and Webinars | 548 | ||
| Local Online Searches | 548 | ||
| Mixed Marketing | 549 | ||
| Emerging Channels: Mobile Devices | 549 | ||
| Social Media Marketing | 549 | ||
| Understanding Legal and Ethical Considerations | 549 | ||
| Ethical Concerns | 549 | ||
| Marketing Plan | 550 | ||
| Return on Investment | 551 | ||
| Negotiating and Contracting | 551 | ||
| Importance of Contracts | 551 | ||
| Independent Contractor Contract | 552 | ||
| Employment Contract | 552 | ||
| Role and Position | 553 | ||
| Collaborative Practice Agreement | 554 | ||
| Contract Negotiation | 554 | ||
| Conclusion | 555 | ||
| References | 555 | ||
| 21 Understanding Regulatory, Legal, and Credentialing Requirements | 557 | ||
| Chapter Contents | 557 | ||
| Current Issues | 557 | ||
| Titling of Advanced Practice Registered Nurses | 558 | ||
| Consensus Model for Advanced Practice Registered Nurse Regulation: Licensure, Accreditation, Certification, and Education | 558 | ||
| Implementation of Consensus Model Regulation | 559 | ||
| Definitions Associated with the Regulation of APRNs | 559 | ||
| State Licensure and Recognition | 559 | ||
| Prescriptive Authority | 560 | ||
| Drug Enforcement Administration Number | 561 | ||
| Scope of Practice for Advanced Practice Nurses | 561 | ||
| Benchmarks of Advanced Practice Nursing and Education | 562 | ||
| Advanced Practice Nurse Competencies | 562 | ||
| Professional Advanced Practice Registered Nurse Competencies | 562 | ||
| Master’s and Doctor of Nursing Practice Essentials | 562 | ||
| Standards of Practice and Care for Advanced Practice Nurses | 562 | ||
| Components of Advanced Practice Nurse Credentialing and Regulation | 563 | ||
| Elements of Regulation | 563 | ||
| Credentialing | 563 | ||
| Advanced Practice Nurse Master’s and Doctoral Education | 564 | ||
| Advanced Practice Nurse Program Accreditation | 564 | ||
| Postgraduate Education | 565 | ||
| Dual Role Education | 565 | ||
| Advanced Practice Registered Nurse Certification | 565 | ||
| Continued Competency Measured Through Recertification | 566 | ||
| Mandatory Continuing Education Requirements | 566 | ||
| Mandatory Practice Requirements | 566 | ||
| Institutional Credentialing | 566 | ||
| Issues Affecting APRN Credentialing and Regulation | 567 | ||
| Collaborative Practice Arrangements | 568 | ||
| Identifier Numbers | 568 | ||
| National Provider Identifier Number | 568 | ||
| Medicare and Medicaid Provider Numbers | 569 | ||
| Reimbursement | 569 | ||
| Risk Management, Malpractice, and Negligence | 571 | ||
| Malpractice Insurance | 571 | ||
| Privacy Issues | 572 | ||
| Health Insurance Portability and Accountability Act | 572 | ||
| Telehealth and Telepractice | 572 | ||
| Safety and Cost Containment Initiatives | 573 | ||
| Influencing the Regulatory Process | 574 | ||
| Novice and Advanced Practice Nurses | 574 | ||
| Experienced and Expert Advanced Practice Nurses | 574 | ||
| Current Practice Climate for Advanced Practice Nurses | 574 | ||
| Need for True Collaboration | 575 | ||
| Moving Out of the Shadows and Into the Light | 575 | ||
| Visioning for Advanced Practice | 575 | ||
| Future Regulatory Challenges Facing Advanced Practice Nurses | 575 | ||
| Conclusion | 576 | ||
| References | 576 | ||
| 22 Health Policy Issues in Changing Environments | 579 | ||
| Chapter Contents | 579 | ||
| Policy Process | 580 | ||
| Policy: Historic Core Function in Nursing | 580 | ||
| Overview of the Health Policy Process: Politics Versus Policy | 580 | ||
| Health Policy | 580 | ||
| Politics | 580 | ||
| United States Differs from the International Community | 581 | ||
| Policy Frameworks and Key Concepts | 583 | ||
| Longest Model | 583 | ||
| Federalism | 583 | ||
| Incrementalism | 584 | ||
| The Kingdon Model | 584 | ||
| Federal Budget Cycle | 584 | ||
| Entitlement Versus Discretionary Spending | 584 | ||
| Budget Cycle | 586 | ||
| Policy Formulation: How a Bill Becomes Law | 586 | ||
| Congressional Committees | 587 | ||
| House or Senate Floor Action | 588 | ||
| Presidential Action | 588 | ||
| Interpretative Function of Rulemaking: Policy Implementation | 588 | ||
| Congressional Advisory Bodies | 588 | ||
| Policy Modification | 588 | ||
| Role of Public Comment | 589 | ||
| Current and Emerging Health Policy Issues Relevant to Advanced Practice Nurses | 589 | ||
| Context for Framing APN Policy Issues: Cost, Quality, and Access | 589 | ||
| Cost | 589 | ||
| Quality | 590 | ||
| Access | 590 | ||
| Policy Initiatives in Health Reform | 591 | ||
| Cost and Quality | 591 | ||
| Access | 592 | ||
| Emerging Advanced Practice Nurse Policy Issues | 593 | ||
| Payment Issues | 593 | ||
| Retail Clinics | 594 | ||
| Data | 594 | ||
| Workforce Policy | 595 | ||
| Political Competence in the Policy Arena | 595 | ||
| Health Policymaking: A Requisite Skill For Individual Advanced Practice Nurses | 595 | ||
| Political Competence | 595 | ||
| Individual Skills | 596 | ||
| Barriers to Political Competence | 598 | ||
| Using Force Versus Power | 598 | ||
| Behavior at Meetings | 599 | ||
| Organizational Skills | 600 | ||
| Moving Advanced Practice Nurses Forward in Health Policy | 600 | ||
| Communicating Findings | 600 | ||
| Advanced Practice Nurse Policy Research Agenda | 602 | ||
| Conclusion | 602 | ||
| References | 605 | ||
| 23 Integrative Review of Outcomes and Performance Improvement Research on Advanced Practice Nursing | 607 | ||
| Chapter Contents | 607 | ||
| Review of Terms | 608 | ||
| Conceptual Models of Care Delivery Impact | 612 | ||
| Models for Evaluating Outcomes Achieved by Advanced Practice Nurses | 612 | ||
| Outcomes Evaluation Model | 612 | ||
| Nurse Practitioner Role Effectiveness Model | 614 | ||
| Evidence to Date | 614 | ||
| Role Description Studies | 616 | ||
| Role Perception and Acceptance Studies | 616 | ||
| Care Delivery Process Studies | 617 | ||
| Brooten’s Advanced Practice Nurse Transitional Care Model | 618 | ||
| Process as Outcome Studies | 619 | ||
| Performance (Process) Improvement Activities | 619 | ||
| Disease Management Activities | 620 | ||
| Outcomes Management Activities | 620 | ||
| Outcomes Research | 623 | ||
| Studies Comparing Advanced Practice Nurse and Physician and Other Provider Outcomes | 623 | ||
| Nurse Practitioner Outcomes | 623 | ||
| Acute Care Nurse Practitioner Outcomes | 630 | ||
| Clinical Nurse Specialist Outcomes | 630 | ||
| Certified Nurse-Midwife Outcomes | 631 | ||
| Certified Registered Nurse Anesthetist Outcomes | 631 | ||
| Neonatal Nurse Practitioner Outcomes | 632 | ||
| Studies Comparing Advanced Practice Nurse and Physician Productivity | 632 | ||
| Relative Work Value of Advanced Practice Nurses | 632 | ||
| Studies Comparing Advanced Practice Nurse and Usual Practice Outcomes | 633 | ||
| Studies Using Noncomparison Groups | 633 | ||
| Summary of Advanced Practice Nursing Outcomes Research | 634 | ||
| Conclusion | 636 | ||
| Acknowledgment | 636 | ||
| References | 636 | ||
| 24 Using Health Care Information Technology to Evaluate and Improve Performance and Patient Outcomes | 645 | ||
| Chapter Contents | 645 | ||
| Regulatory Reporting Initiatives that Drive Performance Improvement | 646 | ||
| Relevance of Regulatory Reporting to Advanced Practice Nursing Outcomes | 651 | ||
| Foundational Competencies in Managing Health Information Technology | 652 | ||
| TIGER Competencies for Use of Health Care Information Technology | 652 | ||
| Coding Taxonomies and Classification Systems | 654 | ||
| Descriptive, Predictive, and Prescriptive Data Analytics | 656 | ||
| Descriptive Analytics | 659 | ||
| Predictive Analytics | 662 | ||
| Prescriptive Analytics | 662 | ||
| Next-Generation Quality Metrics: eMeasures | 663 | ||
| The Quality Data Model Framework | 664 | ||
| Meaningful Use of Health Information Technology and Impact on Advanced Practice Nursing | 664 | ||
| Health Information Exchanges | 665 | ||
| Foundational Competencies in Quality Improvement | 668 | ||
| Continuous Quality Improvement Frameworks | 669 | ||
| Organizational Structures and Cultures That Optimize Performance Improvement | 671 | ||
| Strategies for Designing Quality Improvement and Outcome Evaluation Plans for Advanced Practice Nursing | 671 | ||
| Phases of Preparing a Plan for Outcome Evaluation | 671 | ||
| Define the Core Questions | 673 | ||
| Define the Target Population for Study | 674 | ||
| Identify the Stakeholders | 675 | ||
| Articulate Program Goals and Interventions | 675 | ||
| Define the Data Elements | 677 | ||
| Identify Selection Criteria for the Population of Interest | 677 | ||
| Establish Performance and Outcome Indicators | 678 | ||
| Identify and Evaluate Data Elements, Collection Instruments, and Procedures | 678 | ||
| Derive Meaning from Data and Act on Results | 679 | ||
| Analyze Data and Interpret Findings | 679 | ||
| Present and Disseminate Findings | 680 | ||
| Identify Improvement Opportunities | 680 | ||
| Formulate a Plan for Ongoing Monitoring and Reevaluation | 681 | ||
| Clarify Purpose of the Advanced Practice Nurse’s Role | 681 | ||
| Conclusion | 683 | ||
| References | 684 | ||
| Index | 685 | ||
| A | 685 | ||
| B | 688 | ||
| C | 689 | ||
| D | 697 | ||
| E | 699 | ||
| F | 701 | ||
| G | 702 | ||
| H | 703 | ||
| I | 705 | ||
| J | 707 | ||
| K | 708 | ||
| L | 708 | ||
| M | 709 | ||
| N | 711 | ||
| O | 713 | ||
| P | 715 | ||
| Q | 719 | ||
| R | 719 | ||
| S | 722 | ||
| T | 724 | ||
| U | 725 | ||
| V | 725 | ||
| W | 726 | ||
| Y | 726 |