高度実践看護:統合アプローチ(第4版)<br>Advanced Practice Nursing : An Integrative Approach (4TH)

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高度実践看護:統合アプローチ(第4版)
Advanced Practice Nursing : An Integrative Approach (4TH)

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  • 製本 Hardcover:ハードカバー版/ページ数 822 p.
  • 言語 ENG
  • 商品コード 9781416043928
  • DDC分類 610.73

基本説明

Brandon/Hill Nursing List selection (#196). Textbook covers the history of advanced practice nursing, theory behind the practice, and emerging issues. Covers discrete management and treatment interventions. For graduate students and advanced practice nurses. Previous edition: c2005.

Table of Contents

  PART I HISTORICAL AND DEVELOPMENTAL ASPECTS
OF ADVANCED PRACTICE NURSING
A Brief History of Advanced Practice 3 (30)
Nursing in the United States
Arlene W. Keeling
Introduction 3 (1)
Late Nineteenth Century: Historical Roots 3 (2)
Nurse Anesthetists 3 (1)
Nurse-Midwives 4 (1)
Psychiatric Specialization in Nursing 4 (1)
``Primary Care'' 4 (1)
1900-1950s: Innovation and Growth 5 (9)
Turn of the Twentieth Century 5 (1)
The Specialities, Circa 1900s 6 (1)
1910s: The Impact of the Progressive 6 (1)
Era and World War I
Nurse Anesthetists, Circa 1910s 6 (1)
Nurse-Midwives, Circa 1910s 7 (1)
1920s: The Roaring 20s 7 (1)
Nurse Anesthetists, Circa 1920s 7 (1)
Nurse-Midwives, Circa 1920s 8 (1)
The Frontier Nursing Service: A New 8 (1)
Model for Nurse-Midwives
1930s: The Great Depression 8 (1)
Nurse Anesthetists, Circa 1930s 9 (1)
Nurse-Midwives, Circa 1930s 9 (1)
``Primary Care,'' Circa 1930s 9 (1)
Clinical Specialization in Psychiatry, 10 (1)
Circa 1930s
1940s: World War II Challenges the 10 (1)
Nation and the Profession
Nurse Anesthetists, Circa 1940s 11 (1)
Nurse-Midwives, Circa 1940s 12 (1)
Psychiatric Nursing, Circa 1940s 12 (1)
1950s: The Growth of Hospitals, 12 (1)
Scientific Nursing, and the GI Bill
Nurse Anesthetists, Circa 1950s 13 (1)
Nurse-Midwives, Circa 1950s 13 (1)
Psychiatric Clinical Nurse Specialists, 13 (1)
Circa 1950s
American Nurses Association Defines 14 (1)
Nursing Practice, Circa 1950s
1960s: Technology and Role Expansion 14 (3)
Nurse Anesthetists, Circa 1960s 14 (1)
Nurse-Midwives, Circa 1960s 15 (1)
Clinical Nurse Specialists, Circa 1960s 15 (1)
Nurse Practitioners, Circa 1960s 15 (1)
Physician Assistants 16 (1)
1970s: Building Credibility and Defining 17 (3)
Practice
Nurse Anesthetists, Circa 1970s 17 (1)
Certified Nurse-Midwives, Circa 1970s 17 (1)
Clinical Nurse Specialists, Circa 1970s 18 (1)
Nurse Practitioners, Circa 1970s 18 (2)
1980s: Maturation 20 (3)
Nurse Anesthetists, Circa 1980s 21 (1)
Nurse-Midwives, Circa 1980s 21 (1)
Clinical Nurse Specialists, Circa 1980s 21 (1)
Nurse Practitioners, Circa 1980s 22 (1)
1990s: Responding to Regulatory and 23 (2)
Health Care Change
Nurse Anesthetists, Circa 1990s 23 (1)
Nurse-Midwives, Circa 1990s 23 (1)
Clinical Nurse Specialists, Circa 1990s 23 (1)
Nurse Practitioners, Circa 1990s 24 (1)
The Twenty-First Century: New Challenges 25 (1)
The American Association of Colleges of 26 (1)
Nursing and the Doctor of Nursing
Practice
Summary and Conclusions: Advanced 26 (7)
Practice Nursing in Context
Conceptualizations of Advanced Practice 33 (42)
Nursing
Fudith A. Spross
Marjorie Thomas Lawson
Introduction 33 (1)
The Nature, Purposes, and Components of 34 (1)
Conceptual Models
Conceptualizations of Advanced Practice 35 (1)
Nursing: Problems and Imperatives
Conceptualizations of Advanced Practice 36 (25)
Nursing
Professional Organizations' 37 (1)
Conceptualizations
American Nurses Association and the 38 (1)
American Board of Nursing Specialties
American Association of Colleges of 38 (1)
Nursing
National Council of State Boards of 39 (1)
Nursing
National Organization of Nurse 40 (1)
Practitioner Faculties
National Association of Clinical Nurse 41 (1)
Specialists
American Association of Nurse 41 (1)
Anesthetists and American College of
Nurse-Midwives
The APRN Joint Dialogue Group: A 42 (2)
Regulatory Model of Advanced Practice
Nursing
Summary/Implications for Advanced 44 (2)
Practice Nursing Conceptualizations
Conceptualizations of the Nature of 46 (1)
Advanced Practice Nursing
Fenton's and Brykczynski's Expert 46 (1)
Practice Domains of the Clinical Nurse
Specialist and Nurse Practitioner:
Building on Benner's Model of Expert
Practice
Calkin's Model of Advanced Nursing 47 (3)
Practice
Brown's Framework for Advanced Practice 50 (1)
Nursing
Strong Memorial Hospital's Model of 50 (2)
Advanced Practice Nursing
Oberle and Allen: The Nature of 52 (2)
Advanced Practice Nursing
Shuler's Model of Nurse Practitioner 54 (4)
Practice: A Theoretical Framework
Ball and Cox's Restoring Patients to 58 (1)
Health---Outcome and Indicators of
Advanced Nursing Practice in Critical
Care: A Theory of Legitimate Influence
Hamric's Integrative Model of Advanced 58 (3)
Practice Nursing
Summary/Implications for Advanced 61 (1)
Practice Nursing Conceptualizations
Models That Advanced Practice Nurses Will 61 (7)
Find Useful in Their Practice
Models Useful for Differentiating 62 (1)
Levels of Nursing practice
The American Association of 62 (1)
Critical-Care Nurses Synergy Model
Models Useful for Studying Outcomes of 63 (1)
Advanced Practice Nursing
Brooten's Model of Transitional Care 63 (1)
Models Useful for Conceptualizing 64 (1)
Interdisciplinary Practice
Dunphy and Winland-Brown's Circle of 64 (4)
Caring: A Transformative Model
Recommendations and Future Directions 68 (2)
Conceptualizations of Advanced Practice 68 (1)
Nursing
Consensus Building Around Advanced 69 (1)
Practice Nursing
Research on Advanced Practice Nurses 69 (1)
and Outcomes
Summary 70 (5)
A Definition of Advanced Practice Nursing 75 (20)
Ann B. Hamric
Introduction 75 (1)
Distinguishing Between Specialization and 75 (1)
Advanced Practice Nursing
Distinguishing Between Advanced Nursing 76 (1)
Practice and Advanced Practice Nursing
Defining Advanced Practice Nursing 77 (1)
Core Definition of Advanced Practice 77 (6)
Nursing
Conceptual Definition 78 (1)
Primary Criteria 79 (1)
Graduate Education 79 (1)
Certification 80 (1)
Practice Focused on Patient/Family 81 (2)
Seven Core Competencies of Advanced 83 (2)
Practice Nursing
Direct Clinical Practice: The Central 83 (1)
Competency
Additional Advanced Practice Nurse Core 84 (1)
Competencies
Scope of Practice 85 (1)
Differentiating Advanced Practice Roles: 85 (4)
Operational Definitions of Advanced
Nursing Practice
Critical Elements in Managing Advanced 89 (1)
Practice Nursing Environments
Implications of the Definition of 90 (3)
Advanced Practice Nursing
Implications for Advanced Practice 91 (1)
Nursing Education
Implications for Regulation and 91 (1)
Credentialing
Implications for Research 91 (1)
Implications for Practice Environments 92 (1)
Conclusion 93 (2)
Role Development of the Advanced Practice 95 (28)
Nurse
Karen A. Brykczynski
Introduction 95 (1)
Perspectives on Advanced Practice Nurse 95 (1)
Role Development
Novice-to-Expert Skill Acquisition Model 96 (2)
Role Concepts and Role Development Issues 98 (4)
Role Ambiguity 99 (1)
Role Incongruity 99 (1)
Role Conflict 100(1)
Intraprofessional Role Conflict 100(1)
Interprofessional Role Conflict 100(2)
Role Transitions 102(14)
Advanced Practice Nurse Role 102(2)
Acquisition (in Graduate School)
Strategies to Facilitate Role 104(2)
Acquisition
Advanced Practice Nursing Role 106(6)
Implementation (at Work)
Strategies to Facilitate Role 112(2)
Implementation
Facilitators and Barriers in the Work 114(1)
Setting
Continued Advanced Practice Nurse Role 114(2)
Evolution
Evaluation of Role Development 116(1)
Conclusion 116(7)
PART II COMPETENCIES OF ADVANCED PRACTICE
NURSING
Direct Clinical Practice 123(36)
Mary Fran Tracy
Introduction 123(1)
Direct Care Activities 123(3)
Direct Care and Indirect Care 123(3)
Six Characteristics of Direct Clinical 126(1)
Care Provided by Advanced Practice Nurses
Use of a Holistic Perspective 126(3)
Holism Described 126(2)
Holism and Health Assessment 128(1)
Nursing Model or Medical Model 128(1)
Formation of Therapeutic Partnerships 129(3)
with Patients
Shared Decision Making 129(1)
Cultural Influences on Partnerships 130(1)
Therapeutic Partnerships with 131(1)
Noncommunicative Patients
Expert Clinical Thinking and Skillful 132(7)
Performance
Knowledge 132(1)
Clinical Thinking 132(1)
Thinking Errors 133(1)
Time Pressures 134(1)
Direct Care and Information Management 135(2)
Ethical Reasoning 137(1)
Skillful Performance 138(1)
Advanced Physical Assessment 138(1)
Adverse Events and Performance Errors 138(1)
Use of Reflective Practice 139(1)
Use of Evidence as a Guide to Practice 140(2)
Research-Sensitive Practice 141(1)
Research-Based Practice 141(1)
Evidence-Based Practice 141(1)
Theory-Based Practice 141(1)
Diverse Approaches to Health and Illness 142(1)
Management
Interpersonal Interventions 142(1)
Telehealth, Information Technology, and 143(1)
Direct Care
Discrete Management and Treatment 143(4)
Interventions
Preventive Services in Primary Care 143(1)
Preventive Service in Hospitals and 144(1)
Home Care
Therapeutic Interventions 144(2)
Complementary and Alternative Therapies 146(1)
Individualized Interventions 146(1)
Management of Complex Situations 147(3)
Helping Patients Manage Chronic Illness 149(1)
Conditions Conducive to Provision of 150(2)
High-Quality Direct Care by Advanced
Practice Nurses
Healthy Work Environments 150(1)
Consultation, Collaboration, and 151(1)
Referral
Clinical Guidelines 151(1)
Population-Based Data to Inform Practice 151(1)
Contracts 152(1)
Conclusion 152(7)
Expert Coaching and Guidance 159(32)
Fudith A. Spross
Introduction 159(1)
Expert Coaching and Guidance by Advanced 160(1)
Practice Nurses
The Quality-Cost Model of Early 160(1)
Discharge and Nurse Specialist/Advanced
Practice Nurse Transitional Care
The Care Transitions Intervention Model 160(1)
Coaching Through Transitions: A Synthesis 161(6)
of Theoretical Perspectives
Coaching: An Interdisciplinary 161(1)
Perspective
Transitions 162(2)
A Typology of Transitions 164(2)
Characteristics, Conditions, and 166(1)
Outcomes of Transitions
The Foundations of Advanced Practice 167(5)
Nurse Coaching Through Transitions
A Model of Advanced Practice Nurses' 167(1)
Expert Coaching and Guidance
Technical Competence and Clinical 168(1)
Competence
Interpersonal Competence 169(1)
Advanced Communication Skills 169(2)
Therapeutic Relationships 171(1)
Self-Reflection 172(1)
Other Factors 172(1)
Advanced Practice Nurse Coaching: 172(4)
Assessment, Processes, and Outcomes
Assessment 172(2)
Processes and Outcomes 174(2)
Development of Advanced Practice Nurses' 176(4)
Coaching Competence
Graduate Nursing Education: The 178(1)
Influence of Faculty and Preceptors
Strategies for Developing and Applying 179(1)
the Coaching Competency
Expert Coaching and Guidance: Selected 180(4)
Issues
Helping Patients Manage Chronic Illness 180(1)
Health Disparities and Patient 181(1)
Navigator Programs
Evidence-Based Practice and 181(1)
Patient-Centered Care
Health Literacy 182(1)
Telehealth and Coaching 183(1)
Coaching ``Difficult'' Patients 184(1)
Conclusion 184(7)
Consultation 191(26)
Anne-Marie Barron
Patricia A. White
Introduction 191(1)
Consultation and Advanced Practice Nursing 192(1)
Defining Consultation 193(2)
Distinguishing Consultation from 193(2)
Co-management, Referral, and
Collaboration
Distinguishing Consultation from 195(1)
Clinical and Administrative Supervision
Background 195(1)
Consultation in Mental Health Practice 195(1)
Types of Consultation 195(1)
A Model of Advanced Practice Nursing 196(5)
Consultation
Principles of Consultation 196(1)
Description of the Model 196(1)
Purpose and Outcomes 197(1)
The Consultation Process for Formal 198(1)
Consultation
Formal and Informal Consultation 199(1)
Ecological Field of the Consultation 200(1)
Process
Characteristics of the Advanced 200(1)
Practice Nurse Consultant
Characteristics of the Consultee 201(1)
Patient and Family Factors 201(1)
Situational Factors 201(1)
Common Advanced Practice Nurse 201(4)
Consultation Situations
Advanced Practice Nurse-Advanced 201(3)
Practice Nurse Consultation
Advanced Practice Nurse-Physician 204(1)
Consultation
Advanced Practice Nurse-Staff Nurse 205(1)
Consultation
Mechanisms to Facilitate Consultation 205(2)
Issues in Advanced Practice Nurse 207(6)
Consultation
Developing Consultation Skills in 207(1)
Advanced Practice Nurse Students
Using Technology to Provide Consultation 208(2)
Documentation and Legal Considerations 210(1)
Stepping Out of the Consultation Process 211(1)
Developing the Practice of Other Nurses 212(1)
Consultation Practice Over Time 212(1)
Evaluation of the Consultation Competency 213(1)
Summary 214(3)
Research 217(32)
Fudith A. DePalma
Introduction 217(1)
Research Expectations of Advanced 218(1)
Practice Nurses
National Initiatives and Trends 219(3)
Quality and Safety Initiatives 219(1)
Information Technology and Telehealth 220(1)
Evidence-Based Practice 221(1)
Levels/Hierarchies of Evidence 221(1)
Health Care Organizations and 222(1)
Evidence-Based Practice
Interpretation and Use of Research and 222(12)
Other Evidence in Clinical Decision Making
Fundamental and Expanded Levels of 223(1)
Research Competency I
Phases of Competency I 223(1)
Stating the Problem or Clinical Question 223(2)
Searching for/Retrieving Evidence 225(3)
Evaluating and Interpreting Evidence 228(3)
Synthesizing the Evidence 231(1)
Making a Recommendation for Practice 232(1)
Implementing the Recommended 232(1)
Evidence-Based Practice Change
Evaluating the Recommended 233(1)
Evidence-Based Practice Change
Evaluation of Practice 234(3)
Fundamental and Expanded Levels of 234(1)
Competency II
Identifying Key Aspects of Practice to 235(1)
Evaluate
Ensuring Collection of Reliable and 236(1)
Valid Data
Determining If Practice Change Is 236(1)
Necessary Based on Evaluation Results
Participation in Collaborative Research 237(3)
Fundamental and Expanded Levels of 238(2)
Competency III
Acquiring and Developing Research 240(3)
Competencies
Post-Graduate Research Competency 242(1)
Development
Summary and Conclusion 243(6)
Clinical, Professional, and Systems 249(34)
Leadership
Fudith A. Spross
Charlene M. Hanson
Introduction 249(1)
The Context in Which Advanced Practice 249(1)
Nurses Exercise the Leadership Competency
Health Care System Transformation 250(1)
Redesign of Health Professional 250(1)
Education
Interdisciplinary Competencies 250(1)
Advanced Practice Nurses Competencies 250(1)
Leadership Domains of Advanced Practice 250(3)
Nurses
Clinical Leadership 251(1)
Professional Leadership 251(1)
Systems Leadership 252(1)
Health Policy Leadership 253(1)
Leadership: Definitions, Models, and 253(7)
Concepts
Definitions of Leadership 254(1)
Leadership Models That Lead to 254(2)
Empowerment and Transformation
The Fifth Discipline (Senge) 256(1)
The Value-Centered Leadership 257(1)
Model™ (Secretan)
The Seven Habits of Highly Effective 257(1)
People (Covey)
Leadership Models That Address Systems 258(1)
Change and Innovation
Diffusion of Innovation in Service 258(1)
Organizations (Greenhalgh and
Colleagues)
The Tipping Point (Gladwell) 258(1)
Concepts Related to Change 259(1)
Opinion Leadership 259(1)
Driving and Restraining Forces 259(1)
Pace of Change 260(1)
Defining Characteristics of the Advanced 260(3)
Practice Nurse Leadership Competency
Mentoring and Empowerment 261(1)
Mentoring 261(1)
Empowering Others 262(1)
Innovation and Change Agency 262(1)
Political Activism 263(1)
Attributes of Effective Advanced Practice 263(4)
Nurse Leaders
Vision 263(1)
Timing 264(1)
Self-Confidence and Risk Taking 265(1)
Expert Communication and Relationship 265(1)
Building
Boundary Management 265(1)
Self-Reflection 266(1)
Respect for Cultural Diversity 266(1)
Balance in Personal and Professional 266(1)
Life
Developing Skills as Advanced Practice 267(2)
Nurse Leaders
Factors Influencing Leadership 267(1)
Development
Power Resources 267(1)
Personal Characteristics/Experiences 268(1)
Strategies for Acquiring Competency as 268(1)
a Leader
Developing Leadership in the Health 269(5)
Policy Arena
Becoming an Astute Political Activist: 269(1)
The Growth Process
Depth of Involvement 270(1)
Using Professional Organizations to the 270(1)
Best Advantage
Political Action Committees 271(1)
Internships and Fellowships 271(1)
Raising Awareness Through Communication 271(1)
The Internet, E-Mail, Fax, and 272(1)
Telephone Communication
The Media 272(1)
Educating Policymakers and Legislators 272(1)
Educating the Public 272(1)
Special Interest Groups 273(1)
General Political Strategies 273(1)
Obstacles to Leadership Development and 274(2)
Effective Leadership
Professional and System Obstacles 274(1)
Horizontal Violence and Dysfunctional 274(1)
Leadership Styles
Abandoning One's Nursing Identity: The 274(1)
Star Complex
Hoarding or Misusing Power: The Queen 275(1)
Bee Syndrome
Failure to Mentor 275(1)
Strategies for Implementing the 276(2)
Leadership Competency
Developing a Leadership Portfolio 276(1)
Promoting Collaboration Among Advanced 277(1)
Practice Nurse Specialties
Motivating and Empowering Other 277(1)
Networking 277(1)
Engaging Others in Planning and 278(1)
Implementing Change
Institutional Assessment 278(1)
Summary 278(5)
Collaboration 283(32)
Charlene M. Hanson
Fudith A. Spross
Introduction 283(1)
A Conceptualization of Collaboration 284(3)
Domains of Collaboration in Advanced 284(1)
Practice Nursing
Collaboration with Individuals 284(1)
Collaboration with Teams/Groups 284(1)
Collaboration in Organizational and 284(1)
Policy Arenas
Collaboration in Global Arenas 284(1)
Definition of Collaboration 285(1)
Collaboration: What It Is Not 285(1)
Types of Collaboration: 286(1)
Multidisciplinary, Interdisciplinary,
Transdisciplinary
Characteristics of Effective Collaboration 287(3)
Clinical Competence and Accountability 288(1)
Common Purpose 288(1)
Interpersonal Competence and Effective 289(1)
Communication
Trust and Mutual Respect 289(1)
Recognition and Valuing of Diverse, 290(1)
Complementary Knowledge and Skills
Humor 290(1)
Impact of Collaboration on Patients and 290(6)
Clinicians
Evidence That Collaboration Works 291(1)
The National Joint Practice Commission 291(1)
Outcomes of Intensive Care Unit Stays 292(1)
Effect of Hospitalist Physician and 293(1)
Advanced Practice Nurse Collaboration
on Hospital Cost
Primary Care: Impact on Chronic Disease 293(1)
Management
Other Evidence 293(2)
Effects of Failure to Collaborate 295(1)
For Organizations 295(1)
For Individuals 295(1)
Imperatives for Collaboration 296(1)
The Ethical Imperative to Collaborate 296(1)
The Institutional Imperative to 296(1)
Collaborate
The Research Imperative to Study 297(1)
Collaboration
The Context of Collaboration in 297(4)
Contemporary Health Care
Incentives and Opportunities for 298(1)
Collaboration
Barriers to Collaboration 298(1)
Disciplinary Barriers 298(1)
Ineffective Communication and Team 299(1)
Dysfunction
Sociocultural Issues 300(1)
Organizational Barriers 300(1)
Regulatory Barriers 300(1)
Processes Associated With Effective 301(2)
Collaboration
Recurring Interaction 301(1)
Effective Conflict Negotiation and 302(1)
Resolution Skills
Bridging and Consensus Building 302(1)
Partnering and Teambuilding 303(1)
Implementing Collaboration 303(2)
Assessment of Personal, Environmental, 303(2)
and Global Factors
Strategies for Successful Collaboration 305(4)
Individual Strategies 305(1)
Team Strategies 306(1)
Organizational Strategies 306(3)
Conclusion 309(6)
Ethical Decision Making 315(34)
Ann B. Hamric
Sarah A. Delgado
Introduction 315(1)
Characteristics of Ethical Dilemmas in 315(2)
Nursing
Communication Problems 316(1)
Multidisciplinary Involvement 316(1)
Multiple Commitments 316(1)
Ethical Issues Affecting Advanced 317(4)
Practice Nurses
Primary Care Issues 317(1)
Acute and Chronic Care 317(1)
Societal Issues 318(1)
Access to Resources and Issues of 319(1)
Justice
Legal Issues 320(1)
The Ethical Decision-Making Competency of 321(15)
Advanced Practice Nurses
Phases of Core Competency Development 321(1)
Knowledge Development 321(2)
Developing an Educational Foundation 323(1)
Overview of Ethical Theories 323(3)
Professional Codes and Guidelines 326(1)
Personal and Professional Values 326(1)
Professional Boundaries 327(1)
Knowledge Application 327(1)
Ethical Decision-Making Frameworks 328(1)
Strategies for Resolution of Ethical 329(1)
Conflict
Creating an Ethical Environment 330(3)
Preventive Ethics 333(2)
Promoting Social Justice Within the 335(1)
Health Care System
Evaluation of the Ethical Decisionmaking 336(1)
Competency
Barriers to Ethical Practice and 337(5)
Potential Solutions
Intraprofessional Barriers 337(1)
Interprofessional Barriers 338(1)
Patient/Provider Barriers 339(1)
Organizational/Environmental Barriers 340(2)
Conclusion 342(7)
PART III ADVANCED PRACTICE ROLES: THE
OPERATIONAL DEFINITIONS OF ADVANCED PRACTICE
NURSING
The Clinical Nurse Specialist 349(31)
Patricia S.A. Sparacino
Cathy C. Cartwright
Introduction 349(2)
Profile of the Role 351(2)
Definition 351(1)
Distribution and Utilization 351(1)
Graduate Education and Programs 352(1)
Clinical Nurse Specialist Role: A Concept 353(1)
in Evolution
Clinical Nurse Specialist Practice: 353(13)
Spheres of Influence and Advanced
Practice Nursing Competencies
Direct Clinical Practice 354(3)
Expert Coaching and Guidance 357(2)
Patients and Families 359(1)
Nurses and Nursing Personnel 359(1)
Students 360(1)
Other Health Care Providers and the 360(1)
Public
Consultation 360(1)
Internal Consultation 360(1)
External Consultation 361(1)
Research 361(1)
Interpretation and Use of Research and 361(1)
Evidence in Practice
Evaluation of Practice 362(1)
Participation in Collaborative Research 363(1)
Clinical, Professional, and Systems 364(1)
Leadership
Collaboration 364(1)
Ethical Decision Making 365(1)
Exemplar of CNS Practice: An 366(1)
Integrative Perspective on CNS
Competencies and Spheres of Influence
Issues and Challenges 366(8)
Clinical Practice: Visibility and 367(1)
Viability
Role Entry and Role Development 367(1)
Focus on Direct Care 367(3)
Balancing Clinical Nurse Specialist 370(1)
Responsibilities
Organizational Placement 370(1)
Standardization: Education, 371(1)
Certification, and Practice
Education 371(1)
Certification and Credentialing 371(1)
Emerging Clinical Nurse Specialist 371(1)
Specialties
Legislative and Regulatory Challenges 372(1)
Prescriptive Authority 372(1)
Titling and Title Protection 373(1)
Reimbursement 374(1)
Conclusion 374(6)
The Primary Care Nurse Practitioner 380(23)
Ann Reid Anderson
Eileen T. O'Grady
Introduction 380(1)
Historical Roots of Primary Care In the 380(1)
United States
The Federal Government and Primary Care 381(2)
HRSA's Shortage Designation Branch 381(1)
Primary Care Access and the Health Care 381(1)
Home
Primary Care Workforce Composition 382(1)
Profile of the Primary Care Nurse 383(2)
Practitioner Role
Primary Care Nurse Practitioner Practice 383(1)
Nurse Practitioner Practice and the 384(1)
Nursing Process
The Doctor of Nursing Practice 385(1)
Advanced Practice Nurse Competencies in 385(10)
Primary Care Nurse Practitioner Practice
Direct Clinical Practice 386(1)
Reflective Practice: A Component of 386(2)
Direct Patient Care
Expert Coaching and Guidance 388(2)
Consultation 390(3)
Research 393(1)
Collaboration and Leadership 394(1)
Ethical Decision Making 395(1)
Exemplars of Primary Care Nurse 395(1)
Practitioner Practice
Advanced Practice Nurse Challenges and 395(4)
the Future of Primary Care
Overcoming Invisibility 395(3)
Removing Regulatory Barriers 398(1)
Caring for the Chronically Ill and Aging 398(1)
Reinventing the Primary Care 398(1)
Infrastructure
Convenient Care Clinics 399(1)
The Nurse Practioner as Disruptive 399(1)
Innovator
Conclusion 400(3)
The Acute Care Nurse Practitioner 403(34)
Marilyn Hravnak
Ruth M. Kleinpell
Kathy S. Magdic
Jane Guttendorf
Introduction 403(1)
Emergence of the Acute Care Nurse 403(1)
Practitioner Role
Shaping the Scope of Practice for the 404(7)
Acute Care Nurse Practitioner
National (Professional Organizations) 404(3)
State (Government) 407(3)
Institutional 410(1)
Service Related 411(1)
Individual 411(1)
Competencies of the Acute Care Nurse 411(6)
Practitioner Role
Acute Care Nurse Practitioner Specialty 412(1)
Competencies
Acute Care Nurse Practitioner Specialty 412(1)
Central Competency: Direct Clinical
Practice
Acute Care Nurse Practitioner Central 412(1)
Competency: Direct Clinical
Practice---Diagnosing and Managing
Disease
Acute Care Nurse Practitioner Central 413(4)
Competency: Direct Clinical
Practice---Promoting and Protecting
Health and Preventing Disease
Additional Advanced Practice Nurse Core 417(2)
Competencies as Enacted by Acute Care
Nurse Practitioners
Profiles of the Acute Care Nurse 419(5)
Practitioner Role
Acute Care Nurse Practitioner 422(1)
Differences and Commonalities with
Other Advanced Practice Nurse and
Physician Assistant Roles
Acute Care Nurse Practitioners and 423(1)
Physician Hospitalists
Outcome Studies Related to Acute Care 424(1)
Nurse Practitioner Practice
Acute Care Nurse Practitioner Role 424(2)
Implementation Examples
Role Vignettes in Other Clinical 424(1)
Practice Settings
Bone Marrow Transplantation Services 425(1)
Diagnostic and Interventional Services 425(1)
Heart Failure Services 425(1)
Orthopedic Services 425(1)
Rapid Response Team 425(1)
Preparation of Acute Care Nurse 426(1)
Practitioners
Reimbursement for Acute Care Nurse 427(3)
Practitioners
Medicare Reimbursement for Acute Care 429(1)
Nurse Practitioners in the
Office/Non-Hospital Clinic Setting
Medicare Reimbursement for Acute Care 429(1)
Nurse Practitioners in the Hospital
Inpatient/Hospital Outpatient/Emergency
Department
Critical Care Reimbursement for Acute 430(1)
Care Nurse Practitioners
Challenges Specific to the Acute Care 430(2)
Nurse Practitioner Role
Conclusion 432(5)
The Blended Role of the Clinical Nurse 437(25)
Specialist and the Nurse Practitioner
Patricia M. Hentz
Ann B. Hamric
Introduction 437(1)
Calls For Merging Clinical Nurse 438(1)
Specialist/Nurse Practitioner Roles:
Merging Versus Blending
Evolution of the Blended Role 438(1)
Early Descriptions of the Blended Role 438(1)
Recent Developments 439(1)
Health Care Trends Driving Evolution of 439(3)
the Blended Role
Changing Population Dynamics and Health 439(1)
Care Needs
Health Care Cost Containment and Quality 440(1)
Access and Affordability 441(1)
Increasing Specialty Knowledge Base 441(1)
Impact of Physician and Nursing 441(1)
Workforce Shortages
Profile of the Blended Role Advanced 442(8)
Practice Nurse
Settings 442(1)
Core Competencies: Framework for 442(1)
Practice
Expert Clinical Practice 443(1)
Ethical Decision Making 444(1)
Expert Guidance and Coaching of Other 444(2)
Care Providers, Patients, and Families
Consultation 446(1)
Research 447(1)
Leadership: Clinical, Professional, and 447(1)
Systems
Collaboration 448(1)
Differentiating Blended Role Practice 448(2)
from Other Advanced Practice Nurse Roles
Evaluation of Blended Role Practice 450(1)
Challenges in Implementation of the 451(2)
Blended Role
Titling 451(1)
Balancing Nurse Practitioner and 451(1)
Clinical Nurse Specialist
Responsibilities in the Blended Role
Impact on Physicians 452(1)
Accountability Issues 453(1)
Promoting Successful Role Development and 453(4)
Implementation: Strategies and Barriers
Dealing with Role Strain 454(1)
Educational Issues 455(1)
Certification 456(1)
A Look to the Future 457(1)
The Practice Doctorate 457(1)
New Blending Configurations 458(1)
A Call for a Cohesive Deliberative 458(1)
Approach
Conclusion 458(4)
The Certified Nurse-Midwife 462(27)
Cheryl A. Sarton
Maureen A. Kelley
Introduction 462(1)
Historical Perspective 463(1)
The Nurse-Midwifery Profession in the 463(6)
United States Today
Education and Accreditation 465(1)
Certification/Certification Maintenance 466(1)
Continuing Competency Assessment 466(1)
Re-entry to Practice 467(1)
Regulation, Credentialing, and 467(1)
Reimbursement
The American College of Nurse-Midwives 467(2)
Implementing Advanced Practice Nursing 469(6)
Competencies
Overview of Advanced Practice Nurse and 469(1)
Certified Nurse-Midwife Competencies
Direct Clinical Practice 470(1)
Expert Guidance and Coaching of 470(1)
Patients, Families, and Other Care
Providers
Consultation 471(1)
Collaboration 471(1)
Research 472(1)
Clinical and Professional Leadership 473(1)
Ethical Decision Making 473(1)
Advocacy 474(1)
The Current Practice of Nurse-Midwifery 475(2)
Scope of Practice 475(1)
Nurse-Midwifery Management Processes 475(1)
Independent Management 475(1)
Consultation 476(1)
Co-Management or Collaborative Care 476(1)
Referral 476(1)
Practice Settings 476(1)
Differences in Practice Between 477(1)
Nurse-Midwives and Other Providers
Certified Nurse-Midwife Practice Summary 477(1)
Exemplars of Nurse-Midwifery Practice 477(4)
Professional Issues 481(3)
Image 481(1)
Credentialing Non-Nurses (Direct-Entry 482(1)
Midwives)
Credentialing Nurse-Midwives 482(1)
Congruence/Incongruence of Midwifery 483(1)
Practice with Advanced Practice Nursing
Congruence with Physicians 483(1)
Practice Issues 484(1)
Legislative, Regulatory, and Financial 484(1)
Barriers
Workload 484(1)
Malpractice 485(1)
Quality and Safety 485(1)
Conclusion 485(4)
The Certified Registered Nurse Anesthetist 489(31)
Margaret Faut-Callahan
Michael J. Kremer
Introduction 489(1)
Brief History of Certified Registered 489(1)
Nurse Anesthetist Education and Practice
Role Differentiation Between Certified 490(1)
Registered Nurse Anesthetists and
Anesthesiologists
Profile of the Certified Registered Nurse 490(6)
Anesthetist
Certified Registered Nurse Anesthetist 490(1)
Scope and Standards of Practice
Certified Registered Nurse Anesthetist 491(1)
Credentialing Requirements
Certified Registered Nurse Anesthetist 491(1)
Certification
Institutional Credentialing of 491(1)
Certified Registered Nurse Anesthetists
American Association of Nurse 492(2)
Anesthetists Data Supporting Certified
Registered Nurse Anesthetist Practice
Profiles
Employment Factors 494(1)
Shortage Predictions 494(2)
Certified Registered Nurse Anesthetist 496(1)
Settings for Practice
Access to Care 496(1)
International Practice Opportunities 497(1)
Certified Registered Nurse Anesthetist 497(9)
Role Development and Measures of Clinical
Competence
Nurse Anesthesia as a Subculture of 497(1)
Advanced Practice Nursing
Direct Patient Care 498(3)
Collaboration 501(3)
Evidence-Based Practice and Leadership 504(1)
Accountability and Ethics 505(1)
Examplars 506(1)
Nurse Anesthesia Education 506(7)
Program of Study 512(1)
Doctor of Nursing Practice 512(1)
American Association of Nurse Anesthetists 513(1)
Organization and Structure 513(1)
Mission and Vision 514(1)
Safety and Quality Issues 514(1)
Continued Challenges 515(2)
Reimbursement for Nurse Anesthesia 515(1)
Clinical Services
Nurse Anesthesia Educational Funding 516(1)
Medicare Anesthesia Payment Teaching 517(1)
Rules
Summary 517(3)
Evolving and Innovative Opportunities for 520(23)
Advanced Practice Nursing
Jeanne Salyer
Ann B. Hamric
Introduction 520(1)
Patterns in the Evolution of Specialty to 520(3)
Advanced Practice Nursing
Innovative Practice Opportunities: Stage I 523(1)
Acute Care Nurse Practitioner 524(1)
Hospitalist Practice
Commentary: Stage I 524(1)
Specialties in Transition: Stage II 524(7)
Clinical Transplant Coordination 526(3)
Forensic Nursing 529(1)
Commentary: Stage II 529(2)
Emerging Advanced Practice Nursing Roles: 531(3)
Stage III
Wound, Ostomy, and Continence Nursing 531(1)
Genetics Advanced Practice Nursing 532(2)
Commentary: Stage III 534(1)
Established Advanced Practice Nursing 534(3)
Roles: Stage IV
Advanced Diabetes Manager 534(2)
Commentary: Stage IV 536(1)
Summary and Conclusions 537(6)
PART IV CRITICAL ELEMENTS IN MANAGING
ADVANCED PRACTICE NURSING ENVIRONMENTS
Business Planning and Reimbursement 543(32)
Mechanisms
Charlene M. Hanson
Sally D. Bennett
Introduction 543(1)
Business Planning: Principles of Practice 544(2)
Management
Designing and Delivering Care to 544(1)
Patients
Inventory of Skills 545(1)
Direct Processes of Care 546(3)
Direct Patient Care 546(1)
Mission, Vision, and Values 547(1)
Informed Consent 547(1)
Compliance with Health Insurance 548(1)
Portability and Accountability Act
Safety and Security 548(1)
Patient Communication 548(1)
Resolution of Complaints 548(1)
Clinical Relationships with Other Staff 549(1)
and Providers
Indirect Processes of Care 549(5)
Business Relationships 550(1)
Program and Business Structure 550(2)
External Regulatory Bodies 552(1)
Diagnostic Services 553(1)
Process Resources 554(3)
Facility, Equipment, and Supplies 554(2)
Managing Prescriptive Authority and 556(1)
Sample Medications
The Business Plan Summary 557(2)
Payment Mechanisms for Advanced Practice 559(12)
Nurses
Documentation of Services 560(1)
Medical Classification Systems 561(2)
Nursing Classification Systems 563(1)
Summary of Documentation 564(1)
Reimbursement for Advanced Practice 565(1)
Nurses
Fostering Patient Responsibility 565(1)
Payment Mechanisms 566(4)
Reimbursement Summary 570(1)
Pay for Performance 571(1)
Using Information Systems and Telehealth 571(1)
to Enhance Patient Care and Productivity
New Business Opportunities for Advanced 572(1)
Practice Nurses
Convenient Care Clinics 572(1)
Traveler Health Services 572(1)
Pain Management Clinics 572(1)
Hospitalist Services 572(1)
Conclusion 572(3)
Marketing and Contracting Considerations 575(30)
Donna R. Hodnicki
Health Care as a Business: A Call to 575(1)
Action for Advanced Practice Nurses
The Influence of Doctor of Nursing 575(1)
Practice Education on Advanced Practice
Nursing Marketing
The Influence of the Marketplace on 576(1)
Advanced Practice Nursing Marketing
What is Marketing? 576(3)
Classic Marketing Categories and 577(1)
Implementation Concepts
Product 577(1)
Price 577(1)
Place 578(1)
Promotion 578(1)
Partnering 579(1)
Applying Key Marketing Concepts to 579(3)
Advanced Practice Nursing Practice
Marketable Properties of Advanced 582(2)
Practice Nurses
External and Internal Marketing 583(1)
Public Relations, the Media, and 584(5)
Technology
Invisibility of Advanced Practice Nurses 584(2)
Effects of Negative Publicity 586(1)
Traditional Images of Nurses and 587(2)
Advanced Practice Nurses
Marketing Strategies for Advanced 589(5)
Practice Nurses
Transition Considerations for New 589(1)
Graduates
Strategies for the Nurse Entrepreneur 589(2)
Avoiding Marketing Missteps 591(1)
Strategies for Seeking Employment 592(1)
Professional Portfolio 592(1)
Resume and Curriculum Vitae 593(1)
Query and Cover Letters 593(1)
Interview Preparation 594(1)
Negotiating/Accepting a Position 594(1)
Contract Considerations 594(4)
Negotiating a Contract 594(1)
Employment Contracts 594(1)
Managed Care Contracts 594(2)
Collaborative Practice Agreements 596(1)
Service Agreements 597(1)
Professional Development Plan 598(1)
Marketing a Service 598(3)
Approaches to Marketing a Service 598(1)
Marketing to Physicians, Consumers, and 599(1)
Others
Keeping Up with Population, Clinical, 600(1)
and Business Trends
Conclusion 601(4)
Understanding Regulatory, Legal, and 605(22)
Credentialing Requirements
Charlene M. Hanson
Introduction 605(1)
Definitions 605(1)
State Licensure/Recognition 606(1)
Prescriptive Authority 606(1)
Drug Enforcement Administration Number 607(1)
Scope of Practice for Advanced Practice 607(2)
Nurses
Benchmarks of Advanced Practice Nursing 608(1)
and Education
Advanced Practice Nurse Competencies 608(1)
Professional Specialty Competencies 608(1)
Master's and Doctor of Nursing Practice 609(1)
Essentials
Standards of Practice and Standards of 609(1)
Care for Advanced Practice Nurses
Legal Concerns Surrounding Advanced 609(1)
Practice Nurse Titling
Components of Advanced Practice Nurse 610(5)
Credentialing and Regulation
Elements of Regulation for Advanced 610(1)
Practice Nursing
Credentialing 610(1)
Advanced Practice Nurse Master's and 611(1)
Doctoral Education
Advanced Practice Nurse Program 611(2)
Accreditation
Postgraduate Education 613(1)
Dual and Blended Role Education 613(1)
National Advanced Practice Nurse 613(1)
Specialty Certification
Recertification 613(1)
Mandatory Continuing Education 614(1)
Requirements
Mandatory Practice Requirements 614(1)
Institutional Credentialing 614(1)
Issues That Affect Advaced Practice Nurse 615(6)
Credentialing and Regulation
Collaborative Practice Arrangements 615(1)
National Provider Identifier Number 616(1)
Medicare/Medicaid Provider Numbers 616(1)
Reimbursement 616(2)
Risk Management, Malpractice, and 618(1)
Negligence
Liability Insurance 619(1)
Privacy Issues 620(1)
Health Insurance Protability and 620(1)
Accountability Act
Telehealth and Telepractice 620(1)
Safety and Cost Containment Initiatives 621(1)
Influencing the Regulatory Process 621(1)
For Novice or Any Advanced Practice 621(1)
Nurses
For Experienced or Expert Advanced 622(1)
Practice Nurses
Current Practice Climate for Advanced 622(1)
Practice Nurses
Visioning for Advanced Practice 623(1)
The Doctor of Nursing Practice 623(1)
The National Council of State Boards of 623(1)
Nursing Vision for a New Regulatory
Model for Advance Practice Nurses
The Consensus Group Vision for 624(1)
Education and Practice
Future Regulatory Challenges Facing 624(1)
Advanced Practice Nurses
Conclusion 624(3)
Health Policy Issues in Changing 627(30)
Environments
Eileen T. O'Grady
Jean E. Johnson
Introduction 627(1)
The Policy Process 627(8)
Policy as Historical Core Function in 627(1)
Nursing
Overview of the Health Policy Process: 627(1)
Politics Versus Policy
Politics 628(1)
Policy Framework 628(1)
Federalism 628(1)
Incrementalism 629(1)
Agenda Setting 629(2)
The Federal Budget Cycle 631(1)
Policy Formulation: How a Bill Becomes 632(1)
a Law
Congressional Committees 632(1)
House or Senate Floor Action 633(1)
Presidential Action 633(1)
The Interpretive Function of 633(1)
Rulemaking: Policy Implementation
Congressional Advisory Bodies 633(1)
Policy Modification 633(1)
Role of Public Comment 633(2)
Current and Emerging Health Policy Issues 635(12)
Relevant to Advanced Practice Nurses:
Cost, Quality, and Access
Health Care Costs 635(1)
Factors Offsetting Cost 635(2)
Cost Containment 637(2)
Health Care Quality 639(1)
Patient Safety 640(1)
Advanced Practice Nurses and Quality 641(1)
Measuring Quality 641(1)
Interdisciplinary Approach to Patient 642(1)
Care
Health Care Access 642(2)
Advanced Practice Nurses and Access 644(1)
Sources of Data That Inform Policy 644(1)
Decisions
Advanced Practice Nurse Health Policy 645(1)
Issues
Medicare 645(1)
Advanced Practice Nurse Medicare Payment 645(1)
Medicaid 645(1)
State Children's Health Insurance 646(1)
Program
Health Disparities 647(1)
Political Competence In The Policy Arena 647(6)
Health Policymaking: a Requisite skill 647(2)
for Individual Advanced Practice Nurses
Barriers to Political Competence 649(3)
Moving Advanced Practice Nurses Forward 652(1)
in Health Policy
Advanced Practice Nurse Policy Research 652(1)
Agenda
Advanced Practice Nurse Policy 653(1)
Initiatives
Conclusion 653(4)
Strengthening Advanced Practice Nursing in 657(24)
Organizational Structures: Administrative
Considerations
Brenda M. Nevidjon
Cynthia J. Simonson
Introduction 657(1)
Trends Driving Administrative Decision 658(7)
Making
The Changing Health Care Environment 658(2)
Care Delivery Systems and Financial 660(1)
Pressures
Financial Presures and Reimbursement 661(2)
Health Care Professional Shortages 663(1)
Quality and Safety 663(1)
Regulatory and Compliance Issues 664(1)
Common Problems and Strategies for 665(5)
Solving Them
Developing a Climate of Support for 665(1)
Advanced Practice Nurses
Modulating Interprofessional and 665(2)
Intraprofessional Tensions
Maximizing ``Profitability,'' 667(1)
Developing Policies, Procedures, and 668(1)
Protocols
Compliance with Regulatory Agencies 668(1)
Ensuring Patient Safety 669(1)
Technology and Informatics 670(1)
Strategies to Strengthen Advanced 670(6)
Practice Nursing Roles
Considerations When Applying for a 670(2)
Position
The ``Fit'' of the Advanced Practice 672(1)
Nurse Within the Organization
Organization Entry and Success 672(1)
Reporting Relationships 673(1)
Resources 674(1)
Measuring the Impact of Advanced 675(1)
Practice Nurses
Considerations For the Future 676(2)
Summary 678(3)
Outcomes Evaluation and Performance 681(52)
Improvement: An Integrative Review of
Research on Advanced Practice Nursing
Gail L. Ingersoll
Introduction 681(1)
Review of Terms 681(5)
Conceptual Models of Care Delivery Impact 686(4)
Quality of Care Models 687(1)
Value of Care Model 687(1)
Outcomes Evaluation Model 687(3)
Nursing Role Effectiveness Model 690(1)
The Evidence Thus Far 690(29)
Role Description Studies 691(1)
Role Perception/Acceptance Studies 692(1)
Care Delivery Process Studies 693(1)
Process-as-Outcome Studies 694(1)
Process (Performance) Improvement 695(1)
Activities
Disease Management Activities 695(1)
Outcomes Management Activities 696(1)
Outcomes Research 697(1)
Studies Comparing Advanced Practice 697(3)
Nurse and Physician Outcomes
Studies Comparing Advanced Practice 700(1)
Nurse and Physician Productivity
Studies Comparing Advanced Practice 701(1)
Nurse and Usual Pactice Outcomes
Studies Using Non-Comparsion Groups 701(1)
Program Evaluation 702(15)
Cost Analyses 717(1)
Summary of the Research Thus Far 717(2)
Using Evidence to Guide Individual 719(5)
Advanced Practice Nurse Performance Review
Advanced Practice Role Considerations 719(1)
Essential Elements of Advanced Practice 720(1)
Nurse Performance Review
The Evaluation Process 720(1)
Performance Review Components 720(1)
Self-Assessment 720(1)
Peer Review 720(2)
Customer Review 722(1)
Supporting Evidence 722(2)
Collating the Evidence 724(1)
Resource Needs 724(1)
Summary 724(9)
Outcomes Evaluation and Performance 733(38)
Improvement: Using Data and Information
Technology to Improve Practice
Vicky A. Mahn-DiNicola
Introduction 733(1)
Regulatory Initiatives That Drive 734(5)
Performance Improvement
Acute Care Hospitals 734(2)
Home Health Settings 736(1)
Nursing Home Settings 736(2)
Primary Care and Outpatient Settings 738(1)
Quality Improvement and Data Analytical 739(10)
Competencies Required For Advanced
Practice Nursing
Quality Improvement 739(1)
Continuous Quality Improvement 739(1)
Frameworks
Data and Outcomes Management 740(1)
Common Performance Measures 740(2)
Average Length-of-Stay Indicators 742(1)
Shared Accountability for Managing 743(1)
Utilization
Common Utilization Measures 743(3)
Productivity and Acuity Considerations 746(1)
Organizing Multi-Series Site 747(2)
Information to Evaluate Care Across the
Continuum
Organizational Structures and Cultures 749(1)
That Optimize Performance Improvement
Evolving Information Technologies That 749(6)
Affect Advanced Practice Nursing
Evidence-Based Practice 749(1)
Computerized Provider Order Entry 750(1)
Systems
Electronic Medical Record 750(3)
Integrated Data Management Systems 753(1)
Clinical Data Repository 754(1)
Clinical Data Warehouse 754(1)
Strategies For Designing Quality 755(14)
Improvement and Outcome Evaluation Plans
For Advanced Practice Nursing
Phases of Preparing a Plan for Data 755(1)
Analysis
Define the Core Questions 755(4)
Define the Data Elements 759(5)
Derive Meaning from Data and Act on 764(5)
Results
Summary 769(2)
Appendix A. Sample Employment Contract 771(4)
Appendix B. Sample Collaborative Practice 775(2)
Agreement
Appendix C. Sample Query Letter 777