Concept Map
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NR500-JINKS_R_WK5ASSESSMENT_FNP1.pptx
Family Nurse Practitioner
Name:Raven Jinks
Institution:Chamberlain University
Introduction
My area of interest and specialty.
Effecting positive change to improve practice outcomes.
Identification of common practice problem in my area of specialty.
Provision of recommendations for positive change.
Nursing is a versatile profession hence medical caregivers need to adjust accordingly to the disruptive change in the profession. Positive change in nursing is always tailored towards improving patient outcomes. My area of interest and specialty in effecting positive change is a Family Nurse Practitioner. The key concepts I will discuss in this presentation include my area of interest and specialty, the process of effecting positive change to improve practice outcomes, identifying a common problem in my practice area of specialty and provision of recommendations for positive change in family nursing practice.
The sections covered in this presentation are an introduction, evidence-based projects, conceptual model, reasons for selecting Family Nurse Practitioner, the area of interest, recommendations for change, external factors that influence change, AACN MSN essentials and a conclusion of the presentation.
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Evidence-based Projects
Increases their knowledge to promote quality patient outcomes.
Equips nurses with skills for ensuring patient safety.
Helps nurses evaluate the current patient care processes and outcomes.
Evidenced-based projects for masters-prepared nurses are instrumental in a number of ways. To start with, evidence-based projects increase nurses’ knowledge in the diagnosis and treatment of diseases hence improved patient outcomes (White, Dudley-Brown, & Terhaar, 2016). Nurses have a challenge of solely relying on their respective clinical experience in the provision of quality care, they need to routinely question their practice and come up with better methods of treatments and this is achieved through the use of evidence-based projects.
Nurses have the responsibility of ensuring that their patients are safe from any kind of medical danger. Evidence-based projects for masters-prepared nurses provide a good avenue upon which the nurses can acquire knowledge and skills for ensuring patient safety (White et al., 2016). The healthcare system is a complex field that calls for extra care in the delivery of quality treatment and the implementation of safer care systems that protects patients from medical errors.
In the evaluation of current patient care processes and outcomes, according to White et al. (2016), evidence-based projects are used by nurses in the formulation of interventions to correct the current patient care process thus promoting best patient outcomes.
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Conceptual model
The Ottawa Model of Research Use (OMRU) is the best suited for effecting change in nursing. The model uses three man domains that are arranged in three consecutive columns that provide the framework for the conceptual model for change (Nilsen, 2015). The three main domains are assessing the barriers and support, monitoring intervention and degree of use, and evaluating the outcomes.
Under assessment of barriers and support, the model assesses three main components have to be critically analyzed. For instance, evidence-based innovations, potential adopters, and practice environment which contains subcomponents with connecting arrows that show the interactions between the three main components (Nilsen, 2015). Evidence based innovations include the development process and innovation attributes. Potential adopters consists of five subcomponents namely awareness, attitudes, knowledge/skill, concerns, and current practice. The practice environment consists five aspects such as patients, cultural/social, structural, economic, and uncontrolled events (Nilsen, 2015). The subcomponents in the main domains indicate the support and barriers in specific areas that should be assessed in the research.
Nilsen, (2015) maintains that in the monitor intervention and degree of use there are two main components implementation intervention strategies and adoption. Lastly the evaluate outcomes has one component and three subcomponent: patient, practitioner, and systems. These areas signify the areas an evaluator needs to focus on when evaluating the outcomes of the project.
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Reasons For Selecting Family nurse practitioner (FNP)
One gets closer to being a doctor.
One works in many and different geographical areas.
There is an increased demand for nurses with advanced specialization like FNP.
There is direct working with the people.
A nurse who has trained as FNP has a higher chance of acting more of a doctor that any actually being a doctor as opposed to other nursing areas of specialization. A FNP works directly with the patients with more responsibilities as opposed to just being a registered nurse (RN). In some states such as Washington DC and other fifty states in the US, FNP are able to prescribe medication.
FNP have the chance to work in many and different geographical locations. There are nurses who target to only work in large hospitals while others prefer to work in remote areas with rural communities. A FNP stands a chance to work in either of the environment.
The salary for a FNP is slightly higher as compared to the income of an RN. However, the FNP does not earn as a family physician but there are small disparities in their income. For instance, according to the American pay scale (2018), the annual salary of an RN in the US is $68 450 while a FNP earns an approximate of $91 000 annually.
The high demand for properly trained nurses with advanced degrees in FNP informed my decision to choose the FNP practice. Many employers have started educating their workers to get advanced specialized degrees such as FNP (Poronsky, 2013). Lastly, since FNP practice involves working directly with the people and the community which is the essence of nursing. Other advanced practice degrees such as clinical nurse specialists always operate from the scenes, unlike FNP which is all interactive.
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Area of interest
Preconception and prenatal care.
Well-woman and illness care.
Well-child and illness care.
Episodic care for acute illnesses for all ages, including minor acute injuries.
Trained FNP with a number of medical issues in nursing in addition to the general functions that are performed by advanced practice nurses. For instance, the FNP provides both preconception and prenatal care for families, well-woman and illness care, and episodic care for acute illnesses for all ages, including minor acute injuries.
The provision of primary care by FNP remains to be instrumental in helping families and the communities at large to effectively lead a quality. The FNP efficient medical services since they are easily reachable within the communities.
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Cont’d Area Of Interest
My specific area of specialty is defined below.
Management of chronic conditions such as hypertension, diabetes and asthma.
Monitoring and co-management of primary care conditions with a specialist for potentially unstable conditions such as cardiac arrests.
Case management for any long-term illness or condition.
My main area of interest is the provision of primary care for any chronic conditions such as hypertension, diabetes, asthma and any other case management for any long-term illness or condition. For instance, patients with potentially unstable conditions such as cardiac diseases and neuromuscular conditions through collaborative care with physicians and doctors.
The rationale I used for selecting the provision of primary care for patients with chronic illness or condition is the increase rate in development of lifestyle diseases such as hypertension and diabetes (Valentijn, Schepman, Opheij, & Bruijnzeels, 2013). People have been occupied by their work and the need to meet job deadlines which has significantly reduced their time for physical activities hence development of lifestyle diseases and related chronic illness or conditions.
The provision of primary care in managing chronic illness or condition being my area of interest is important in my future practice since I will be able to successfully offer quality diagnosis and treatment for patients suffering from these lifestyle diseases (Valentijn et al, 2013). Importantly, I will be able to understand the best management practices for containing such diseases so that my patients can be able to do their normal duties.
Primary care concept majorly is the first level of medical care, it generally refers to the treatment care that patients receive for injuries and other minor illnesses. Moreover, primary care involve preventive medical measures and patients have a tendency of using the same nurses or doctors in their primary healthcare issues (Stellefson, Dipnarine, & Stopka, 2013). Some of the common facts in primary care is the existence of a primary care nursing model that states the provision of patient care is the responsibility of a specific medical practitioner until the patient reports positive and quality outcome.
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Issue or Concern/ Recommendation for Change
Reduction in the primary care gap through the following ways.
Legislative changes.
Promote consistency in provision of collaborative care.
The main issue or concern associated with the provision of primary care by FNP is the primary care gap. In the face of a primary care gap, patients are vulnerable to putting their focus on nurses especially the nurse practitioners as the solution. The primary care gap results in a lot of workload nurse practitioners hence high rates of nurse burnouts (Kellermann et al., 2013). In the past few years, primary care gap has been witnessed in the provision of healthcare services due to factors such the legislation of the Affordable Care Act (ACA), the introduction of new educational qualifications for healthcare professionals as well as the diversity and complexity of patients.
Legislative changes may negatively affect the role of FNP in the provision of healthcare. For instance, legislative changes may increase the workload for FNP or reduce the scope of their work (Sommers, Gunja, Finegold, & Musco, 2015). For instance, the ACA legislation identified that there was a shortage of primary care physicians, however, it led to an increase in the number of nurse practitioners.
There is a need for all stakeholders to promote consistency in the provision of collaborative care to shun away from the primary care gap challenge. The professional relationship between FNP and other healthcare professionals including physicians, pharmacists as well psychologist are for consultative and referral purposes. With effective collaboration, much can be achieved in terms of improved communication hence quality outcomes.
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Cont’d Issue or Concern/ Recommendation for Change
Personal challenges
Addressing scope of practice restrictions
Personal challenges need to be overcome by the FNP so as a formidable solution to the primary care gap can be avoided. Personal challenges such as monotony and negative attitudes a certain geographical area likely lower their performance. The monotony challenge can be remedied by exposing the FNP to continuous and refresher courses which can enable them to engage in different jobs in the same geographical location (Kellermann et al., 2013). FNP are faced with the challenge of achieving balance in tight schedules such as working over the weekends and at night. FNP may find it difficult to strike a balance between personal time and professional dedication.
There is a need to address the scope of work restrictions to promote primary care. FNP is restricted to perform some duties due to the policies and regulations instituted by Medicaid agencies, state licensing agencies, and individual health care facilities. Some of these restrictions are unnecessary since FNP are trained to provide almost 95% of the primary care services which includes preventive and chronic illness/condition care.
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Factors Influencing Change
Internal factors
Good leadership and management.
Communication.
Mission.
Good leadership and management: great leaders inspire and give direction. Healthcare facilities need to have a good leadership and management team that will communicate change in a shrewd manner minus causing damage to the already existing systems (Northouse, 2018). Charismatic leaders give hope for success of the change.
Communication: successful organizations are anchored on robust communication systems and practices. The respective team leaders communicate freely and frequently in the quest improve results (Burke, 2017).
Mission: in order to effect change, there is need for the healthcare facilities and FNP to understand the main purpose for the change and how it intends to achieve the desired change. Therefore, change should be tailor made towards achieving an outline mission.
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Cont’d Factors Influencing Change
External factors
Technological changes.
Political factors.
Legal factors.
Technological changes: organizations that embrace new technologies prosper; companies that respond slowly or resist, generally do not (Burke, 2017). Consumers tend to prefer high end technological products and services.
Political factors: a good and stable political system creates a good environment for investment and entrepreneurial practices. Governments have always considered organizations as the propellers for social change (Burke, 2017) and therefore, the government will always pass legislation that will protect the interest of the public. The same case applies in the healthcare sector.
Legal factors: the government and other healthcare organizations may pass legislation, which impacts the relationship between the healthcare facilities and patients. For instance, the FNP are required to collaborative with physicians before making prescription.
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AACN MSN Essentials
Essential 1
Background for Practice from Sciences and Humanities- nurses have to integrate knowledge from sciences and humanities for continual improvement in the provision of nursing care across diverse settings.
Essential 1: Background for practice from sciences and humanities- Essential 1 dictates that nurses, FNP included need to have a good background practice from sciences and humanities so that they can be able to offer quality healthcare services. Some of the fields that nurses need to be conversant with include bio psychosocial fields, genetics, public health, quality improvement, and organizational sciences for the continual improvement of nursing care across diverse settings (American Association of Colleges of Nursing [AACN], 2017). Similarly, in the provision of primary care for patients with chronic illness and conditions FNP need to have a sound background for nursing practice form sciences and humanities that will enable them to effectively perform their duties.
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Cont’d AACN MSN Essentials
Essential II
Quality Improvement and Safety :master’s-prepared nurses are required to have deep knowledge of the methods, tools, performance measures, as well as quality standards.
With regard to essential II, the nurses must be prepared to enhance principles that are tailor made to enhance quality among different healthcare centers or family setting for FNP in different geographical locations. In the provision of primary care for patients with chronic illnesses and conditions, FNP need to ensure that there is improvement in quality and safety of the patients (AACN, 2017). FNP are expected to remain articulate and tolerant with patients so as to give the best medical care.
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Conclusion
Presentation identifies my area of specialty
Identifies the way to enhance positive change.
Evidence based projects are important in nursing
OMRU model was used to develop a conceptual model for change.
Both internal and external factors can effect change.
Essentials I and Essential III support my area of interest.
The presentation identifies my area of specialty to be FNP. There is a need to effect positive change so as to improve practice outcomes. The use of evidence-based projects in nursing is important as it increases nurses’ knowledge in diagnosis and treatment of diseases. It also helps nurses in ensuring the safety of their patients. The OMRU model for change was used as a conceptual model for effecting change.
I chose FNP since it involves direct working with the people in different geographical locations and it pays well as compared to an RN. My area of interest is the provision of primary care for patients with chronic illnesses and condition. The major recommendation for change was the removal of the primary care gap in service delivery among nurses.
Both internal and external factors affect change in health care organizations. Internal factors included leadership, communication, and mission while external factors are technological changes, political and legal factors. Essential I and essential III were identified to support my evidence-based project in relation to the provision of primary care for people with chronic illnesses and condition. FNP needs to embrace positive change in the healthcare sector to provide the best patient-centered treatment for improved quality outcomes.
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References
American Association of Colleges of Nursing. (2017). The Essentials of Master’s Education in Nursing. Washington, DC: AACN; 2011.
Burke, W. W. (2017). Organization change: Theory and practice. Sage Publications.
Family Nurse Practitioner (NP) Salary | PayScale . (2018). Payscale.com. Retrieved 23 November 2018, from https://www.payscale.com/research/US/Job=Family_Nurse_Practitioner_(NP)/Salary
Kellermann, A. L., Saultz, J. W., Mehrotra, A., Jones, S. S., & Dalal, S. (2013). Primary care technicians: A solution to the primary care workforce gap. Health Affairs, 32(11), 1893-1898.
Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation Science, 10(1), 53.
Northouse, P. G. (2018). Leadership: Theory and practice. Sage publications.
Poronsky, C. B. (2013). Exploring the transition from registered nurse to family nurse practitioner. Journal of Professional Nursing, 29(6), 350-358.
Sommers, B. D., Gunja, M. Z., Finegold, K., & Musco, T. (2015). Changes in self-reported insurance coverage, access to care, and health under the Affordable Care Act. Jama, 314(4), 366-374.
Stellefson, M., Dipnarine, K., & Stopka, C. (2013). Peer reviewed: The chronic care model and diabetes management in US primary care settings: A systematic review. Preventing chronic disease, 10.
Valentijn, P. P., Schepman, S. M., Opheij, W., & Bruijnzeels, M. A. (2013). Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care. International journal of integrated care, 13.
White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2016). Translation of evidence into nursing and health care. Springer Publishing Company.
