could take a job in a specialized acute care practice without further education to prepare for that specialty. This issue of aligning APN job expectations with education and certification is not always well understood by practice environments, educators, or even APNs themselves. However, the need to ensure congruence among particular APN specialties and roles and education, certification, and subsequent practice has been identified by regulators, and more stringent regulations regarding this issue are being promulgated (NCSBN, 2008).Implications for ResearchAs noted in Chapter 10, one of the core competencies of advanced practice nursing is the use of evidence-based practice in an APN's practice and in changing the practice environment to incorporate the use of evidence. The practice doctorate initiative identified the increased need forleadership in evidence-based practice and application of knowledge to solve practice problems and improve health outcomes as reasons for moving to the DNP degree for APN practice (AACN, 2006). If research is to be relevant to health care delivery and to nursing practice at all levels, APNs must be involved. APNs need to recognize the importance of advancing the profession's and health care system's knowledge about effective patient care practices and to realize that they are a vital link in building and translating this knowledge in clinical practice.Related to this research involvement is the necessity for more research differentiating basic and advanced practice nursing and identifying the patient populations that benefit most from APN intervention. For example, there is compelling empirical evidence that APNs can effectively manage chronic disease—preventing or mitigating complications, reducing rehospitalizations, and increasing patients' quality of life. This evidence is presented in the chapters in Part IIIand in Chapter 23. Linking advanced practice nursing to specific patient outcomes remains a major research imperative for this century. It is interesting to note the increasing research being conducted in international settings as more countries implement advanced practice nursing and study the effectiveness of these new practitioners; discussions of this research are woven throughout the chapters of this book.Similarly, research is needed on the outcomes of the different APN educational pathways in terms of APN graduate experiences and patient outcomes. Such data would be invaluable in continuing to refine advanced practice education. Outcomes achieved by graduates from DNP programs need similar study in comparison to master's-level APN graduates; in critiquing the need for the DNP degree, Fulton and Lyon (2005)noted the absence of research data on whether there are weaknesses in current master's-level graduates.
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- Winter '17
- Nursing, advanced practice nursing