Advanced Nursing Profession: Impact Of Technology, APN Skills, And Regulatory Frameworks

Impact of Technology on Nursing Practice

Discuss about the Art and Science of Advanced Practice.

Advanced Nursing Profession is a specialised nursing type, which allows nurses to provide specialised care for patients, and is different from the regular registered nursing. Different policies and guidelines frame the works and practice of APN and registered nurses. The following essay will discuss how technology have affected nursing practice, the skills for APN, and how APN differs from registered nurses and how regulatory frameworks are necessary for nursing practice.

Information and Communication technologies (ICT) have several implications in the healthcare industry and also on nursing practice. Rouleau et al. (2015) evaluated the influence of ICT on nurses and nursing care practice. The authors suggested the ICT can be applied across different domains, such as: communication and management systems, system for automated decision support as well as information systems. The effects have been divided into Primary and Secondary outcomes by the authors. The Primary Outcomes includes effects on 1. Practice environments: providing autonomy to nursing roles, foster support from co workers and administration, allow collaboration and decentralized decision making. 2 Nursing process: Helping assessment, evaluation, care planning, education, communication, care orientation, maintain quality, utilizing updated knowledge. It also helps in clinical management, discharge planning and in disease prevention/health promotion. 3. Professional Satisfaction: improving perception of the quality of care given to patients, foster responsibility, success and growth and to enjoy the work. 4. Improving Nursing outcomes and patient outcomes: Fostering safety, quality and comfort in care, empowerment of patients, improving functional status, patient and nurse satisfaction, improving patient experience. The Secondary Outcome includes improving satisfaction of nurses and patients with ICT. Piscotty et al. (2015) also pointed out that in healthcare, IT can mediate the relation between the nursing care provided and the care that is used, influencing usage of care.

As per the Nursing and Midwifery Board of Australia (NMBA), Advanced Practice Nursing (APN) is a strategy of nursing that utilises overall skills, knowledge and experience in the care of patients. The APN involves the use of advanced knowledge, experiences and skills, to develop relationship between nurse and patient. The practice is based on the concept that optimal outcomes in patient health and patient care can be achieved through the utilization of a high degree of knowledge, experience and skills, along with the combination of critical analysis with problem solving skills and effective decision making practices. The Nursing and Midwifery Board of Australia highlights the outlook that nurses practicing APN should have a master’s level knowledge, and can work in either specialist of a generalist capacity. The Board also requires three years full time (equivalent to 5000 hours) of advanced practice to demonstrate necessary clinical focus for APN (nursingmidwiferyboard.gov.au, 2018; Dunphy et al., 2015).

Skills Required for APN

These ensures that APN have specialised skills and knowledge which can enable them to provide specialised care, and utilise evidence based practice for the best possible outcomes. APN can include practice domains such as: support of systems, direct and comprehensive care, research, education, publication and professional leadership. These can allow APN’s to provide a comprehensive care and supportive care, as well as act as health educators, researchers, research authors and healthcare leaders (internationalapn.org, 2018; Joel, 2017; Blair & Jansen, 2015).

Registered nursing does not require any specialization as in case of APN. A master’s degree in Nursing can be sufficient to start the practice, and no specialised degree would be needed. Unlike APN, where the duties can be varied and include wide array of duties, registered nursing can include routine activities such as taking health histories, assess, diagnose and treat chronic and acute conditions, and act as primary care provider and give referrals for specialized care. Registered nurses can also prescribe medications, however, the types of medication and the level of supervision is controlled by regulatory frameworks of the profession. Registered Nurses can work in only specific nursing setups such as long term care facility, private practice, ambulatory clinics, and community clinics only, unlike APN who can work in virtually every healthcare settings, as well as health education and health policy settings (nursingmidwiferyboard.gov.au 2018; Jokiniemi et al., 2015).

According to the NMBA, RN practice involves a continued process of critical thinking and analysis of care and continuance of positive relations. Due to this, the registered nurses are required to professionally develop and maintain their ability to continue professional practice. Moreover, RN helps to determine, coordinate and provide safe and quality care. The practice can include comprehensive assessment, developing care plan, implementing and evaluating outcomes, and are accountable for supervision and delegation of nursing activity to enrolled nurses (nursingmidwiferyboard.gov.au 2018; Jokiniemi et al., 2015).

Regulatory guidelines is one of the methods by which healthcare authorities can protect and serve the public and it assists to protect the public by focussing the service or care given to the public to be competent, ethical and meets the standards as is seen acceptable by the national legal frameworks and society (crnbc.ca 2018). The regulatory standards ensure a) set up, monitor and evaluate standards of professional practice, b) setting up conditions or requirements for registration of nurses and healthcare professionals, c) establishing and enabling employment registration of nurses as well as procedures related to enquiry and discipline, d) providing recognitions for education programs and courses of r nurses (nursingmidwiferyboard.gov.au 2018).

Differences between APN and RN

The NMBA outlines several policies, professional standards, position statements, and frameworks to regulate the nursing practice in Australia. The policies, codes and guidelines help to understand the expectations and professional requirements of NMBA for nursing and outline pathways to meet those requirements. These policies can include: social media policy, exemptions from continuous professional development (CPD), re entry to professional practice, English language skills registration and standard policy and mothercraft nursing policy (Masters 2015).  The Professional Standards defines the behaviour and practice of the nurses and midwives, and it outlines the code of conduct, standards for practice and the ethics code (Blais, 2015). The Guidelines also outlines the expectations and requirements of the board and outlines pathways to address them. The position statements help to provide guidance to the nursing professionals and also clarify the views of NMBA on different issues. The frameworks which includes framework for analysing national competency and standards of practice, framework for decision making and re entry to procedures, and also helps to guide the professional practice, outlining the board’s expectations and requirements and help aspiring professionals to acquire them (nursingmidwiferyboard.gov.au 2018).

In Australia, NMBA provides and outlines the regulatory policies, standards, frameworks and protocols for professional nursing practice. These standards ensure that the care provided to the patients is of standard quality, ethical, effective and competent. The guidelines also sets up the code of conduct that is to be expected from healthcare professionals, and standards of practice according to the legal and legislative requirements, and also helps to explain the expectations and requirements of the board from healthcare professionals such as nurses (nursingmidwiferyboard.gov.au 2018; Nursing and Midwifery Council, 2015; Maloney, 2017). Since these guidelines enable the development and maintenance of best practices and fosters development of care and maintenance of quality of care, it is vital that NMBA should continue to regulate the nursing practice in Australia.

The Code of Ethics is aimed to understand the rights of individuals and upholds such rights in the professional practice. It helps to identify the moral commitments of healthcare professionals, offer a basis for self reflection on ethical practice, provide guide to ethical practice and show commonalities in moral standards. It emphasises on aspects such as accountability, moral agency, responsibility, ethics and ethical problems (health.sapanta.com.au 2018).

The code is also underlined by the Code of Professional Conduct in Australia. The code of professional conduct identifies the minimum requirements of the practice in the profession and also gives focus on the identification of acts of professional misconducts, which along with the code of ethics forms the frameworks of nursing practice (health.sapanta.com.au 2018).

Conclusion:

The above discussions show how APN differs from registered nursing, and how technology helps to advance nursing profession. It also highlights that regulatory frameworks are important for maintaining ethical, safe and efficient care for the patients, and help to improve both patient outcomes as well as foster professional satisfaction.

References:

Blair, K. A., & Jansen, M. P. (Eds.). (2015). Advanced practice nursing: Core concepts for professional role development. Springer Publishing Company.

Blais, K. (2015). Professional nursing practice: Concepts and perspectives. Pearson.

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Dunphy, L. M., Winland-Brown, J., Porter, B., & Thomas, D. (2015). Primary care: Art and science of advanced practice nursing. FA Davis.

health.sapanta.com.au (2018), health.sapanta.com.au, Retrieved: May 9, 2018, from: https://www.health.sapanta.com.au/srcn/code.pdf

internationalapn.org (2018), internationalapn.org, Retrieved: May 9, 2018, from: https://internationalapn.org/category/australia/australia-australia/

Joel, L. A. (2017). Advanced practice nursing: Essentials for role development. FA Davis.

Jokiniemi, K., Haatainen, K., & Pietilä, A. M. (2015). From challenges to advanced practice registered nursing role development: Qualitative interview study. International journal of nursing practice, 21(6), 896-903.

Maloney, P. (2017). Looking Back and Looking Forward Through the Lens of the Nursing Professional Development.

Masters, K. (2015). Role development in professional nursing practice. Jones & Bartlett Publishers.

Nursing and Midwifery Council. (2015). The Code: Professional standards of practice and behaviour for nurses and midwives.

nursingmidwiferyboard.gov.au (2018), nursingmidwiferyboard.gov.au, Retrieved: May 9, 2018, from: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements.aspx

nursingmidwiferyboard.gov.au (2018), nursingmidwiferyboard.gov.au, Retrieved: May 9, 2018, from: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

nursingmidwiferyboard.gov.au (2018), nursingmidwiferyboard.gov.au, Retrieved: May 9, 2018, from: https://www.nursingmidwiferyboard.gov.au/documents/default.aspx?record=WD13%2F10753&dbid=AP&chksum=ke%2FhMxMHGxnQev5BI%2B0ueQ%3D%3D

Piscotty, R. J., Kalisch, B., & Gracey?Thomas, A. (2015). Impact of healthcare information technology on nursing practice. Journal of Nursing Scholarship, 47(4), 287-293.

Rouleau, G., Gagnon, M. P., & Côté, J. (2015). Impacts of information and communication technologies on nursing care: an overview of systematic reviews (protocol). Systematic reviews, 4(1), 75.