Advanced Practice Nursing, Core Competencies,

¶ … Advanced Practice Nursing, Core Competencies, and Scope of Practice

There has been an increased demand for better health care services. Such demands are a result of the emerging roles of advance practice nurses. Advance practice nursing is an evolution or an elite extension of the branch of conventional nursing. This evolution results in nurses being able to contribute to the healthcare delivery system in effective new ways which is highly required today.

According to the State of Texas' board of nursing examiners, an Advanced Practice Nurse is defined as "registered nurses who hold authorization from the board to practice as advanced practice nurses based on completion of an advanced educational program acceptable to the Board. The term includes a nurse practitioner, nurse-midwife, nurse anesthetist, and a clinical nurse specialist. The advanced practice nurse is prepared to practice in an expanded role to provide health care to individuals, families, and/or groups in a variety of settings, including, but not limited to, homes, hospitals, institutions, offices, industry, schools, community agencies, public and private clinics, and private practice. The advanced practice nurse acts independently and/or in collaboration with other health care professionals in the delivery of health care services." [Board of Nurse Examiners]

CORE COMPETENCIES

The core competency of advanced practice nurses include the application and adaptation of advanced skills in unstable and/or complex environments. They should be able to apply advanced clinical reasoning and decision making to guide, inform and teach. Another competency included the use of advanced complete assessment of the patient along with their diagnosis, treatment planning, and its implementation and evaluation skills. An advanced practice nurse should be able to prescribe and administer treatments within their scope of practice. They should consult and refer to as well as accept referrals and be open to consultation from other health care professionals to ensure efficient health care services. They should work as a team with other health care providers and plan, implement and evaluate in the interest of the patient. "These core competencies are grouped under five categories: clinical, research, leadership, collaboration and change agent." [Registered Nurses Association of British Columbia]

An advanced practice nurse should be able to use risk management strategies and quality improvements and apply them to create a safe sanative environment. They need to carry out ethical practice. Another important aspect of their competencies include the use of research producing evidence-based practice which will improve the quality, efficiency and safety of health care services. They need to be up-to-date with the new technological and scientific advancements in their field of advanced practice nursing. Competency is required in the documentation of assessments, diagnosis, management and monitoring treatment as well as follow-up care, counsel initiate, develop and discontinue therapeutic relationships.

Their competency further includes them to be able to practice independently with authorization for the interest of patients, their families and the entire community. Their practice should be based on established scientific evidence which would bring the best healthcare services to the patients. In the course of their practice, an advanced practice nurse should have leadership qualities and should be competent enough to undertake management responsibilities. They should accept accountability and responsibility for the decisions they make in their field and should protect the interests of patients by helping in the development of better healthcare policies at a local as well as national level.

Additionally an advanced practice nurse should have enhanced cultural competency. It is essential for any healthcare provider to look past the cultural barrier and be able to treat any patient regardless of their cultural background. They should blend amongst them and their families and provide them with appropriate healthcare services. "Campinha-Bacote, (1996) defined cultural competence as 'a process, not an end point, in which the nurse continuously strives to achieve the ability to effectively work within the cultural context of an individual, family or community from a diverse cultural/ethnic background'" [Journal of Cultural Diversity]

SCOPE OF PRACTICE

An advanced practice nurse is supposed to diagnose a patient and recognize the underlying problem. They are then to provide adequate treatment which includes the prescription of medicines as well as administering anesthetics. [Charles I. Artz, Esq.]

Further their nature of practice further includes research work and the utilization of research within the scope of their practice. They are allowed to admit patients to hospitals and the authority to refer patients to other healthcare professionals like licensed physicians and dentists. Additionally an advanced practice nurse also gives consulting services to other healthcare providers. They have professional autonomy and independent practice which also includes management. Moreover they are to manage the physical and mental illness status of the patient with regard to nursing care.

Their scope of practice also includes providing guidance and teaching as well as collaborating with the patient and his/her family in order to provide the best health care needs. They are also required to make decisions in solving patient care problems as well as analyzing other sources of data and identifying alternate reasons to the nature of a healthcare problem.