NUR 512 Discussion 1: Barriers for Advanced Nursing Practice

Sample Answer for NUR 512 Discussion 1: Barriers for Advanced Nursing Practice Included After Question

NUR 512 Describe 3 barriers that have slowed down the progress of advanced practice nursing and strategies to help overcome these barriers. (Saunders, 2014)

Module 1 Discussion

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icon Barriers for Advanced Practice Nursing


Describe three barriers that have slowed down the progress of advanced practice nursing and strategies to help overcome these barriers. (Saunders, 2014)

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
  • You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 
  • All replies must be constructive and use literature where possible.
  • Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
  • You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date. 
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Grading Rubric 


Your assignment will be graded according to the grading rubric.

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Discussion Rubric
CriteriaRatingsPoints
Identification of Main Issues, Problems, and ConceptsDistinguished – 5 points
Identify and demonstrate a sophisticated understanding of the issues, problems, and concepts.
Excellent – 4 points
Identifies and demonstrate an accomplished understanding of most of issues, problems, and concepts.
Fair – 2 points
Identifies and demonstrate an acceptable understanding of most of issues, problems, and concepts.
Poor – 1 point
Identifies and demonstrate an unacceptable understanding of most of issues, problems, and concepts.
5 points
Use of Citations, Writing Mechanics and APA Formatting GuidelinesDistinguished – 3 points
Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing. High level of APA precision and free of grammar and spelling errors.
Excellent – 2 points
Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. Moderate level of APA precision and free of grammar and spelling errors.
Fair – 1 point
Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing. APA style and writing mechanics need more precision and attention to detail.
Poor – 0 points
Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing. APA style and writing mechanics need serious attention.
3 points
Response to Posts of PeersDistinguished – 2 points
Student constructively responded to two other posts and either extended, expanded or provided a rebuttal to each.
Fair – 1 point
Student constructively responded to one other post and either extended, expanded or provided a rebuttal.
Poor – 0 points
Student provided no response to a peer’s post.
2 points
Total Points 10

A Sample Answer For the Assignment: NUR 512 Discussion 1: Barriers for Advanced Nursing Practice

Title: NUR 512 Discussion 1: Barriers for Advanced Nursing Practice

Advanced Practice Nursing Barriers

The nursing practice continues evolving due to progressive patient care needs and workplace issues. Amid these developments, the role of advanced nursing practitioners continues to be critical in patient care delivery, organizational change, and the evolution of nursing. There is also an urgent need for adequate nurse practitioners and continued support to enable them to provide care according to their education and training. However, many barriers exist in advancing nursing practice affecting nurse practitioners’ roles and hampering other aspects of care. The purpose of this discussion is to explore these barriers and potential solutions.

Barriers

Barriers to advanced nursing practice include regulation factors, job characteristics, and organizational factors. Savatteri et al. (2021) found that the lack of standard regulations across states affects how nurse practitioners work and influence patient care across states. In some states, the lack of independent practice limits nurse practitioners’ role since they cannot work to the full extent of their training and education. This limitation further affects practitioners’ availability, particularly in rural areas where healthcare access and affordability problems are rampant (Ortiz et al., 2018). The other barrier to advanced nursing practice is inadequate knowledge and skills to work in primary care settings. Savatteri et al. (2021) observed that the availability of opportunities and access to special education for nurse practitioners are still limited. This barrier affects nurse practitioners’ availability and ability to implement their roles competently. The third barrier is the high nursing shortage. Typically, nurse practitioners work to the best of their ability when they are not overwhelmed. The nursing shortage hampers nurse practitioners’ job satisfaction, resulting in nurse turnover.

Strategies to Overcome Barriers

These barriers require multidimensional interventions due to their multilayered nature. The first practical intervention is to expedite the implementation of full practice authority across states. In full practice authority states, nurse practitioners can work independently to the full extent of their training without physician supervision (Ortiz et al., 2018). Such an intervention would be pivotal in the progress of advanced practice nursing since it will increase the availability of advanced nurse practitioners. The knowledge and training problem can be addressed by increasing opportunities for nurse training and supporting nurse education. The government should invest in robust nurse training programs at the local level to increase access to education. Increased training opportunities can also help to address the nursing shortage problem. Healthcare organizations should further develop robust organization-wide interventions to prevent nurse turnover to avoid the loss of skills associated with nurse turnover.

Conclusion

Patients require timely and adequate healthcare services irrespective of their needs, severity of illnesses, and other factors. However, such care cannot be addressed without effective solutions to barriers to advanced nursing practice. As highlighted in this discussion, barriers are manifold and include practice regulations, education and training problems, and a nursing shortage. These problems affect different states differently due to the difference in regulations, resources, and the number of nurse practitioners and physicians. Therefore, interventions should be state-centered, and support should be diverse according to the specific needs of an area, state, or organization. A commitment from the government and healthcare leaders is crucial to achieving a sustainable solution.

References

Ortiz, J., Hofler, R., Bushy, A., Lin, Y. L., Khanijahani, A., & Bitney, A. (2018). Impact of nurse practitioner practice regulations on rural population health outcomes. Healthcare (Basel, Switzerland)6(2), 65. https://doi.org/10.3390/healthcare6020065

Savatteri, A., Calafato, T. L., Mazzoleni, B., Barisone, M., & Dal Molin, A. (2021). Barriers and facilitators to the implementation of nurse’s role in primary care settings: an integrative review. BMC Nursing20(1), 1-12. https://doi.org/10.1186/s12912-021-00696-y

According to the American Nurses Association (2023), advanced practice nurses (APNs) ought to have access to a platform to fully apply the knowledge and abilities they have acquired via education and training. However, the current obstacles prevent nurse practitioners from fully utilizing their expertise in practice. At the state and federal levels, APNs face several practice barriers.

Advanced practice nurses have a limited role due to collaborating with physicians for hospital admissions and prescription power. It is important to note that some medical practitioners can ruin their cooperative relationship with APRNs by being confrontational or refusing to assist them, such as by opting against signing off reports (Kleinpell et al., 2021). Furthermore, some doctors believe APRNs are encroaching on their domain and cutting into their expertise (Kleinpell et al., 2021). The traditional healthcare model has consistently positioned doctors as the experts; as a result, doctors who are used to this approach exhibit opposition.

According to Kleinpell et al. (2022), the American Association of Nurse Practitioners (AANP) defines three practice contexts: decreased authority, restricted practice, and full practice. Nurse practitioners (NPs) have full practice authority, which allows them to diagnose patients, order and interpret diagnostic tests, write prescriptions, and manage patient care (Kleinpell et al., 2022). However, NPs’ participation in at least one aspect of NP practice in settings with less authority is limited by licensure requirements and practice.

Lastly, the two-level pricing structure is still a barrier even though the Primary Care Health Practitioner Incentives Act permits NPs to be compensated for their services (Torrens et al., 2020). Since independent practice is outside the purview of nurse practitioners, despite their entitlement to full reimbursement for incident-to-services, it presents an additional barrier to the growth of autonomous practices and patient accessibility to advancements. In some cases, reimbursement can get even more complicated when APRNs are required by a collaborative agreement to bill services under a doctor’s name.

Interprofessional education promotes a collaborative environment between APRNs and doctors to enhance patient outcomes. The training will raise understanding and appreciation of the skills and abilities of APRNs (Kleinpell et al., 2021). Handling concerns regarding the scope of practice will help doctors and APRNs understand their respective roles and duties (Kleinpell et al., 2021). Through interprofessional education, doctors can better appreciate the contributions advanced practice registered nurses (APRNs) make to healthcare and realize that the goal of the modern health model is to enhance patient care.

States are currently putting Full Practice Authority (FPA) into effect after making some of the short-term adjustments made during the COVID-19 pandemic permanent (Giovenco, 2021). In the future, perhaps, more states should pass laws that remove restrictions on advanced practice registered nurses (APRNs’) practice and allow them to practice to the fullest extent permitted by their education and certification (Giovenco, 2021). This is because patient care and outcomes will increase in FPA states, encouraging restrictive governments to loosen their limitations.

Nursing leaders and organizations should advocate for equitable APRN reimbursement by scrutinizing and enhancing existing regulations. As more states enact laws that support and acknowledge advanced nursing practitioners, advancements in resolving payment concerns will be made gradually; advancements can also be made by persistent and ongoing lobbying.

References

American Nurses Association. (2023). Advanced Practice Registered Nurses (APRN). ANA. https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/aprn/

Links to an external site.

Giovenco, M. (2021). Lessons the Long-Term Care Industry Can Learn from the COVID-19 Pandemic. Stetson L. Rev., 51, 123.

Kleinpell, R., Myers, C. R., Schorn, M. N., & Likes, W. (2021). Impact of COVID-19 pandemic on APRN practice: Results from a national survey. Nursing outlook, 69(5), 783-792.

Kleinpell, R., Myers, C. R., Likes, W., & Schorn, M. N. (2022). Breaking down institutional barriers to advanced practice registered nurse practice. Nursing Administration Quarterly, 46(2), 137-143.

Torrens, C., Campbell, P., Hoskins, G., Strachan, H., Wells, M., Cunningham, M., … & Maxwell, M. (2020). Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: a scoping review. International journal of nursing studies, 104, 103443.

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