SEMINARON

Independent practiceissues in nursing

Definition

• NURSE PRACTIONERSNurse practitioners (NPs) are registered

nurses who have graduate level nursing preparation as a nurse practitioner at the master’s or doctoral level and perform comprehensive assessments and promote health and the prevention of illness and injury.

NURSINGAccording to Virginia Anderson

Assisting the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to a peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge. And to do this in such a way as to help him gain independence as soon as possible.

CONCEPT OF NURSE PRACTIONERS• History• Qualification• Scope of practice

→ Diagnosing, treating, evaluating and managing acute and chronic illness and disease (e.g. diabetes, high blood pressure)

→ Obtaining medical histories and conducting physical examinations→ Ordering, performing, and interpreting diagnostic studies (e.g., routine lab tests, bone x-rays,

ECGs)→ Prescribing physical therapy and other rehabilitation treatments→ Prescribing drugs for acute and chronic illness (extent of prescriptive authority varies by state

regulations)→ Providing prenatal care and family planning services→ Providing well-child care, including screening and immunizations→ Providing primary and specialty care services, health-maintenance care for adults, including

annual physicals→ Providing care for patients in acute and critical care settings→ Performing or assisting in minor surgeries and procedures (with additional training and/or

under physician supervision in states where mandated; e.g. dermatological biopsies, suturing, casting)

→ Counseling and educating patients on health behaviors, self-care skills, and treatment options

KEY ISSUES TO CONSIDER - PROFESSIONAL ISSUES

1. Implications of dual registration2. Use of the title ‘RN’3. Conflict of interest4. Endorsement5. Advertising6. Fees7. Informed consent8. Managing information

AREAS OF INDEPENDENT NURSING PRACTICE

• ENTERPRISE• CONSULTANCY• GERIATRIC NURSING• MEDICAL SURGICAL NURSING PRACTICE• PAEDIATRIC NURSING• PSYCHIATRIC NURSING

RESPONSIBILITY OF A INDEPENDENT NURSE PRACTIONER

• UNIVERSAL PRECAUTION• UNACCEPTABLE PRACTICES• VERIFYING RECIPIENT ELIGIBILITY• PRIVATE DUTY NURSING REQUIREMENTS• EMERGENCY AND BACK-UP PROCEDURES• WRITTEN STATEMENT OF RECIPIENT RIGHTS• CONTRACTS WITH RECIPIENT AND/OR FAMILY• REQUIRED INFORMATION FOR MEDICAL RECORD• TERMINATING SERVICE TO A RECIPIENT

• These advanced practice registered nurses diagnose; develop differential diagnoses; order, conduct, supervise, and interpret diagnostic and laboratory tests; and prescribe pharmacologic and non-pharmacologic treatments in the direct management of acute and chronic illness and disease. Nurse practitioners provide health and medical care in primary, acute, and long-term care settings. NPs may specialize in areas such as family, geriatric, pediatric, primary, or acute care. Nurse practitioners practice autonomously and in collaboration with other healthcare professionals to treat and manage patients’ health programs, and serve in various settings as researchers, consultants, and patient advocates for individuals, families, groups and communities.