When APNs begin to transfer new skills or interventions into their repertoire, they become nursing skills, informed by the clinical practice values of the profession.Actual practices differ significantly based on the particular role adopted, specialty practiced, and organizational framework within which the role is performed. In spite of the need to keep job descriptions and job titles distinct in practice settings, it is critical that the public's acceptance of advanced practice nursing be enhanced and confusion decreased. As Safriet (1993, 1998)noted, nursing's future depends on reaching consensus on titles and consistent preparation for title holders. The nursing profession must be clear, concrete, and consistent about APN titles and theirfunctions in discussions with nursing's larger constituencies: consumers, other health care professionals, health care administrators, and health care policymakers.Conceptual DefinitionAdvanced practice nursing is the patient-focused application of an expanded range of competencies to improve health outcomes for patients and populations in a specialized clinical area of the larger discipline of nursing.1The term competenciesrefers to a broad area of skillful performance; seven core competencies combine to distinguish nursing practice at this level. Competencies include activities undertaken as part of delivering advanced nursing care directly to patients. Some competencies are processesthat APNs use in all dimensions of their practice, such as collaboration and leadership. At this stage of the development of the nursing discipline, competencies may be based in theory, practice, or research. Although the discipline is expanding its research-based evidence to guide practice, an expanded ability to use theory also is a key distinguishing feature of advanced
practice nursing. In addition, a strong experiential component is necessary to develop the competencies and clinical practice expertise that characterize APN practice. Graduate education and in-depth clinical practice experience work together to develop the APN. The definition also emphasizes the patient-focused and specialized nature of advanced practice nursing. APNs expand their capability to provide and direct care, with the ultimate goal of improving patient and specialty population outcomes; this focus on outcome attainment is a central feature of advanced practice nursing and the main justification for differentiating this level of practice. Finally, the critical importance of ensuring that any type of advanced practice is grounded within the larger discipline of nursing is made explicit.Certain activities of APN practice overlap with those performed by physicians and other health care professionals. However, the experiential, theoretical, and philosophical perspectives of nursing make these activities advanced nursing practice when they are carried out by an APN.
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- Winter '17
- Nursing, advanced practice nursing