APN Leader Interview Project

Introduction

Health settings are attempting to deal with rising and changing health care needs using available resources in a manner best suited for their patients. Expanded needs have led to the increase of advanced practice nursing roles. The delivery of health care services and nurses are continually changing in response to the needs and demands of patients. APN core competencies come in handy in providing guidance and direction to the nursing profession, nurses, regulatory authorities and educators in determining the conventional level of practice for individuals prepared beyond the level of the generalist nurse. This paper discusses NONPF NP Core Competencies required for the advanced practice nursing clinical roles.  An interview conducted with an APN will also be discussed as practitioners work within the context of a health care environment that is often demanding knowledge and skill beyond clinical expertise.

NONPF NP Core Competencies

Scientific Foundation competencies

This core competency requires a nurse to apply scientific principles to prevent disease and disability. The competency is basic to nursing practice.  Nurses should critically analyze data and evidence to promote the advanced nursing practice.  Evidence-based practice is the common term used to describe the diligent and careful utilization of current best evidence along with the clinical expertise to guide health care decisions. Suitable evidence includes empirical evidence from different scientific methods such as qualitative and descriptive research. To translate knowledge to improve practice, nurses may use scientific principles, information from case reports and expert opinion. Where enough research evidence is available, nursing should be guided by research evidence, clinical expertise, and patient values (Duffield et al., 2009).

Leadership competencies

Nursing practice recognizes the need for capable and strong leadership for the vision of transforming healthcare to be realized. Nursing profession produces leaders at every level of the system who play leadership roles in organizations, politics, policy and practice.  As a requisite of implementation and transformation of health demands, practitioners must exhibit high-level collaborative skills and leadership capacity in their positions to impact the potential for contemporary high patient care (Melnyk et al., 2014).

Quality competencies

Practitioners should be committed to continually improve the quality of clinical practice. Nurse practitioners have a significant impact on care quality and safety.  Quality is one of the inter-related concepts of health care access as well as cost. The definition of quality has continuously evolved.  The quality of care includes both experiential and clinical aspects of care viewed from the patient's perspective.  Effectiveness and Safety further define quality (Duffield et al., 2009).

Practice inquiry competencies

The practice inquiry dimension focuses on the use of clinical investigation that closely aligns with the complexities and realities of everyday practice by practice nurses. The recognition of APNs' practice inquiry competencies is appropriate for its interface with the emphasis on translating science to health care delivery systems, clinical practice, and policy (Duffield et al., 2009).

Technology and information literacy competencies

Nurses with good technology and information knowledge are able to easily integrate knowledge in nursing practice resulting in positive patient outcomes.  These nurses can translate scientific and technical health information for various user needs.  Knowledge and skills in information technology, information literacy, and nursing informatics allow nurses to promote quality, safe and cost-effective care. Information literacy allows individuals to locate, evaluate, and use information effectively when needed. Information literacy competencies focus on the process of finding, analyzing and making decisions on the basis of available information. This forms one of the foundations for evidence-based practice (Melnyk et al., 2014).

Policy competencies

Nurses have skills and qualities gained as part of their nursing practice that are valuable in different contexts including policy development. Nurses are instrumental to improving access to quality and cost-effective care to improve the health of populations. To this end, it is important that they are able to effectively influence change at organizational, systems, local, regional, national and international levels. Thus, nurses are well positioned to serve as a vehicle for influencing policy.  Nurses should demonstrate and advocate an understanding of policy and practice. They should analyze legal, ethical and social factors influencing policy development (Cooke et al., 2008).

Health delivery system competencies

Nurses require a common vision centered on a commitment to, first meeting patients needs. They should apply their knowledge to improve healthcare delivery. They should recognize that they impact healthcare delivery system in different ways.

Ethics competencies

Nurses should take ethical principles into consideration in their decisions-making practices by evaluating ethical consequences of their decisions. They are also required to apply ethically sound solutions to complex problems.

Independent practice competencies

Nurse practitioners are experts who work within a specific area of practice incorporating advanced skills and knowledge. They should, therefore, demonstrate a high level of accountability as they practice to prevent disease and to diagnose, promote health and manage health needs (Cooke et al., 2008).

Interview with the APN

Below is an interview conducted with a family nurse practitioner based in Southwest Virginia.  I interviewed and observed this nurse and analyzed her work based on the APN core competencies. Medical Associates of Southwest Virginia provides care to approximately 50 patients per day. The family nurse provides care to patients living in a rural setting. Most Patients travel from surrounding rural counties to seek care for different chronic and acute conditions. The patient population consists of mostly Caucasian with chronic diseases such as cardiovascular disease, chronic obstructive pulmonary disease, diabetes, and obesity. The medical staff includes one cardiologist, one internal medicine physician, one doctor of osteopathic medicine and one nurse practitioner. The practice also features osteopathic manipulative treatment, clinical laboratory services, wound care and diabetic education and counseling.

The nurse described her job role as a nurse with advanced training, education and privileges providing holistic medical and nursing care to a particular patient population.  Based on observations, the nurse’s job description included a physical examination of adult patients, performing thorough assessment and management of acute and chronic conditions, educating patients in health promotion, screening all patients for health maintenance needs, providing patients with educational material and initiating diagnostic studies. Other roles included coordinating the efficient flow of patients through the system, providing assessment and treatment of non-emergent conditions and helping to monitor the status of referrals.  

The nurse has direct patient contact to promote adequately direct patient care. One of her roles is to analyze trends in patient data and intervenes accordingly by diagnosing the patient.  While developing a therapeutic relationship, she empowered patients to make informed decisions about their health. She explained that she had hardly any time to partake in high-level research activities.  However, she keeps up to date by reading The Diabetic Educator and The Journal for Nurse Practitioners.  She notes that she attends lectures hosted by local physicians and dinner meetings hosted by pharmaceutical companies from time to time.  She participates in local and state organizations, which is noticeably an expectation of an advanced practice nurse.  She also participated as a preceptor for various family nurse practitioner graduate students. She rarely participated in legislative and policy-making activities in relation to health services. She followed nursing policies and guidelines and regularly evaluated the implications of contemporary health care policies.  She believed that any practitioner should be competent in the process of ethical decision-making. 

Analysis of APN competencies

The nurse practitioner scores well on leadership competencies, independent practice competencies, practice inquiry competencies, health delivery system competencies and ethic competencies. Leadership competencies are revealed in her role as a preceptor of nursing graduate students.  She participates in local and state organizations, which is noticeably an expectation of an advanced practice nurse. She also functions as a licensed independent practitioner. She explained that she had hardly any time to partake in high-level research activities. For a nurse practitioner, this is unacceptable.  It is expected that advanced practice nurses actively participant in the research competency.  She practiced ethical responsibilities in her work. For example, she encouraged older adult patients to address advance directives and living wills.

Conclusion

The growth in Advanced Practice Roles such as the Nurse Practitioner titles and Clinical Nurse Specialist and brings more interest and recognition in the possible benefits that APNs can bring to the care of patients. Different studies have shown significant value and outcome that arise from significant contributions of advanced practice nurses in the clinical setting.  Accordingly, some studies show that nurse practitioners have better or equal clinical outcomes as compared to physicians in the primary care setting.  APN competencies often demand knowledge and skill beyond clinical expertise.

References

Cooke, L., Gemmill, R., & Grant, M. (2008). APN core competencies: A framework for developing and testing an APN discharge intervention. Clinical nurse specialist CNS, 22(5), 218.

Duffield, C., Gardner, G., Chang, A. M., & Catling-Paull, C. (2009). Advanced nursing practice: a global perspective. Collegian, 16(2), 55-62.

Melnyk, B. M., Gallagher‐Ford, L., Long, L. E., & Fineout‐Overholt, E. (2014). Advanced Practice Nurses in Real‐World Clinical Settings: Proficiencies to Improve Healthcare Quality, Reliability, Patient Outcomes, and Costs. Worldviews on Evidence‐Based Nursing, 11(1), 5-15.

Sherry Roberts is the author of this paper. A senior editor at MeldaResearch.Com in article critique writing service if you need a similar paper you can place your order for top research paper writing companies.