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Interdisciplinary Teamwork article

Interdisciplinary team work is a complex process in which different types of staff work together to share expertise, knowledge, and skills to impact on patient care. Despite increasing emphasis on interdisciplinary team work over the past decade, in particular the growth of interdisciplinary education [ 1], there is little evidence as to the most effective way of delivering interdisciplinary team work [ 2].

Interdisciplinary team work is a complex process in which different types of staff work together to share expertise, knowledge, and skills to impact on patient care. Despite increasing emphasis on interdisciplinary team work over the past decade, in particular the growth of interdisciplinary education [ 1], there is little evidence as to the most effective way of delivering interdisciplinary team work [ 2].

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.

Growth of APRN profession may have long term effects.

Very good article on pros and cons of APRN expansion.

The researchers in this article focused on analyzing what kind of economic impact that giving APRNs full scope of practice in North Carolina would have. They calculated the impact by first projecting the increase in APRN graduates choosing to work in the state after full scope would be awarded. Projections of the increase in demand for providers due to both the ACA and an aging population were also taken into consideration. The findings in this analysis were that giving APRNs full scope of practice in the state would benefit the economy with increased output, employment, and tax revenue all while decreasing provider shortages. The state could save upwards of $495 million in gross product annually.

Hopefully, results such as these will give other states with more restrictive policies incentive to change their practice guidelines.

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

This article discusses the merger of the adult and gerontology specialties.

With increasing interaction between governing bodies and cultures this article explores the APRN scope of practice on a global scale. It also examines access to care as a global issue postulating the need to standardize the scope of the Nurse Practitioner.

Pediatric NP's began training in 1965 in order to enhance the role of the pediatric nurse; however, since then PNP's are seeking increased autonomy from MD's in order to work to the full extent of the knowledge and skills. The article describes how PNP's are aptly trained to assess kid's who are abused, exploited, neglected, or need immunizations. As a result, PNP's have a unique role, separate from MD's, to enhance any practice.

Probably posted before me. At any rate I'm attempting some effort here.

Personally I think NP residencies are a very important vehicle for transitioning into practice, and should be financially supported by the government the same way that medical residencies are supported!

Found this an interesting perspective because of the increasing demand for primary care providers.

Our study demonstrated that participation in the Quality Improvement and Innovation Partnership (QIIP) Learning Collaborative (LC) program influenced team functioning in Primary Health Care (PHC) teams, and facilitated the development of team based care processes. Enhanced communication processes increased both the recognition and the use of team members' scope of practice. Being respected and understood improved team collaboration as well as team functioning. Supporting and sharing leadership was a central component to successful team functioning.

This is a Canadian public ad campaign, defining what nurse practitioners are, what they can do, and how they can help improve quality of and access to care. It is well-made. I feel that similar campaigns in the U.S. Would help to increase public knowledge and understanding of our profession.

This article describes the orientation process used in a pediatric cardiac center for APNs to increase confidence in skills, knowledge of role, mentorship, and NP retention during the first year of practice.

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.