Section Summary Implications for Advanced Practice Nursing Conceptualizations

Section summary implications for advanced practice

This preview shows page 44 - 49 out of 67 pages.

direct service to patients, whereas others are aimed at communication and system issues. Section Summary: Implications for Advanced Practice Nursing Conceptualizations When one considers conceptualizations of advanced practice nursing described by professional organizations and individual authors, similarities and differences emerge. Many conceptual models address competencies that APNs must possess. All are in agreement that the direct care of patients is central to APN practice. Most models affirm two or more competencies identified by
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Hamric and some models emphasize some competencies more than others. Some models (e.g., the Calkin and Strong models) address the issue of skill mix as it relates to APNs, an issue of concern to administrators who hire APNs. A notable difference across models is the extent to which the concept of environment as it relates to APN practice is addressed. In the next section, selected models, which APNs may find useful as they develop and evaluate their own practices, are described . Models of APN role development are explored in Chapter 4 . FIG 2-10 Ball and Cox's theory of legitimate influence. (From Ball, C., & Cox, C. L. [2003]. Restoring patients to health: Outcomes and indicators of advanced nursing practice in adult critical care, Part 1. International Journal of Nursing Practice, 9, 356—367.) TABLE 2-2 Model Constructs and Underlying Theoretical Concepts Included in Shuler's Model of Nurse Practitioner Practice
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Model Constructs Holistic Patient Needs Nurse Practitioner —Patient Interaction Self-Care Health Prevention Health Promotion W Underlying theoretical concepts Basic needs Wellness activities Health and illness Psychological health Family Culture Social support Environmental health Spirituality Contracting Role modeling Self-care activities Teaching/learning Contracting Culture Family Social support Environmental health Wellness activities Preventive health activities Health promotion activities Compliance Problem solving Teaching/learning Contracting Culture Family Social support Environmental health Primary prevention Secondary prevention Tertiary prevention Preventive health behavior Family Culture Environmental health Health promotion behavior Wellness Family Culture Environmental health Social support Se ac W ac Di pr ac He pr ac Fa Cu So En he Sp Co Te lea From Shuler, P. A., & Davis, J. E. (1993a). The Shuler nurse practitioner practice model: A theoretical framewor practitioner clinicians, educators, and researchers, Part 1 . Journal of the American Academy of Nurse Practitione
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FIG 2-11 American Association of Critical-Care Nurses Synergy Model. The Synergy Model
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delineates three levels of outcomes—those derived from the patient, those derived from the nurse, and those derived from the health care system. (From Curley, M. A. Q. [1998]. Patient-nurse synergy: Optimizing patient's outcomes. American Journal of Critical Care, 7, 64—72.) TABLE 2-3 Comparison of Concepts in Ball and Cox's Theory * and Hamric's Competencies Hamric Competency Ball and Cox Concept Direct care Credibility; advanced clinical practice; restoring “to health outcomes” Guidance and coaching
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  • Winter '17
  • Nursing, advanced practice nursing

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