Stanley, 2011.pdf - 2207_FM-i-xxxiii:2207_FM-i-xxxiii.qxd 4:02 PM Page iii Edition 3 Advanced Practice NURSING EMPHASIZING COMMON ROLES Joan M Stanley

Stanley, 2011.pdf - 2207_FM-i-xxxiii:2207_FM-i-xxxiii.qxd...

This preview shows page 1 out of 456 pages.

You've reached the end of your free preview.

Want to read all 456 pages?

Unformatted text preview: 2207_FM-i-xxxiii:2207_FM-i-xxxiii.qxd 05/10/10 4:02 PM Page iii Edition 3 Advanced Practice NURSING EMPHASIZING COMMON ROLES Joan M. Stanley, PhD, RN, CRNP, FAAN Senior Director of Education Policy American Association of Colleges of Nursing Washington, DC 2207_FM-i-xxxiii:2207_FM-i-xxxiii.qxd 05/10/10 4:02 PM Page iv F. A. Davis Company 1915 Arch Street Philadelphia, PA 19103 Copyright © 2011 by F. A. Davis Company All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1 Publisher, Nursing: Joanne Patzek DaCunha, RN, MSN Developmental Editor: Barbara Tchabovsky Director of Content Development: Darlene D. Pedersen Project Editor: Tyler R. Baber Manager of Art and Design: Carolyn O’Brien As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes. The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The author(s), editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised always to check product information (package inserts) for changes and new information regarding dose and contraindications before administering any drug. Caution is especially urged when using new or infrequently ordered drugs. Library of Congress Cataloging-in-Publication Data Advanced practice nursing : emphasizing common roles / [edited by] Joan M. Stanley. — Ed. 3. p. ; cm. Includes bibliographical references and index. ISBN 978-0-8036-2207-4 (pbk. : alk. paper) 1. Nurse practitioners—United States. 2. Midwives—United States. 3. Nurse anesthetists—United States I. Stanley, Joan M. (Joan Marlene), 1949[DNLM: 1. Advanced Practice Nursing. WY 128 A2445 2011] RT82.8.A37 2011 610.7306’92—dc22 2010013948 Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F. A. Davis Company for users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the fee of $.25 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of payment has been arranged. The fee code for users of the Transactional Reporting Service is: 8036-2207/11 0 + $.25. 2207_FM-i-xxxiii:2207_FM-i-xxxiii.qxd 05/10/10 4:02 PM Page vii F O R E W O R D The current healthcare reform debate in Congress and across the nation raises the possibility of major changes in the emphasis and structure of our healthcare system. Regardless of the immediate outcome, concerns about cost, quality, access, effectiveness of interventions, prioritizing prevention, and workforce inadequacy are likely to persist and provoke transformations far beyond the legislative horizon. Once Pandora’s Box is open, it is impossible to shut again. In this context, the contribution of nursing to the quality of care and patient outcomes—and especially the contribution of advanced practice registered nurses (APRNs)—is attaining growing recognition. APRNs are seen increasingly as a promising, long-overlooked source of solutions to the shortage of primary care physicians and the inadequate management of chronic diseases. The potential for nurse practitioners and other APRNs to influence the form and substance of healthcare delivery has never been so manifest. New models of care and new practice structures are being proposed that harness the knowledge and skills of APRNs. This book, now in its third edition, provides an in-depth understanding of the past, present, and future of advanced practice nursing and why APRNs are poised to lead the reconceptualization of health care and assume greater prominence in its delivery. The authors ably describe current issues and trends faced by APRNs, their historical antecedents, and the major policy implications of practice, education, and regulatory developments. Although each of the four APRN roles—certified nurse-midwife, certified registered nurse anesthetist, clinical nurse specialist, certified nurse practitioner—has evolved along a different path, collectively they have changed nursing education and the way care is delivered. APRNs continue to lead changes in practice and in the healthcare system. The chapters in this book cover a wide range of topics, from microsystems thinking, practice inquiry, intra- and interprofessional education, and ethics to credentialing, reimbursement, and marketing. The implications of pay for performance and retail clinics are detailed, as are issues related to scope of practice. The description of recent education/practice developments, such as the Doctor of Nursing Practice degree and the Consensus Model for APRN Regulation, documents the evolution of APRNs and provides a vision for the future of advanced practice nursing. Each chapter presents perspectives on issues relevant to current APRN practice, education, certification, and licensure. A valuable part of each chapter is the suggested exercises. Thinking through the questions will give APRNs and others a chance to explore issues from a perspective they may not have considered. In addition, new to this third edition is a complementary instructor online resource that provides suggestions for teaching the content, a selection of PowerPoint slides for classroom use, and additional learning exercises for faculty to help them integrate this content into the APRN curriculum and learning experiences. Also, provided online for students are additional learning exercises and useful Web links. This book will be a valuable resource for students, faculty, practicing APRNs, health systems that employ APRNs, policy makers, and certifying organizations. Janet D. Allan, PhD, RN, NP, FAAN Dean and Professor The University of Maryland School of Nursing vii 2207_FM-i-xxxiii:2207_FM-i-xxxiii.qxd 05/10/10 4:02 PM Page ix A C K N O W L E D G M E N T S As an APRN for the past 37 years, I have made many lasting and cherished friends among the APRN community. Heartfelt thanks go out to all on whom I called and who allowed me to cajole them into contributing to this project. Their collegiality continues to be demonstrated over and over. Special thanks go to my editor, Joanne DaCunha, and her staff for their patience and support through the many stages of writing and production. Finally, loving thanks go to my husband, Jack, and my two sons, Jon and Jeff, for their understanding, love, and support. And to my sister, June, an FNP, who has always been there for me when I needed a listening ear or a laugh: Thank you! ix 2207_FM-i-xxxiii:2207_FM-i-xxxiii.qxd 05/10/10 4:02 PM Page xi C O N T R I B U T O R S Janet D. Allan, PhD, RN, NP, FAAN Dean and Professor The University of Maryland School of Nursing Baltimore, Maryland Mary Anne Dumas, PhD, RN, FNP-BC, FAANP Professor, School of Nursing Stony Brook University Stony Brook, New York Geraldine “Polly” Bednash, PhD, RN, FAAN Chief Executive Officer American Association of Colleges of Nursing Washington, DC Marilyn Winterton Edmunds, PhD, ANP-BC/GNP-BC Editor of the Journal for Nurse Practitioners Linda A. Bernhard, PhD, RN Associate Professor of Nursing and Women’s Studies Ohio State University Columbus, Ohio Margaret T. Bowers, MSN, RN, FNP-BC Assistant Clinical Professor Duke University School of Nursing Nurse Practitioner in the Duke Heart Failure Disease Management Program Durham, North Carolina Christine E. Burke, PhD, CNM Clinical Practice The Denver Health Authority Denver, Colorado Linda Callahan, PhD, CRNA Professor, Department of Nursing California State University Long Beach, California Katherine Crabtree, DNSC, APRN-BC, FAAN Professor of Nursing Oregon Health and Science University Portland, Oregon Linda Lindsey Davis, PhD, RN, ANP, DP-NAP, FAAN Professor, Duke University School of Nursing Senior Fellow, Duke Center for Aging and Human Development Durham, North Carolina Margaret Faut-Callahan, PhD, CRNA, FAAN Dean, Marquette University School of Nursing Milwaukee, Wisconsin Francis R. Gerbasi, PhD, CRNA Executive Director Council on Accreditation of Nurse Anesthesia Educational Programs Chicago, Illinois Elaine Germano, DrPH, CNM, FACNM Education Projects Manager American College of Nurse-Midwives Silver Spring, Maryland Catherine L. Gilliss, DNSC, RN, FAAN Dean and Professor Duke University School of Nursing Vice Chancellor of Nursing Affairs at Duke Medicine Durham, North Carolina Kelly A. Goudreau, DSN, RN, ACNS-BC Designated Learning/Education Officer Portland VA Medical Center Portland, Oregon Gene Harkless, DNSC, FNP-C, CNL Associate Professor and Graduate Program Coordinator University of New Hampshire Durham, New Hampshire Visiting Professor Sor Trondelag University College of Nursing Trondheim, Norway xi 2207_FM-i-xxxiii:2207_FM-i-xxxiii.qxd 05/10/10 4:02 PM Page xii xii Contributors Anita Hunter, PhD, CPNP, FAAN Professor University of San Diego San Diego, California Jean Johnson, PhD, RN, FAAN Senior Associate Dean for Health Sciences Professor, Department of Nursing George Washington University Washington, DC M. Christina Johnson, MS, CNM Director of Professional Practice and Health Policy American College of Nurse-Midwives Silver Spring, Maryland Mary Knudtson, DNSC, NP, FAAN Executive Director of Student Health Services University of California in Santa Cruz Professor of Nursing University of California, Irvine Irvine, California Michael J. Kremer, PhD, CRNA, FAAN Associate Professor and Director of the Nurse Anesthesia Program Rush University College of Nursing Chicago, Illinois Leo A. Le Bel, M.Ed, JD, APRN, CRNA Certified Registered Nurse Anesthetist, Practicing in Connecticut Co-owner of a Connecticut healthcare consulting company Huntington, Connecticut Mary Jeanette Mannino, JD, CRNA Director, Anesthesia and Ambulatory Surgery The Mannino Group Washington, DC Margaret McAllister, PhD, RN, CNS, FNP Clinical Associate Professor and Coordinator of the Family Nurse Practitioner Program University of Massachusetts Boston College of Nursing and Health Sciences Boston, Massachusetts Eileen T. O’Grady, PhD, RN, NP Visiting Professor Pace University Leinhard School of Nursing New York City, New York Julie A. Stanik-Hutt, PhD, ACNP-BC, CCNS, FAAN Associate Professor and Director of the Master’s Program Johns Hopkins University, School of Nursing Baltimore, Maryland Joan M. Stanley, PhD, RN, CRNP, FAAN Senior Director of Education Policy American Association of Colleges of Nursing Washington, DC Deirdre K. Thornlow, PhD, RN, CPHQ Assistant Professor Duke University School of Nursing Durham, North Carolina Jan Towers, PhD, NP-C, CRNP, FAANP, FAAN Director of Health Policy American Academy of Nurse Practitioners Washington, DC Michelle Walsh, PhD, RN, CPNP Pediatric Nurse Practitioner Nationwide Children’s Hospital Columbus, Ohio 2207_FM-i-xxxiii:2207_FM-i-xxxiii.qxd 05/10/10 4:02 PM Page xiii R E V I E W E R S Tammy L. Austin-Ketch, PhD(c), APRN, BC, FNP Clinical Assistant Professor University at Buffalo State University of New York Buffalo, New York Susan A. Bruce, PhD(c), ANP Clinical Associate Professor University at Buffalo Buffalo, New York Linda L. Lindeke, PhD, RN, CNP Associate Professor, Director of Graduate Studies University of Minnesota Minneapolis, Minnesota Mary L. Shea, PhD(c) Assistant Professor Colby-Sawyer College New London, New Hampshire Sharon J. Thompson, PhD, RN, MPH Assistant Professor and Graduate Nursing Program Director Gannon University Villa Maria School of Nursing Erie, Pennsylvania L. Diane Weed, PhD, FNP Associate Professor Troy University School of Nursing Troy, Alabama Joanne Farley Serembus, EdD, RN, CCRN, CNE Director, MSN and RN-BSN Programs Drexel University College of Nursing and Health Professions Philadelphia, Pennsylvania xiii 2207_FM-i-xxxiii:2207_FM-i-xxxiii.qxd 05/10/10 4:02 PM Page xv C O N S U L T A N T S Lynne M. Dunphy, PhD, FNP, CS Associate Professor Florida Atlantic University Boca Raton, Florida Laurie Kennedy-Malone, PhD, RN, APRN-BC, GNP Associate Professor Director of the Adult/Gerontological Nurse Practitioner Program School of Nursing University of North Carolina at Greensboro Greensboro, North Carolina xv 2207_FM-i-xxxiii:2207_FM-i-xxxiii.qxd 05/10/10 4:02 PM Page xvii C O N T E N T S Foreward Introduction CHAPTER 1 The Evolution of Advanced Practice in Nursing vii xxi 3 Jan Towers, PhD, NP-C, CRNP, FAANP, FAAN Certified Nurse-Midwives 4 Certified Registered Nurse Anesthetists 10 Clinical Nurse Specialists 16 Nurse Practitioners 19 Interface Among Certified Nurse-Midwives, Certified Registered Nurse 23 Anesthetists, Clinical Nurse Specialists, and Nurse Practitioners CHAPTER 2 Advanced Practice Nursing in the Current Sociopolitical Environment 33 Julie A. Stanik–Hutt, PhD, ACNP-BC, CCNS, FAAN CHAPTER 3 People and Their Health 34 Healthcare Delivery System 39 The APRN and the Healthcare Delivery System 41 Continuing Issues for Advanced Nursing Practice 46 Emerging Issues for Advanced Nursing Practice 51 The American Healthcare System: Implications for Advanced Practice Registered Nursing 63 Mary Knudtson, DNSC, NP, FAAN CHAPTER 4 The American Healthcare Revolution 64 Financing Health Care 65 Possible Solutions to Evolving Healthcare Concerns 81 Implications for Advanced Practice Registered Nursing 83 Selected Theories and Models for Advanced Practice Nursing 89 Michelle Walsh, PhD, RN, CPNP Linda A. Bernhard, PhD, RN Theories of Leadership 90 Theories and Strategies of Change 96 Models of Health Promotion 100 Models of Advanced Practice Nursing 106 Comparison of Advanced Practice Models 109 xvii 2207_FM-i-xxxiii:2207_FM-i-xxxiii.qxd 05/10/10 4:02 PM Page xviii xviii Contents CHAPTER 5 Acute and Primary Care Advanced Practice Nursing: Past, Present, and Future 115 Margaret T. Bowers, MSN, RN, FNP-BC Catherine L. Gilliss, DNSC, RN, FAAN Linda Lindsey Davis, PhD, RN, ANP, DP-NAP, FAAN CHAPTER 6 Health Care in the 20th Century 116 Health Care in the 21st Century 117 The Nature of Primary Care 117 Primary Care Providers in the 21st Century 123 Evolution of APRN Roles 126 Research on Advanced Nursing Practice 130 Policy Issues Influencing Advanced Practice in Emerging Care Systems 132 Formulation and Approval of Credentialing and Clinical Privileges 147 Geraldine “Polly” Bednash, PhD, RN, FAAN Leo A. Le Bel, MEd, JD, APRN, CRNA CHAPTER 7 Regulation: Professional and Public 148 Professional Certification for Advanced Practice Registered Nursing 157 Clinical Practice and Institutional Privileges 162 Reimbursement for Expanded Professional Nursing Practice Services 181 Michael J. Kremer, PhD, CRNA, FAAN Margaret Faut-Callahan, PhD, CRNA, FAAN CHAPTER 8 The Economic System 183 Criteria for an Economic System Related to Health Care 183 Types of Economic Systems 184 Market Competition 186 Disequilibrium 189 Supplier-Induced Demand 189 The Effects of Changes in Price, Supply, and Demand for Health Care 191 Cost Considerations in Provision of Care and Reimbursement for Physicians and APRNs 193 Key Terms in Finance and Reimbursement 200 Reimbursement for Specific APRN Roles 204 Marketing the Role: Formulating, Articulating, and Negotiating Advanced Practice Nursing Positions 221 Christine E. Burke, PhD, CNM The Traditional Marketing Approach: The 4 Ps 222 Knowledge of Personal Values, Professional Skills, and Practical Necessities 224 Knowledge of Practice Regulations 226 2207_FM-i-xxxiii:2207_FM-i-xxxiii.qxd 05/10/10 4:02 PM Page xix Contents xix Knowledge of Existing Services CHAPTER 9 226 Knowledge of Clients’ Healthcare Needs and Desires 227 Knowledge of the Target Population’s Understanding of the Role and Scope of Practice of the APRN 227 Knowledge of the Utilization and Cost-Effectiveness of and Satisfaction With APRN Services 227 Knowledge of Specific Marketing Elements 228 Communication Skills 231 Evaluation of Job Opportunities 238 Close of the Deal 239 Mentors and Career Advancement 242 Advanced Practice Nursing: Inquiry and Evaluation 247 Deirdre K. Thornlow, PhD, RN, CPHQ Practice-Based Evidence CHAPTER 10 248 Evidence-Based Practice 256 Practice Inquiry 260 APRN Inquiry and Evaluation Competencies 268 Publishing in Nursing Journals 279 Marilyn Winterton Edmunds, PhD, ANP-BC/GNP-BC CHAPTER 11 Choose the Journal and Publisher 280 Factors That Make an Article Publishable 282 Writing for Other Forms of Media 289 Contemporary Issues in Publishing 289 Legal and Ethical Aspects of Advanced Nursing Practice 293 Linda Callahan, PhD, CRNA Mary Jeanette Mannino, JD, CRNA CHAPTER 12 Nurse Practice Acts 294 Professional Negligence (Malpractice) 295 Malpractice Insurance 300 The Patient and the APRN 301 Professional Ethics 301 Ethical Decision-Making in the Genomic Era 308 Potential Ethical Concerns of the APRN 319 Global Health and International Opportunities Anita Hunter, PhD, CPNP, FAAN Katherine Crabtree, DNSC, APRN-BC, FAAN What the Problems Are 328 Where, How, and What Interventions Should Be Implemented 331 2207_FM-i-xxxiii:2207_FM-i-xxxiii.qxd 05/10/10 4:02 PM Page xx xx Contents CHAPTER 13 Ethics and Spiritual and Cultural Responsivity in a Global Environment 334 The APRN Role Outside the United States 334 Globalization of Advanced Practice Registered Nursing 336 APRN Impacts on Global Nursing Practice and Education 338 Preparing APRNs With a Global Perspective 344 Advanced Practice Nursing and Health Policy 351 Eileen T. O’Grady, PhD, RN, NP CHAPTER 14 Tensions Among Healthcare Costs, Quality, and Access 353 The American Health Policy Process 355 The APRN Health Policy Agenda 360 APRN Workforce: A Dearth of Data 363 APRN Political Competence 364 Important Health Policy Web Sites 369 The Advanced Practice Registered Nurse as Educator 379 Margaret McAllister, PhD, RN, CNS, FNP The APRN Role in Teaching Patients, Families, and Professional Colleagues 380 CHAPTER 15 Role of the APRN in Continuing Education 381 Patient Education and Learning Theories 385 Patient Literacy and Readability Formulas 389 Patient Counseling 392 The APRN as Preceptor 392 Clinical Microsystem Thinking and Resources for Advanced Practice Nursing 401 Gene Harkless, DNSC, FNP-C, CNL Clinical Microsystem Thinking CHAPTER 16 402 Methods and Measurements in Improving the Work of Clinical Microsystems 403 Clinical Micro-, Meso-, and Macrosystems: Implications for APRN Practice and Education 409 The Future of APRN Practice and the Impact of Current Healthcare Trends 417 Jean Johnson, PhD, RN, FAAN Joan Stanley, PhD, RN, CRNP, FAAN Emphasis on Cost Containment 418 Increased Need for Primary Care Services 420 Growing Numbers of Uninsured and Underinsured 420 Implementation of the APRN Regulatory Model 421 Index 425 2207_FM-i-xxxiii:2207_FM-i-xxxiii.qxd 05/10/10 4:02 PM Page xxi I N T R O D U C T I O N Joan M. Stanley, PhD, RN, CRNP, FAAN One commonality that undergirds all four advanced practice registered nursing (APRN) roles—certified registered nurse anesthetist (CRNA), clinical nurse specialist (CNS), certified nurse-midwife (CNM), and nurse practitioner (NP)—is the discipline of nursing. At the same time, it is the unique combination of advanced nursing knowledge, science, and practice that differentiates each of the APRN roles from one another and from other health profe...
View Full Document

  • Spring '16
  • Barbara Harris
  • Nursing, advanced practice nursing, PhD, APRNs, FAAN

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture