DNP 835 Identify a practice-level outcome study and describe the expectation of its effect on health care

Outcome measures are significant in showing the worth of the Advanced Practice Nurse’s role in health care. Identify a practice-level outcome study and describe the expectation of its effect on health care.

While people of all ages receive emergency and critical care services across the world, the elderly population continues to exhaust a greater proportion of these services [1]. The complexity and acuity of care have heightened with greater prevalence of chronic illness and multimorbidity among older adults [2]. Correspondingly, the demand for emergency and critical care services has increased [1],

alongside a concomitant increase in the forecasted workforce requirements for such services [3]. The Accreditation Council for Graduate Medical Education regulations in 2006 in the United States of America (USA) recommends a high-intensity model of care involving 24-h physician coverage [3, 4]. This implementation accentuates inadequacies of the healthcare workforce to provide emergent and critical care services. In the USA, it is predicted that, compared to healthcare system’s demands, there will be a 22% shortfall of critical care physicians by 2020 and a subsequent 35% shortfall by 2030 [1].

With the impending rise in demand for health services, an effective utilization of the workforce is paramount to ensure high-quality yet cost-effective health service delivery [5]. Across some countries, healthcare workers’ wages account for approximately 50% of the total healthcare expenditure [6]. Hence, cost containment strategies will inevitably involve the workforce [7]. Efforts are underway for measures to enhance productivity through increasing the capacity of the workforce.

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One potential measure is a greater utilization of nurses in advance practice. The global annual growth of the nurse practitioner (NP) workforce has been estimated to be between three to nine times greater compared to physicians; therefore, of interest to health policymakers is the utilization of NPs and advanced practice nurses (APNs) [8, 9]. The nomenclature varies internationally. The “NP” title is used in Australia, Belgium, Canada, Sweden, the United Kingdom (UK), and the USA whereas the “APN” title is used in Switzerland, Singapore, and South Korea [10]. Nonetheless, NPs and APNs (NP/APNs) are registered nurses “who acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice” ([4], p. 26) and enter the workforce with a master’s degree [11].

This advanced practice role was first introduced in the 1960s as a solution to the lack of primary care physicians, to meet the primary care needs of the rural and underserved populations [12]. Primary care has first contact with patients and, subsequently, provides continuity of care within the healthcare system through the coordination of care according to patients’ needs [13]. Studies to evaluate the quality of primary care provided by NP/APNs have been shown to be comparable to that of physicians in terms of effectiveness and safety [14]. To fulfill primary care needs, NP/APNs in this setting are trained generalists who have a breadth of knowledge to render a wide scope of care.

Since the inception of advanced nursing practice in primary care, its role has extended to other healthcare settings such as the acute care. Acute care provides short-term restorative stabilization to patients in unstable chronic conditions and with complex acute and critical illnesses. Acute care encompasses emergency and critical care [15]. Emergency and primary care advanced nursing practice do share similarities in that they serve as first-contact access to healthcare, but the acuity of the patient manifestations delineates the two. Unlike in primary care NP/APNs, emergency NP/APNs are trained to manage patients with acute life- or limb-threatening conditions [15]. In the past decade, greater practice autonomy has been given to NP/APNs in emergency and critical care. This expanded practice allows nurses to assume some medical tasks typically performed by physicians, aiming at not only increasing the access to healthcare and service efficiency but also eventually mitigating the cost of health services.

The development of advanced nursing practice contributed to a service model aiming to respond flexibly to the ever-changing needs of patients [16]. Systematic reviews of studies on the effectiveness and safety of NP/APN-led primary care have reported positive effects of NP/APN service on clinical outcomes, patient satisfaction, and costs [14, 17] These reviews focused on the primary care setting, it may be inappropriate to extrapolate their findings to the emergency and critical care settings since the patient acuity and clinical needs differ among settings.

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Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

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Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

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Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed
• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• Student paper example
• Citing Sources
• The Writing Center is a great resource