NSG 5000 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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