Emory Becoming an APRN

This is an article from The Journal of Nurse Practitioners. The IOM is recommending a transition to practice (residency program) for new graduate nurse practitioners; along with a competency tool to assess the effectiveness of such program.

This is a great systematic review that delves into state by state regulations on scope of practice for APRNs and how restrictive practice ultimately reduces access to healthcare particularly in rural populations. The impact of the ACA and shortage of PCPs to meet this demand is also explored. Enjoy!

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

Impact out of how PCNP's in palliative care are making a positive and sometimes neutral (no negative) impact in healthcare and healthcare cost. There are better articles (from abstract alone), but no full length available for some reason via Emory Database/CINAHL/google (just not free/inaccessible).

A story of a new NP graduate finding a NP job very soon after graduation

How NPs can fulfill the role of healthcare in rural America

The AAFP view on primary care for the 21st century and how NPs an help to bridge the healthcare gap.

This article was presented by the National Governors Association on the role that NPs can fill in healthcare

Nurse Practitioner Workforce Article

This article is about how important it is to articulate your role as a nurse. I love how they explain articulating your role as a nursing competency. I think this is a great article for this class as we learn what the APRN role is and how to articulate it to our inter professional teams. Nurse Educ Pract. 2013 Nov;13(6):519-23. doi: 10.1016/j.nepr.2013.02.014. Epub 2013 Mar 18.

This article shares an experience of an NP in Nevada who had been trying to care for patients in under served areas but was having difficulty finding MDs to sign agreements with in those areas. This inhibited her ability to treat people in need but, thankfully, a new law was passed July 1 that enabled her to treat these people to the full extent her education taught her to, without having to rely on an agreement with an MD. It is important for us to remain aware of our scope of practice but also to fight for our ability to practice to the full extent we're being taught to do.

As NP we need to advocate for ourselves in everyday life as well as the political arena because politics is where our profession will achieve the most success. With supportive policy backing up our practice our future is limitless.

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