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Issues have emerged throughout the United States, and in the state of Colorado. These issues threaten the capacity of healthcare sector to meet future requirements for basic healthcare. Increasing segment of the population of sixty five years and above and their associated disease load is posing potential threat to health care system and its personnel. A survey done by Colorado health institute projects that healthcare provision will be extended to 530 thousand individuals, who do not have health insurance, and extend the services in areas where primary health care physicians are enough, but uneven geographically distribution causes shortages especially in rural areas. Advanced Practice Nurses are medical practitioners in the nursing field, who engages in non-physician clinical issues providing quality primary health services. APNs are registered nurses as clinical specialists prepared at the graduate degree level. They specialize in fields such as nurse practitioner, nurse mid-wife, and nurse anesthetists. APNs engaging in primary health care plays roles in nurse controlled health clinics and patients-centered medical environments. Lack of reliable information about the activities of APNs and clinicians providing non-physician health care inhibits the basic care planning in the state of Colorado. A survey had been carried out by Colorado Health Institute on RPAs to elucidate on their roles as primary health care providers. In order to protect and safeguard life, well being, properties and general public welfare of individuals residing in any state, any country and in any village from unauthorized, less qualified and shoddy application of medical programs and activities by the people in the nursing practice, it is indispensable for sound regulatory body to be put in place. The legislation arm of government, the Colorado general assembly ratified the nurse practice act and further asserted that it is the policy of the state to control the activities of nurses in medical provisions through the agencies run by state, with powers to execute the applications in the nurse practice act article.
Advancement Practice Nursing
Advanced practice nurses are registered nurses, RNs who have accomplished a national accreditation graduate degree, have passed national certification examination and have been approved by the board as advanced practice nurses in any of the following roles: certified nurse midwife, certified registered nurse anesthetist, clinical nurse specialist and nurse practitioner. Some of the APNs may be trained in more than one practice; some may double as certified nurse specialist-nurse practitioner. Based on the laws in the practice state, APNs are independent in the roles. Some states require them to work in collaboration with physicians, other allows them to diagnose and treat common diseases. They can also order diagnostic tests, perform minor medical procedures, prescribe and dispense medications without the supervision of a physician.
Scope and Standard of Practice by APNs
Advanced Practice Nurse Role majorly concentrates on one field of practice, Nurse practitioner. Nurse practitioners account for a good number of APNs in the USA. They are trained to discharge their mandates across all the populations and offer expert direct health care services in form of medical assessments, diagnosis, mitigation and controlling common severe and chronic diseases. They also prescribe medication, and offer ambulatory services. Nurse practitioners also concentrate majorly on acute health care found in hospital settings. They are therefore, found in large number in hospital settings. Clinical Nurse Specialists operates on a wider rage of specialization. They provide direct health care to patients with acute and complex health care issues, they improve patient health care provision and nursing practices by conducting best- practice research. Clinical Nursing role is broad and the field was established to keep in pace with the expanding clinical information and system dynamics to maintain nurses with best qualifications and clinical knowledge in the hospitals.
Nurse Anesthetists and Nurse Midwifery are the most established Advanced Practice Nurse roles. They are the most specialized medical practitioners. They provide range of services to patients including dispensation of anesthesia, looking after the patients, offering airway management, managing emergencies on recovery from anesthesia and provide post follow ups after anesthesia dispensation. Midwives who are certified, Certified Nurse Midwives are distinct from the other types of midwives because they receive training in both nursing and midwifery. CNMs have high health assessment and mitigation skills directed on child delivery and mother’s health. Certified Nurse Midwives help mothers in the delivery of babies, and offer direct care to mothers and babies before, during, and after giving birth. They also work together with physicians to manage high risk pregnancies. CNMs also provide general health care to women in gynecology, family planning among others. They report to hospitals as their primary place of work station, but sometimes they go to the field to offer their services
Education Requirement for Advanced Nurse Practice
Advanced practice nurses are registered nurses RNs who have accomplished a national accreditation graduate degree, have passed national certification examination and have been approved by the board as advanced practice nurses in any of the following roles: certified nurse midwife, certified registered nurse anesthetist, clinical nurse specialist and nurse practitioner. In the United States, over three hundred and fifty institutions offered graduate level Nurse Practice Programs in was in 2009. Almost three hundred offered Graduate level Clinical Nursing programs. About thirty four institutions offered master level education majorly on Nurse Midwifery. Fifty five schools offered Nurse Anesthesia at master’s level. American Association of College of Nursing issued a statement that Doctor of Nurse Practice be the standard for basic Advance Practice Nurse. To become a registered Advanced Practice Nurse in the state of Colorado, an applicant must be a licensed nurse, possess a degree in nursing and pass national certification exam, APNs are approved by state board of Nursing through the Advanced Practice registry.
The niche of practice limitation is an issue affecting Advanced Practice Nurse practice. Collaboration agreements, prescriptive rules and lack of hospital admission privileges are some of the challenges affecting the practice in Colorado. Institute of Medicine (IOM) issued a report on the potential of nursing to change the health care sector to the better. One of the recommendations was for the nurses to be allowed to practice to full potential based on their levels of education and training. The range of practice that determines APN’s legal basis to provide services determined at state level through nurse practice act ratified by state board of nursing. The recommendation calls for the inclusion of board of medicine in the ratification of nursing practices. The ability to reimburse, bill directly the services and activities of nurses affects the APNs practices, limiting their independence and inability to receive credit for their work. There exist reimbursement parity between APNs and physicians blurring the distinction between medical and nursing practices.
Dispensation of duties concern by APNs may obstruct their ability to function independently within the scope of practice. Colorado rules have expanded the scope of APNs at the same time raising requirements to practice as advanced practice nurse. By 2008, completion of the accreditation requirement was enough, a degree was essential for one to operate as a nurse in Colorado. As years passed by, several legislations came into place to control APNs; these legislations were meant to bring professionalism in the industry and to safeguard life. The field of APN should therefore, allocated more funds to promote their mobility since they work more independently when discharging their services and duties in hospitals, and at community levels.
Advanced Practice Nurses include licenses issued by the board to individuals who submit the application containing all the information required as set by the regulation, submit proof showing that an applicant has completed a professional nursing education which meets the quality as set by the board, pass examination as a prerequisite for endorsement, pay required fee among other requirements. An applicant who fully meets all the above conditions is certified by the board and issued a clinical certificate of operation.
Guiding principles in Advanced Nursing Practice are formulated for the objective of modeling and executing projects for hospitals and personnel in those hospitals to model professional Advanced Nursing Practices in the decision making, hiring of nurses, and planning of issues important in the nursing field. The program should be a pilot project for modeling elaborate participation of nurses in decision making activities in the hospitals. The study may help in developing recommendations for good practices and execution strategies in the Advanced Nursing Practices. These policies are applicable to APNs, in all areas of specialization. Qualifications are given more emphasis in the field and are regulated by qualified bodies, organizations and government legislations that must be complied with.
Advanced Practice Nurse as practiced in Colorado provides safeguards and better methods of providing medical services by nurses and other medical practitioners, to ensure professionalism in the field. Since APNs practice advanced level of healthcare provision, it is imperative for professionalism to be maintained in the field. Regulations are then set in place to accomplish the task. Such regulations to exist and followed by those involved in healthcare sector to protect human lives.