Nursing Case Study Practitioner Scope of Practice

To complete this assessment you will develop a statement of the scope and context of your NP role. This statement may evolve over time and should be suitable for inclusion in your professional portfolio.

See NMBA Guidelines on endorsement as a Nurse Practitioner

http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Codes-Guidelines.aspx

The statement will be marked against the following minimum criteria

• Focus of nursing activities e.g. clinical speciality, health promotion, research, management
• Type of practice setting e.g. public, private, clinic, hospital, community
• Location of practice setting – urban, rural and remote
• Characteristics of clients, family, group and/or community e.g. health status, age, learning needs, cultural and social considerations, etc;
• Complexity of practice e.g. practice guidelines/professional standards, clinical interventions
• Degree of autonomy
• Resources available – clinical support and resources, insurance coverage, quality assurance, risk management, accountability, relevant legislation
• Compare and contrast your current role and responsibilities with those proposed for your role as an NP
• All aspects of the Grading Matrix

The statement should be written in an essay format including relevant subject headings and be well referenced supported by best available evidence.

Introduction

Nurse practitioners are categorized under advanced practice nurses and responsible for facilitating optimal care services to patients in a personalized environment. They differ from registered nurses in their educational qualification and practice skills. They hold a master degree in nursing with specialization in a particular domain of nursing.

In Australia, one of the fastest growing generations is the old age or older persons. With advancement in age, their mobility, functionality decreases and they are more prone to increased dependency on others or residential care. At times, they get admitted to the emergency department demanding expert medical and nursing care in case of complex needs.

Nurse practitioner makes use of clinical skills, experience and knowledge in the subject domain to assess, plan and evaluate different nursing interventions in a person-centered approach. This forms the scope of practice for the nurse practitioners. Their improved and enhanced knowledge and clinical care skills not only help in improving patient health status but also reduce the cost of healthcare and staying at hospitals.

Research suggests nurse practitioners can effectively reduce the waiting times and in turn, it helps in increase in GP time in complex cases (Chenoweth et al, 2010). They look after enhancing communication skills, maintenance of consistency in care and continuity in health care through effective collaboration and integrated medical care. A number of factors determine the success of a nurse practitioner role such as support from organizational policies, support from the legislative framework, support from guidelines etc.

The biggest barrier to recognition and performance of a nurse practitioner role is a lack of acceptance of their role by other healthcare professionals and patients. At times ambiguity in role and responsibilities among different colleagues lead to such issues. Similarly, the challenge of training and education to such highly skilled nursing professionals pose as a barrier to the optimal nurse practitioner role definition.

The current essay deals with the nurse practitioner scope of practice in an aged care system. In recent years, the numbers of older patients getting admitted to the aged care system have increased owing to a lack of early intervention and poor diagnosis. Research shows increased care with advanced knowledge and skill can qualitatively and quantitatively improve the quality of life in the case of older patients.

Nurse practitioner's role has been well appreciated and reported in aged care homes especially in USA and UK (King et al, 2013). They have significantly contributed towards a reduction in the cost of medications and acute care admissions. Interdisciplinary team collaboration is another strong area of nurse practitioner that has significantly improved the healthcare outcomes in adult care settings. Nurse practitioners not only help patients and healthcare department by providing services, but also help the residential nurses to gain knowledge, learn skills, and implicate them in practice through proper coaching and proper mentoring.

In short, nurse practitioners can be considered as champions of the nursing domain. Their multi-tasking ability, multi-disciplinary knowledge, and collaboration, diversified clinical skills at times seem conflicting with roles and responsibilities of other health care professionals, In order to avoid such confusions, it is necessary to understand the scope of practice of nurse practitioners in aged care.

Scope Of Practice

The scope of practice for nurse practitioners in aged care involves the following responsibilities and roles

Advance assessments of patients, ordering pathological tests like pathological test and radiology, can prescribe medications from the agreed formulations, can refer patients to other departments in context of their health status and need, discharge planning, care of patients in case of non-emergency situations like infection, injury, end of life care planning, palliative care, case management by collaborating with other allied professionals like pharmacist, aged care specialists etc.

The nurse practitioner must not involve in emergency situations beyond their scope of practice, repetitive work practices must be avoided in the case of the nurse practitioner as these works can be carried out by allied health professionals.