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Question Description

  • Outline and discuss a plan to promote the value of the APN model to the public.
  • Using the latest statistics and evidence, provide a compelling argument and a brief background to the public about why APNP care is essential.
  • Discuss how you would promote the value of utilizing an APN as a provider of services.
  • Use data from sources that illustrate how efficient, and cost containing APNPs are versus other health care provider roles. This is not an exercise that diminishes our other colleagues, but one that promotes the value of the APNP role.

Students are expected to:

  1. Post an initial substantive response of 250 words to each question
  2. Please be sure to validate your opinions and ideas with citations and references in APA format.
  3. References and citations should conform to the APA 6th edition.
  4. Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.
  5. The peer postings should be at least one paragraph (approximately 100 words) and include references and in text citation

Rebecca’s Response

Promoting the APN Role

Recent care delivery models have focused on providing value-based care to patients. The changes provide opportunity for APNs to take a leadership role in implementing models and systems to effectively deliver that care. APNs are able to improve the patient experience of care, including quality and satisfaction, improve overall population health, and reduce the cost of health care (Galioto, 2017). The public can be made aware of the important and value of APNs but allows flyers to be posted in primary care facilities and other medical offices.

Essential Care

APNs are essential advocates for health care policy. They have the clinical expertise and the educational background to present the case for passing legislation on health care issues. APNs are on the front lines of health care and treat multiple patients with unique needs and can relate personal experiences regarding how legislation can impact these patients. As nurse leaders, APNs must be involved in health policy. The APNs who advocate for major health policies can influence countless people throughout their state and the nation, depending on the level of the health policy. APNs can conduct quality improvement projects in their working environments, and can use their findings to help implement new policies at the facilities where they work. Another major way APNs can affect health policy is to write to their state or federal legislators regarding a health policy bill that has been filed. Because they work with patients on a daily basis, APNs can share personal stories about how an enacted bill could have helped a specific patient reduce complications, or perhaps may have reduced health costs by screening or treatment at an earlier disease stage. Involvement in health policy is the most important role an APN can have in impacting positive change in health care that will benefit multiple generations of patients across institutions, states, the nation, and even globally (Chilton, 2015).

The Value of an APN

APNs are of great value within the health care setting. APNs are becoming more valuable and are also becoming more necessary. Consumer demand for APRN provided care is growing due to a shortage of primary care physicians, the soaring cost of health care, and a population that is aging and living longer with more acute and chronic conditions. APRNs practice in settings ranging from hospitals to community health centers to school-based health clinics, and they are especially valued in rural and underserved areas, where primary care physicians are hardest to find (Robert Wood Johnson Foundation, 2018).

Reduction in Costs

There are many ways the APNs help reduce healthcare costs while improving quality. APNs help reduce the cost of patient visits across healthcare settings. Numerous studies show extensive savings within facilities that employ nurse practitioners. In a 2009 study in Nursing Economics, it was found that APN-led care was associated with lower drug costs for inpatients in acute-care settings. Nursing Management has also published findings that show APNs in managed care deliver care at 23% below the average cost associated with other primary-care providers. APNs also keep patients out of the hospital. While chronic conditions take a toll on patients’ physical and emotional well-being, they also result in added costs. APNs are proven to decrease patient hospitalizations, ER visits and lengths of stay at various facilities, keeping healthcare costs down for patients, institutions and taxpayers, and reducing time and income lost from work (Cooke, 2015).

References

Chilton. (2015). Nurse Practitioners Have an Essential Role in Health Policy. The Journal for Nurse Practitioners, 14(8), 16-18. Retrieved October 6, 2018.

Cooke. (2015, August). Ten ways NPs reduce costs, improve quality. Retrieved October 6, 2018, from http://www.managedhealthcareexecutive.com/mhe-arti…

Galioto. (2017, December). APNs Have a Role in Leading Value-Based Care. Retrieved October 6, 2018, from https://voice.ons.org/news-and-views/apns-have-a-r…

Robert Wood Johnson Foundation. (2018, February 27). APRNs a “Big Part of the Solution” to the Primary Care Provider Shortage. Retrieved October 6, 2018, from https://www.rwjf.org/en/library/articles-and-news/…Helen’s Response

  • A plan to promote the value of the APN to the public:

Advanced practice nursing presents a contribution to client care with the application of the advanced scope of practice, experience in many domains of practice, integrated nursing knowledge and leadership (Kilpatrick, Lavoie-Tremblay, Ritchie, & Lamothe, 2014). I would share with the public information from the Federal Trade Commission, National Council of State Boards of Nursing, and the Institute of Medicine. Value is added when APNs see patients partly due to increased access to healthcare. A way the value of APNs can be promoted is by changing existing regulation/law so that the profession is independent. This needs to be accomplished nationwide.

  • Why APN Care is Essential, Efficient, & Cost Effective

In 2012, the National Healthcare Quality Report documented that access to care in the U.S. is suboptimal, especially pertaining to low-income groups and minorities; access to care is diminishing; and there is emergent attention needed in the areas of maternal-child health, cancer care, and non-communicable disease care (National Council of State Boards of Nursing, 2014). According to the Federal Trade Commission (FTC), the goal should be to refrain from restraint of practice and allow APNs to fully work independently (FTC, 2014). An excerpt from the Institute of Medicine in the FTC report states that practice restrictions undermine the nursing profession’s ability to provide care and to improve healthcare (FTC, 2014). APNs in independent practice provide care that is safe, lower in cost and high in quality. A review of 31 studies shows that the care that APNs provide is equal to or higher than physicians though the cost of care is 15% less than physicians (Woo, Lee, & Tam, 2017).

Findings in one study demonstrate that APNs perform as well as physicians in terms of clinical outcomes and patient satisfaction (Swan, Ferguson, Chang, Larson, & Smaldone, 2015). There is also evidence that APNs require fewer primary care visits, and that APNs demonstrated similar guideline adherence to physicians and provide more patient education (Swan et al., 2015). A RAND corporation study showed that the care by APNs was equal to that of physicians at a lower cost with higher patient satisfaction (Hooker & Muchow, 2015). The evidence in this study adds to the body of evidence that primary care provided by APNs is similar to or superior to the care provided by physicians (Swan et al., 2018). In primary care settings where patients were randomly assigned to APNs or physicians, and where APNs had the same authority, administrative duties, responsibilities, and productivity as physicians, patient outcomes were comparable (Swan et al., 2018).

References:

Federal Trade Commission. (2014). Policy perspectives: Competition an the role of the advanced practice nurse [Pdf].

Kilpatrick, K., Lavoie-Tremblay, M., Ritchie, J.A., & Lamothe, L. (2014). Advanced practice nursing, healthcare teams, and perceptions of team effectiveness. Journal of Trauma Nursing, 21(6), 291-299. Doi: 10.1097/JTN.0000000000000090

National Council of State Boards of Nursing. (2014). Journal of Nursing Regulation, 4(4), 5-12. URL: http://www.journalofnursingregulation.com

Swan, M, Ferguson, S., Chang, A., Larson, E., & Smaldone, A. (2015). Quality of primary care by advanced practice nurses: A systematic review. International Journal for Quality in Health Care, 27(5), 396-404. Doi: 10.1093/intqhc/mzv054

Woo, B.F.Y., Lee, J.X.Y., & Tam, W.W.S. (2017). The impact of advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: A systematic review. Human Resources for Health, 15(68), 1-22. Doi: 10.1186/s12960-017-0237-9


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