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BACKGROUND: The trauma service experienced preventable delays caused by an Accreditation Council for Graduate Medical Education work restrictions and a 16% increase in patient census. Furthermore, nurses needed a consistently accessible provider for the coordination of care. We hypothesized that using experienced acute care nurse practitioners (ACNPs) on the stepdown unit would improve throughput and decrease length of stay (LOS) and hospital charges. Moreover, we hypothesized that adding ACNPs would improve staff satisfaction. On December 1, 2011, the Vanderbilt University Medical Center Division of Trauma reassigned ACNPs to the stepdown area 5 days a week for a pilot program. METHODS: LOS data from December 1, 2011 through December 1, 2012 was compared with data from the same months from the previous two years and estimated hospital charges and patient days were extrapolated. Physician and nursing surveys were performed. Data from 2010 (n = 2,559) and 2011 (n= 2,671) were averaged and the mean LOS for the entire trauma service was 7.2 days. After adding an experienced ACNP, the average LOS decreased to 6.4 days, a 0.8 day reduction. Per patient, there was a $ 9,111.50 savings in hospital charges, for a reduction of $27.8 million dollars in hospital charges over the 12 month pilot program. RESULTS: A confidential survey administered to attending physicians showed that 100% agreed that a nurse practitioner in the stepdown area was beneficial and helped throughput. Dayshift nurses were surveyed, and 100% agreed or strongly agreed that the ACNPs were knowledgeable about the patient's plan of care, experienced in the care of trauma patients, and improved patient care overall. CONCLUSION: The addition of experienced ACNPs resulted in the decrease of overall trauma service LOS, saving almost $9 million in hospital charges

The purpose of this hermeneutic phenomenology (van Manen, 1990) was to gain insight into the meaning and lived experience of nurse practitioners (NP) with at least one year of work experience regarding their initial transition from new graduate to hospital-based practitioner. This study provided information regarding NP hospital-based transition experience that had not been revealed in the nursing literature. The meaning of transitioning into hospital-based practice was discovered through analysis of nurse practitioner letters and interviews in this phenomenological study. Six themes emerged from this research including: Going from expert RN to novice NP; system integration; "Don't Give Up"; Learning "On the Fly"; They Don't Understand my NP Role; and Succeeding Through Collaboration.   Master's prepared, board-certified NPs in North Carolina (NC) with between one and three years of NP practice experience in a hospital setting comprised the population of interest for this study. Twelve participants were purposefully sampled from nine hospitals in NC. Individual, voice-recorded, in-depth, open-ended telephone interviews were conducted with each participant.   The majority of the participants indicated a timeframe that ranged from six to 18 months regarding how long it took them to feel more comfortable in their NP role, the lack of comfort was most intense during the first nine months of practice. Participants confronted multiple obstacles and challenges as new NPs. These challenges included navigating and negotiating a new health care provider role; becoming integrated into a hospital system in what was a new role for them and sometimes for the system; learning how to function effectively as a NP while simultaneously working to re-establish themselves as proficient clinicians with a newly expanded practice scope; building key relationships; and educating physicians, hospital leaders, clinical staff, patients, and families about the NP

This article touches on a topic of particular interest to me, specifically how APRN's can help fill a critical shortage of primary care providers in HIV medicine. The article validates that APRN's (NP's) are more than capable of providing high quality care to those living with HIV. Moreover, we are well positioned to fill the provider shortage that is only expected to grow over the next decade and beyond.

As NPs, many of us who have not practiced as nurses, it might be difficult to get your foot in the door of that first job. This is a personal strategy that I came up with to try and help mitigate that for myself, I'm obviously hoping that it works! For those of us who know where we want to work, for me that's in HIV medicine, I think it's important to develop the competencies that your employer will be looking for when you walk in the door. This article does a nice job of laying those out for entry level NPs looking to get into HIV medicine. What I'm trying to do is add as many of these skills to my resume while I'm attending school. My hope is that will give me an edge over NPs that I'm competing with who may not have been in the specialty specific time. If you can identify your desired areas of practice then its just a matter of looking for opportunities to add to your skillset. Look for faculty that have a shared interest, see if you can work on a research project with them. Look for nursing organizations in that specialty. There are two HIV specific organizations for APRNs looking to get into HIV medicine (ANAC and AAHIV). Join them and start networking. Take as much CNE as you can in your specialty topic - much of its free and can be done online at your own pace.

The Online Journal of Issues in Nursing ANA Home About OJIN FAQs Author Guidelines Featured Authors Editorial Staff Board Contact Us Site Map What's New New Postings Journal Recognition OJIN News Journal Topics Care Coordination Cornerstone Documents in Healthcare Emotional Health: Strategies for Nurses Healthy Nurses: Perspectives on Caring for Ourselves APRN Roles Opportunities and Challenges Societal Violence: What is Our Response? Healthcare and Quality: Perspectives from Nursing Delivering Nursing Care: Current Factors to Consider Patient and Visitor Violence More... Columns Cochrane Review Briefs Informatics Legislative Ethics Information Resources Keynotes of Note Table of Contents Vol 21 2016 Vol 20 2015 Vol 19 2014 Vol 18 2013 Vol 17 2012 Vol 16 - 2011 Vol 15 - 2010 Vol 14 - 2009 Vol. 13 - 2008 More... Letters to the Editor Continuing Ed ANA Home Login » ANA OJIN About Logo OJIN is a peer-reviewed, online publication that addresses current topics affecting nursing practice, research, education, and the wider health care sector. Find Out More... Announcements Permission to Reprint OJIN Articles Planning a conference or class? Call for OJIN Manuscripts on a previous topics... Benefit for Members Members have access to current topic Send a Letter to the Editor on any OJIN column or article... More... Letter to the Editor Since the introduction of the Health Insurance Portability and Accountability Act (HIPAA) in 1996, nurses have become the frontline

Diverse regulatory criteria, such as variable accreditation standards, disparate certification and licensing requirements, inconsistent population foci, and scopes of practice, represent barriers to optimized APRN function within today's complex healthcare system and, ultimately, reduced access to safe, quality care for patients. The Consensus Model for APRN Regulation promises to unify APRN education, practice, and licensure, promoting greater mobility among nursing professionals. Elimination of inconsistencies in APRN licensure, education, certification, and accreditation requirements will promote greater value and mobility for the APRN within the healthcare system. Rounds, L. R., Zych, J. J. and Mallary, L. L. (2012), The consensus model for regulation of APRNs: Implications for nurse practitioners. Journal of the American Academy of Nurse Practitioners. doi:10.1111/j.1745-7599.2012.00812.x

For fifty years, health care teams have been a misunderstood, undervalued, and neglected part of health care. Yet, as Drinka and Clark make clear, well functioning interdisciplinary health care teams (IHCTs) have the potential to help the health care system face its demons--financial constraints and comprehensive error-free care. Because of misunderstandings, administrators, funders, and policy makers keep the potential for interdisciplinary teams hidden. IHCTs have characteristics and problems that are unique to health care settings and the health providers who work in them. Drinka and Clark present a groundbreaking attempt to develop a comprehensive framework for IHCTs.

This article reviewed several different studies on interdisciplinary care and looked for ways that we can improve on health care and implement better teamwork. What I found most interesting is that the article talks about how educating staff on the benefits of teamwork is seriously lacking. Two issues are emerging in health care as clinicians face the complexities of current patient care: the need for specialized health professionals, and the need for these professionals to collaborate. Interdisciplinary health care teams with members from many professions answer the call by working together, collaborating and communicating closely to optimize patient care.

This article finds two emerging issues that must be addressed to optimize patient care: "the need for specialized health professionals, and the need for these professionals to collaborate." In nursing we talk a lot about "continuity of care" and that a seamless transition between PCPs, specialists, in-patient, and out-patient services is not only good-practice but vital for thorough health care delivery and improving long term outcomes.

This article describes the Consensus Model developed in 2008 for the APRN role for licensure, accreditation and certification across the United States. Though the intended goal for adoption was in 2015 (still has not happened yet), there is still much work that needs to be done at the state and national level to get this to approved.

This is a review of proposed ideas for hospitals for np programs. Something maybe we should look for in establishments we are applying for.

This article discusses how overall outcomes are better for patients when ACNP are members of a unit or service-based provider team. It also touches on how to hire ACNP for different patient populations.

This article present a gap in research regarding advocacy at the APRN level, despite the large amount of evidence surrounding advocacy at the RN level. The article calls for more research regarding if and how advocacy may differ at the APRN level and how exactly institutions are preparing APRN students for the advocacy role.

Connects efforts for full practice authority for NPs to the ratification of the Equal Rights Amendment by various states. States that ratified the ERA and therefore have a more egalitarian view of women are more likely to have full scope of practice laws for NPs, CNMs, and CRNAs

This link shows all the certifying bodies available and has links to those websites The American Association of Nurse Practitioners (AANP) is the largest and only full-service national professional membership organization for nurse practitioners (NPs) of all specialties.

Only online registrations on this website are accepted. Applications submitted by mail, fax or email will not be accepted and will be returned to the individual. Download Candidate Guide for what is tested, procedures, rules and policies Download Registration Catalog for detailed overview of the testing process This registration portal is only for those taking the test via computer or individual paper and pencil testing.

This study reviewed the struggles new APRNs were having when transitioning to new healthcare providers. It discussed the benefits of a formal residency program for new APRNs and used the benefits the programs provided for new MDs to support the findings that these formal residencies could provide for new APRNs.

This articles takes about the importance of a structured residency program for new nurse practitioners. A structured residency program helps to the NP to get acclimated in the new role of being a provider and ensures patients are receiving quality care.

In this article, author Lugo discusses the findings of her study relating limits on full practice authority for APRNs to issues of gender equality. She investigated the link between state support of the Equal Rights Amendment (ERA) and laws in these states allowing APRNs full scope of practice and prescribing rights. Her study showed that states that have historically and currently supported the ERA in fact allow greater APRN scope of practice, and thus she draws conclusions about attitudes towards women's equality and the regulation of advanced practice nursing, which remains to be a woman-dominated profession.

In this May 2016 article published in the Online Journal of Issues in Nursing, Dr. Nancy Rudner Lugo argues that advanced practicing nursing viewed through a gendered perspective due to nursing's history as a predominantly female profession; because of this, APRNS in states that are less accepting of women's equality have a more narrow scope of practice. There is not currently a national-level evidence based method used to determine APRN scope, and is instead decided at the state level. The author seeks to explain the cause of the discrepancy between differing APRN scopes of practice in different states by comparing the APRN scope of practice between states that did and did not vote to pass the Equal Right Amendment, positing that states with cultural attitudes that are more equitable between genders reflect this at the legislative level, thus explaining the wider or full practice authority given to APRNs in these states. In conclusion, Lugo advocates for increasing the number of women in legislative positions, forming relationships between women's equality organizations and groups working towards expanded health care access, and emphasizing the skills and competency of APRNs in achieving positive patient health outcomes.

This article discusses the challenges in standardizing the APRN scope and practice in order to increase the mobility between states for practicing APRNs. It also would increase access to APRN care nationwide. After the signing of the Affordable Care Act, there was an increase in care provided and the need for nurse practitioners increased with that.The Federal Trade Commission found that mandatory physician supervision for nurse practitioners led to higher costs and reduced quality of care.