NSG 5000 - Mid-term Exam Study Guide. Complete Solutions. Chapter 1 Standardization of APN role 1. Licensed RN 2. Expanded knowledge & skills that builds on basic nursing education (graduate degree or higher) 3. MUST involve direct clinical practice Criteria 1. Graduate degree 2. professional certi...
NSG5000 Mid-term Exam Study Guide Summer 2020 (Chapter 1-6)
Chapter 1
Standardization of APN role
1. Licensed RN 2. Expanded knowledge & skills that builds on basic nursing education (graduate degree or higher) 3. MUST involve direct clinical practice Criteria
1. Graduate degree 2. professional certification w/in specialty 3. practice focused on pt and families (aka direct clinical practice)
National council for state boards of nursing 4 essential elements: Licensure, Accreditation, Certification, Education
Since the 1980s, the term advanced practice nurse (APN) has increasingly been used to delineate CRNAs (certified registered nurse anesthesist), CNMs (certified nurse midwives), CNSs (clinical nurse specialist), and NPs (nurse practitioner). APN= certified APRN’s with a minimum master’s degree.
Throughout the century APN’s have been permitted to provide care to underserved poor, especially in rural areas. Documentation of outcomes of practice helped establish earliest specialties and continues to be critically important for survival of APN practice.
Hameric’s conceptual definition APN= The patient-focused application of an expanded range of competencies to improve health outcomes for patients and populations within
a specialized clinical area of the larger discipline of nursing.
Conceptual definition
“patient-focused application of expanded range of competencies to improve health outcomes for patients in a specialized clinical area of the larger discipline of nursing”
Three primary criteria
Graduate education
Certification
Practice focused on patient/family
Seven core competencies
Direct clinical practice is the central competency Core competencies of APN - guidance and coaching, consultation, evidence-based practice, leadership, collaboration, ethical decision making
--- Also meet one of 6 population foci: Family/Indiv across life span, Adult gerontology, Gender specific, Neonatal, Pediatrics, and Psychiatric-mental health
CRNA- After 2022 ALL nurse anesthesists must graduate with doctoral degree
NURSE- MIDWIFERY- (1966) All nurse mid-wifery programs must be associated with university.
1.Which definition distinguishes Advanced Nursing Practice (ANP) from Advance PracticeNursing(APN)?
The integration and application of a broad range of theoretical and evidenced based knowledge that occurs as part of graduate education
The ANP and APN are indistinguishable and the broad definition is best described in specific roles
The integration of all levels and specializations in nursing that directs direct patient care to individual patients, families and communities
The progression of the nurse to any advanced role that elevates clinical decision making that is gained through work experience and continuing education
2. Which factors best differentiates basic nursing practice from advance practice nursing?
Increased role autonomy; Supervision or collaboration with physician and execution of joint orders
Lateral role autonomy; Independence from most disciplines; Regulations govern
Increased role autonomy; Interprofessional decision making; Disease management
Increased role autonomy; Elevated clinical decision making; Integration of health promotion; Management of acute and chronic conditions; and Collaboration with other disciplines
1st recognized area of APN practice: Anesthesia= first recognized clinical specialty in nursing
Roots in the US traced to late 19th century= American Civil War
By late 19th century, most hospitals used student nurses for staffing with increasing use of graduate nurses as nurse anesthetist (concentrated on administering chloroform and observing patient) Early APN role in anesthesia—what increased demand
the widespread use of the newly discovered chloroform anesthesia and the demand for such treatment for wounded soldiers during the American Civil War (1861 to 1865).
Opportunities for nurse anesthesist increased when US entered World War 1 in 1917
The resulting need for pain relief and anesthesia care for the wounded soldiers created an immediate demand for nurse anesthetists' knowledge and skills It also created opportunities for research and physicians and nurses began investigating new methods of administering anesthesia.
After the war, opportunities for the employment of nurse anesthetists were mixed with medicine becoming increasing complex, scientific, and controlled by medical specialties
Lillian Wald and Henry Street Settlement: For the poor
Lillian Wald, a young graduate nurse from the New York Training School for Nurses, established the Henry Street Settlement (HSS) House on the Lower East Side of Manhattan. Its purpose was to address the needs of the poor, many of whom lived in overcrowded, rat-infested tenements.
Lillian Wald- -First public health nurse/ Mother of community health nursing (offered healthcare and social services to members in the community)
-Believed poor people should have access to health care -Established Henry Street Nursing Settlement (focus on immigrant populations), treated minor illness, prevented disease spread, and public health reforms
- Development of payment by life insurance companies for nursing services at Metropolitan Life Insurance Comp
-Led rural nursing services through the red cross
-First president of NOPHN
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