Advanced Practice Nurse plays several roles in the field of healthcare. They are responsible for obtaining health histories and performing extensive physical examinations which should not be limited to psychosocial, functional, and developmental assessment (Bryant‐Lukosius et al., 2004). APN specialists order and interpret lab results or other diagnostic studies. They maintain the records of the patients and are required to evaluate patients’ response to the care or modify where necessary. APNs can provide counseling and education to families, arrange patients for referrals and take part in research studies. There has been a reduction of primary care physicians and increasing the complexity of the healthcare systems, this has led to many patients seeking the services of the FNPs. Their flexibility, disregarding patients’ differences such age has led to their popularity across the world (Heitz, Steiner & Burman, 2004).

Family Nurse Practitioners can improve their medical health care to the patients by using the EBP. Problem-solving approach  with regards to decision-making within the healthcare organization. Internal and external influences are so critical when it comes to critical thinking and evaluation of evidence to care for the individual patients. A successful nurse practitioner needs to be dedicated and committed to their duties. Considering the fact that the field is so unpredictable since patients can increase at any time, dedicated and committed nurses will discharge their services accordingly. 

Reference

Bryant‐Lukosius, D., DiCenso, A., Browne, G., & Pinelli, J. (2004). Advanced practice nursing roles: development, implementation, and evaluation. Journal of advanced nursing, 48(5), 519-529.

Heitz, L. J., Steiner, S. H., & Burman, M. E. (2004). RN to FNP: A qualitative study of role transition. Journal of Nursing Education, 43(9), 416-420.

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Please answer to this discussion post with a minimum of 200 words. Thanks! 

No plagiarism, APA Style and cited. 

Comment 1

The projected nursing shortage can incur significant impact to the nursing profession and to the public.  For one, the anticipated increase of the U.S aging population, this will put more strain on the nursing profession to find nursing to care for this population. At the same token, there is a great proportion of the nursing workforce that will reach retirement age. This will create an imbalance situation in terms of nurse-to-patient ratios. Such event will indubitably trigger anxiety, job burnout, turnover, absenteeism, and low morality within the nursing profession.

                             The nursing shortage can have adverse impacts to patients’ health-care outcomes. The public might suffer considerably from medical errors; nurses may have less time to spend and care with patients. As a result, the proportions of hospital readmission and patient death can increase exponentially.

The nursing profession will face with the urgency to provide answers to the nursing workforce disparity in relation to the growing aging population. Such ageing population are suffering from chronic diseases that require long-term care. That is, the nursing profession must increase the nursing workforce pool to compensate for the projected shortage.

                           One way that the nursing profession is dealing with resolving this issue is through public-private partnerships. Such a strategy can put emphasis on encouraging nurses to access to higher education so that they become nurse educator. This will require providing incentives to nurse. In the same perspective, efforts should be done to launch advertising programs that show positive aspects of the nursing profession.  Coupled with these, community leaders, healthcare associations, and Nursing Association should advocate elected officials to provide more funds to help the nursing profession.

Comment 2

The nursing shortage is not only related to the “baby boomers” retiring. It is also the qualified nurse not willing to work in the present conditions. These conditions are inadequate workforce planning, understaffed, poor recruitment, retention, return policies, and the ineffective availability of nursing resources. High patient to nurse ratios is causing the nurses today to have “burn out” and they eventually leave their nursing career. The failure to deal with the nursing shortage will lead to the failure to maintain and improve health care and it will have a huge impact on the nursing profession and the public. Addressing the nurse shortage and providing a more positive staffing environment in which the clinical practice can actually be delivered is a resolution to the nursing shortage. Providing a more positive staffing environment includes motivating the nurses, providing support, really looking at patient acuity and nurse to patient ratios, providing incentives on nurse retention and nurse recruitment. Nurses should be able to have the opportunities to develop professionally, have opportunities for growth, gain autonomy, and have a say in the decision making and truly be listened to by their managers and administration team. (Buchan & Aiken, 2014). Most individuals become nurses because they truly care and have compassion. They want to help people get better, this includes on their job along outside their jobs. Nurses take their profession very serious but there is only so much one person can do. Nurses have families also and should be able to come into work and take care of their patients in a safe environment and go home to spend time with their families at the end of the day.

Comment 3

The nursing profession is at risk of an increased shortage of nurses. The increased shortage of nurses can strongly impact health care corporations. In my current position in both the Nursing home/Rehab and the hospital setting,   I have noticed that when we have shortages nurses are placed at risk for harm. Nurses become responsible for increased workload, which can lead to physical and emotional stress. This places both you and your patients at danger. 

Another  issue that arise within my hospital when short staffed is the ability to admit patients. If we have reached a full census we are unable to admit patients from the emergency room. This will place the emergency room on full capacity, meaning patients will need to go to the nearest hospital. This potentially can delay care for patients that urgently need it. Management also prefers that we keep all of our beds full to ensure maximum revenue and with out the appropriate staff we are unable to do so. The nursing shortage is quickly approaching. According to The Health Resources and Services Administration “more than 1 million registered nurses will reach retirement age within the next 10 to 15 years” (AACN, 2014). This will create a major set back reinforcing the issue stated above. Many organizations are working on hiring young graduate students in order to replace the baby boomers class. This provides a company and the nursing community with longevity in an attempt to replace the baby boomer class. Many states are working to expand the nursing programs as well as create more in order to keep up with the current and up and coming shortage.

 1 PAGE REPONSE NEEDED APA STYLE REFERENCE MUST BE LESS THAN 5 YEARS OLD  FOR ADVANCE NURSING INFORMATICS CLASS

Without the various roles and expertise of professional nurses in the development of nursing informatics, clinical information systems would not be able to have a foundation based on evidence-based practice. Evidence based practice is essential to developing clinical information systems in order to further the generation of nursing knowledge. Evidenced based practice is a process that uses the current best evidence in the care of patients as an approach to problem solving (McEwen & Wills, 2017). By nature, nurses gather data and record and collect clinical data that is objective on a daily basis. Professional nurses will gather this clinical data and identify trends seen across groups of patients (McGonigal & Mastrian, 2017). A solution to a problematic trend may be identified, implemented and seen to improve or make a positive impact on such trend which would be an example of evidence-based practice.

            The use of nursing informatics through the electronic medical record, which is one of the most widely used clinical information systems in nursing today, has been heavily dependent on evidence-based practice. The EMR can be broken down to professional nurses chronicling their daily clinical challenges and queries (McGonigal & Mastrian, 2017). Documenting in an EMR includes using clinical practice guidelines which have been generated through evidence-based practice. For example, a patient can be identified as a fall risk using a basic fall risk assessment that has been previously synthesized to tailor specific criteria in identifying fall risks through daily nursing practice. This will usually would include age, previous fall incidence, medication, mobility and cognition. Once this fall risk has been identified, the nurse would open a clinical practice guideline parameter to document implemented patient centered care and focused interventions in the real-world setting (Vance, 2012). This is merely one example of knowledge brought into the CIS through research conducted by nurses. Evidence based practice was founded only to be useful in integrating into clinical information systems when is it used in clinical workflow (Bakken, Currie, Lee, Roberts, Collins & Cimino, 2008).  Hence, the implementation of the CPG driven support system. Every clinical practice guideline has been developed through the use of evidence-based practice and then brought into the clinical information system of EMR.

            The use of an info button is another example of evidence-based practice incorporated into CIS. The primary advantage of the info button approach from the clinician perspective is that the information provided is context-specific (Darvish, Bahramnezhad, Keyhanian & Navidhamidi, 2014). Info buttons actually serve as an additional source of evidence-based practice which can be accessed within another clinical information system, such as an EMR. They can be used to determine critical lab results and possibly their perspective treatments or they can be used to gain access to medication inquisitions. In both instances, the use of evidence-based practice is the foundation of the knowledge and information used.

           Incorporating the use of informatics through clinical information systems such as electronic health records and info buttons allows for information to be computed on a daily basis. Through research, nurses become experts on analyzing and synthesizing knowledge and furthermore put the knowledge to practice with patients and family members. Clinical information systems are a vessel of nursing evidenced based practice put into clinical workflow which allows the continuous and further generation of nursing knowledge. Since clinical information systems are used widely throughout the nursing practice from bedside nurses, nurse practitioners to nurse researchers, it is imperative that the information being provided by such systems stay evident and factual, through evidence based practice.

The content of this unit will be covered over a two week period. During the first week In this unit, concept analysis will be examined as a way to best understand a concept. The readings in the Learning Resources presented a number of approaches to formal concept analysis. Each method has strengths and weaknesses. In this discussion, students will apply some of the concept analysis approaches to a selected concept of their choice. This assignment is intended to allow the student to show evidence of achieving desired learning outcomes (CLO #3, ILO #7 & PLO #7).

To do this, select a concept of interest you want to examine (i.e. pain, family support, palliation, mobility, trust, ischemia, etc.). 

“Submit a post that articulates some strategies to utilize the strengths and compensate for the weaknesses of two different concept analysis methods on the selected concept of your choice”.

Child abuse and maltreatment is not limited to a particular age and can occur in the infant, toddler, preschool, and school-age years. Choose one of the four age groups (infant, toddler, preschool, or school age) and discuss the types of abuse that are most often seen in this age. Discuss warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse. Discuss cultural variations of health practices that can be misidentified as child abuse. Describe the reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse. Please use california as my state.