The political environment significantly impacts the DNP's role as a Nurse Practitioner (NP) in primary care. Laws and regulations regarding NP practice vary from state to state, and som
I need help fixing the attached projects. All areas written in RED and those highlighted requires attention. I have also attached RUBRIC that should be used. Please follow these instructions.
1. The first project needs role to be changed from general RN to a DNP in a Clinic. Everything on this particular project need to be changed Please the instructions on it.
2. The areas needing attention in the second attached project are written in RED and highlighted
Part 2 MY ROLE IS THE DNP DON IN A CLINIC THIS IS GEARED MORE TOWARDS AN RN, ALSO PLEASE CHECK THE RUBRIC AND THE SAMPLE I ATTACHED. ALSO THE INTEXT CITATION NEED TO BE UPDATED.
PEST Analysis
Political influences:
The political environment significantly impacts the DNP's role as a Nurse Practitioner (NP) in primary care. Laws and regulations regarding NP practice vary from state to state, and some states have the more restrictive scope of practice laws for NPs. This can limit the ability of DNP-prepared NPs to practice to the full extent of their education and training. In states with the restrictive scope of practice laws, NPs may not be able to prescribe certain medications or perform certain procedures without physician oversight (Trautman et al., 2018). For example, some states require NPs to have a written or collaborative agreement with a physician to practice. This can limit the ability of NPs to provide care in certain settings, such as rural or underserved areas where there is a shortage of physicians. Additionally, the political environment can also affect reimbursement for NP services. Some insurance plans do not cover services provided by NPs, which can limit access to care for patients and affect the financial viability of NP-led practices.
Economic influences:
The current economic climate significantly influences the function of Nurse Practitioners (NP) with a DNP degree in primary care. There is a rising need for affordable healthcare as the rising expense of healthcare becomes a key issue for many Americans. Here's where NPs with doctoral degrees may make a huge difference in delivering affordable, high-quality treatment. A DNP-educated NP's ability to diagnose and treat common illnesses and injuries, as well as manage chronic conditions and provide preventative care, is one method in which she may deliver care that is both efficient and affordable. As a result, NPs are able to play a more significant role in primary care, which can help curb the demand for more costly specialized services (Larocco, 2021). Furthermore, NPs with a Doctor of Nursing Practice degree have the expertise to address the socioeconomic determinants of health and to plan and carry out interventions that improve population health and reduce the prevalence of the disease.
However, paying for NP services is sometimes difficult. Patients' access to care might be constrained, and NP-led practices' financial stability might be jeopardized by the fact that some insurance plans do not cover services delivered by NPs (Trautman et al., 2018). This can be a problem for both the patients whose insurance doesn't cover NP services and the NPs who deliver them. The ability of NPs to deliver care may also be constrained by states with a restricted scope of practice rules, which prohibit NPs from prescribing specific medications or doing specific procedures without the supervision of a physician. Patients may incur further expenses as a result, such as time and gas spent getting to and from medical appointments.
Social influences:
In primary care, the DNP job as a Nurse Practitioner (NP) is significantly influenced by the surrounding social milieu. Particularly in impoverished and rural areas, primary care doctors are in high demand. This need is being fueled by demographic shifts, including an aging population and an uptick in the prevalence of chronic diseases. Because of their extensive education and training, NPs are ideally prepared to address this shortage in primary care by diagnosing and treating common illnesses and accidents, overseeing the care of chronic disorders, and promoting overall health and wellness. However, not all patients will be familiar with NPs or comprehend the breadth of their responsibilities (Zaccagnini & Pechacek, 2021). Because of this misunderstanding, patients may be confused or distrustful of NPs, making it hard for them to build a clientele. It's also important to note that not all MDs and other medical professionals regard NPs as primary care doctors. Because of this stigma, NPs may have trouble establishing collaborative partnerships with other medical professionals.
In addition, there may be misconceptions about nurse practitioners (NPs) among the general public. Despite popular belief, research shows that nurse practitioners (NPs) deliver treatment that is on par with that of physicians in terms of quality and safety. Still, these ideas may have an impact on how patients and other medical professionals receive NPs. The DNP's primary care function can be complicated by language and cultural issues. Patient outcomes can be enhanced when NPs who speak languages other than English are able to communicate effectively with their patients. Improved patient outcomes can also be achieved through the NP's capacity to comprehend cultural beliefs and behaviors that may have an impact on health and healthcare. Healthcare policy and law are influenced by both the political and social contexts in which they are enacted. A Doctor of Nursing Practice (DNP) in primary care may be impacted by changes in healthcare policy and legislation pertaining to reimbursement for NP services, the scope of practice laws, and certification prerequisites. That's why it's crucial for nurses to know the latest developments in healthcare law and policy and to push for measures that recognize and reward their contributions to primary care.
Technological influences:
The primary care NP position held by those with DNP-prepared nurses is profoundly affected by the current state of technology. New diagnostic and therapeutic options, made possible by technological progress, have the potential to enhance health outcomes for patients. In rural or underserved locations, for instance, NPs can now employ telehealth technologies to treat patients remotely, confer with specialists, and access patient medical information. Access to care that might otherwise be unavailable can greatly enhance patient outcomes in these situations. In addition, NPs are now able to treat patients in underserved and rural areas thanks to the widespread adoption of electronic health records (EHRs). Nurse practitioners (NPs) can benefit from electronic health records (EHRs) because they give them access to patients' past medical history, current test results, and other relevant data that can be used to better care for their patients (Trautman et al., 2018). In addition, they facilitate enhanced physician-to-physician contact and care coordination, both of which contribute to enhanced patient outcomes. Although there are many benefits to using technology, there are also risks that NPs must consider. In this regard, the adoption of electronic health records (EHRs) can be both time-consuming and cumbersome for NP-led clinics. This makes it harder for NPs to spend quality time with patients and can contribute to burnout. Concerns concerning patients' privacy and security may also arise from the usage of telehealth devices. This raises concerns because the current state of development prevents assurance of the same level of privacy and security as face-to-face meetings. Patients with less access to technology or less technical expertise may be at a disadvantage while seeking medical care because of the increased reliance on technology. This can be especially difficult for NPs in rural or underdeveloped areas, where there may be fewer resources, such as computers. In addition, NPs may face difficulties due to the quickening pace of technical developments, which requires them to upgrade their knowledge and skills constantly. This calls for further study and instruction, which takes time and effort.
Implementation Strategies
Implementation strategies for the new role of DNP-prepared NPs in primary care should focus on obtaining stakeholder support and addressing potential funding and cost concerns.
Stakeholder Support: To gain stakeholder support for the new role of DNP-prepared NPs in primary care, it is important to educate stakeholders about the benefits of NPs in primary care and to demonstrate the cost-effectiveness of NP-led practices. This can be done through the use of data and research studies, as well as through the development of strong relationships with key stakeholders such as physicians, healthcare administrators, and policymakers.
Funding and Costs: To address potential funding and cost concerns, it is important to identify potential sources of funding for the new role, such as grants, Medicaid and Medicare reimbursement, and private insurance coverage (Zaccagnini & Pechacek, 2021). Additionally, it is important to demonstrate the cost-effectiveness of NP-led practices through the use of data and research studies.
Theoretical Framework: A theoretical framework can assist with the implementation of the new role by providing a clear and consistent approach to the implementation process. One potential theoretical framework that could be used is the Diffusion of Innovations Theory, which suggests that the adoption of new roles and practices is influenced by the perceived relative advantage, compatibility, complexity, trialability, and observability of the innovation.
Evaluation Methods: To determine the effectiveness of the new role, it is important to establish evaluation methods that can be used to measure the outcomes of NP-led practices. This can include patient satisfaction, quality of care, and cost-effectiveness measures. Additionally, it is important to involve stakeholders in the evaluation process to ensure that the new role is meeting their needs and expectations.
In summary, the implementation of the new role of DNP-prepared NPs in primary care requires a comprehensive approach that addresses stakeholder support, funding and costs, a theoretical framework, and evaluation methods. This will ensure the success of the role and its sustainability in the long term.
Summary
Primary care providers are in high demand in the United States, especially in underserved and rural areas. Because of their education and experience, Nurse Practitioners (NPs) are able to provide a wide variety of primary care services and may work in tandem with physicians, making them ideal candidates to fill this void. DNP-prepared NPs are better equipped to address this gap than MSN-prepared NPs because of their advanced education and training in areas such as leadership, quality improvement, and evidence-based practice; deeper familiarity with healthcare systems; and proficiency in using data to optimize patient outcomes. Practitioners with a Doctor of Nursing Practice degree have honed their abilities to draw on and apply information from a wide range of sources, with an eye on improving the health of communities as a whole. A DNP-educated NP may increase positive health outcomes, patient access, and healthcare efficiency.
Conclusion
There are benefits, drawbacks, chances, and dangers associated with the Doctor of Nursing Practice (DNP) function as a Nurse Practitioner (NP) in primary care. Because of their extensive training in leadership, quality improvement, and evidence-based practice, NPs with doctoral degrees are better able to fill the primary care gap. But they can have trouble being paid for their work and being recognized as primary care doctors by other specialists. The DNP's function as an NP in primary care is significantly influenced by political and economic factors, such as legislation and regulations that govern the scope of practice and reimbursement for services. Threats to the job include the COVID-19 pandemic and the fate of the Affordable Care Act. In general, nurse practitioners (NPs) should keep up with healthcare policy and legislation developments and push for measures that would strengthen their position as primary care providers.
References
American Association of Nurse Practitioners. (2021). National Nurse Practitioner Sample Survey. Retrieved from https://www.aanp.org/research/nurse-practitioner-sample-survey
Chapter 5- The role of Nurses in Improving Health Equity. pp 127-146. National Academies of Sciences, Engineering, and Medicine. 2021. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press. https://doi.org/10.17226/25982.
Health Resources and Services Administration (HRSA). (n.d.). Primary Care Shortage Areas. Retrieved from https://www.hrsa.gov/shortage-designation/primary-care-hpsas
Larocco, S. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. Arthur L. Davis Publishing Agency, Inc.
National Academies of Sciences, Engineering, and Medicine. 2021. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press. https://doi.org/10.17226/25982 The Role of Nurses in Improving Health Care Access and Quality
Trautman, D., Idzik, S., Hammersla, M., & Rosseter, R. (2018). Advancing Scholarship through Translational Research: The role of Ph.D. and DNP prepared nurses. OJIN: The Online Journal of Issues in Nursing, 23(2). https://doi.org/10.3912/ojin.vol23no02man02
Zaccagnini, M., & Pechacek, J. (2021). The Doctor of Nursing practice essentials. (4th Ed.). Burlington, MA: Jones & Bartlett Learning.
American Association of Colleges of Nursing. (2006). Essentials of doctoral education for advanced practice nursing. Retrieved from https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf
Facts about benefits of Joint Commission accreditation. (n.d.). A Trusted Partner in Patient Care | The Joint Commission. https://www.jointcommission.org/resources/news-and-multimedia/fact-sheets/facts-about-benefits-of-joint-commission-accreditation/
National Academies of Sciences, Engineering, and Medicine. 2021. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press (US), 2021 May 11, 3 The Nursing workforce Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK573922/
Pritham, U. A., & White, P. (2016). Assessing DNP impact using program evaluations to capture healthcare system change. The Nurse Practitioner, 41 (4), 44-53. https://doi.org/10.1097/01.npr.0000481509.24736.c8
Siddiqui, A. A. (2021). The use of Pestel Analysis Tool of Quality Management in the health care business and its advantages. American Journal of Biomedical Science & Research, 14(6), 507–512. https://doi.org/10.34297/ajbsr.2021.14.002046
The nursing workforce – The future of nursing 2020-2030 – NCBI bookshelf. (2021, May 11). National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/books/NBK573922/
Trautman, D., Idzik, S., Hammersla, M., & Rosseter, R. (2018). Advancing Scholarship through Translational Research: The role of PhD and DNP prepared nurses. OJIN: The Online Journal of Issues in Nursing, 23(2). https://doi.org/10.3912/ojin.vol23no02man02
Zaccagnini, M., & Pechacek, J. (2021). The Doctor of Nursing practice essentials. (4th Ed.). Burlington, MA: Jones & Bartlett Learning.
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Introduction
Background and Significance
Nursing practitioners play a crucial role within the health care delivery system. Rapid changes in healthcare delivery, financial constraints and consumer demand have impacted the practice of all healthcare providers and are critical factors in the emergence of the role of advanced practice in nursing. Nursing education have evolved over the years, however the process of educating and preparing healthcare providers has faced many challenges throughout history (Groccia & Ford, 2020). The education of nursing practitioners has grown to prepare nurses to identify social determinants of health (SDOH), improve population health, and promote health equity (National Academies of Sciences, Engineering, and Medicine, 2021). Nurse educators play a significant role in ensuring that student nurses are adequately prepared to achieve the course outcome and understand the curriculum. Additionally, nurse educators offer inspiration, mentorship and teach the next generation of nurses about the safe approach to future patient care. Having a DNP as a nursing school faculty member is essential because DNP-prepared nurses are well-equipped to fully implement the science developed by nurse researchers prepared in PhD, DNS, and other research-focused nursing doctorates (American Association of Colleges of Nursing, 2022). In addition, the evolving demands of the nation's complex healthcare environment require the highest levels of scientific knowledge and hands-on experience to ensure high-quality patient outcomes; the Institute of Medicine, the Joint Commission, the Robert Wood Johnson Foundation and other agencies have called for a redesign of the educational programs that prepare today's health workers (American Association of Colleges of Nursing, 2022).
The DNP Essentials take the current MSN Essentials and expand them to include a focus on population health; The practice doctorate also addresses the gaps previously identified in master ‘s programs such as practice management, health policy, information technology, risk management, utilization and translation of evidence based practice, and advanced diagnosis and management (Flanagan et al., 2021). According to McCauley et al., 2020, BSN prepared nurses without healthcare experience are enrolling in DNP programs to become system leaders and those with health care experience and are enrolling in DNP programs to become APRNs, who better to prepare them than DNP prepared nurses. (Giardino, 2014)
Literature Review
Nurse educators with the DNP degree are trained to develop a connection between nursing education and nursing practice. Bellini et al., (2012) argues that to ensure academic nursing progression and active clinical practice are achieved, nursing schools need to have a DNP or PhD as a faculty member as they tend to have the ability to infuse extensive nursing practice knowledge in the nursing curriculum, and this can make a significant contribution towards elevating the gap between nursing education and the nursing practice. Furthermore, Carollo & Mason (2017) also asserts that DNP prepared nurses tend to be appropriately positioned to offer nursing education to students and to encourage them to assume various role in nursing practice following their significant experience in multiple academic and clinical education settings. This affirms the advantage nursing schools have in utilizing a DNP prepared nurse as a faculty member. Other advantages include educator’ ability to emphasize the use of evidence-based approach, an extensive perspective regarding the systems-based issues, nursing experience and other related aspects which aid in preparing the nursing students for various challenges and rigours within the nursing roles and responsibilities (Carollo & Mason, 2017).
Edwards et al. (2018) also affirm that the National nursing organization advocates that the DNP is the preferred educator to prepare nurses for clinical leadership, practice, healthcare system restructuring and research translation into the clinical setting. This is mainly because, despite their specialty, the DNP also tend to have core competencies that tend to align with clinical leadership, health policy, health finance, organizational systems, informatics and the integration of evidence-based practice. Furthermore, Edwards et al. (2018). also identify that the ability to design and assess an innovative patient care model, cost-effectiveness relating to the patient’s care approach and the influence of the health policies in different healthcare levels holds significant knowledge to prepare new nurses to offer quality, safe and satisfactory health care services. McNelis et al. (2018) also supports the notion by affirming that evidence-based practice tends to be a thread throughout the DNP education, and as a result, it tends to strengthen the implementation of research-based interventions which are often utilized in the improvement of patient outcomes. The knowledge of evidence-based practice and its importance in healthcare delivery may be passed from one nursing generation to another by having DNP as a faculty member (McNelis et al., 2018).
Marrocco & El-Masri (2019) on the other hand argues that the constant increase in the population of DNP graduates in relation to the shortage of PhD-prepared nurses has majorly contributed to hiring DNP into higher education with minimal differentiation in the role of DNP and PhD. Additionally, the shift within the faculty mix is expected to increase and, as a result, create enormous confusion, which may, in future, threaten the PhD education investments if the special mandate between the DNP and the PhD, educations are not adequately addressed. Further, the nursing practice tends to be in need of the DNP to be able to effectively resolve various nursing issues. On the other hand, the nursing practice also tends to be in need of the PhD to be in a position to develop and also perform innovative research within the nursing field (Marrocco & El-Masri, 2019). Thus, the belief that nursing education has the potential to tremendously benefit from the recruitment and incorporation of DNPs is guaranteed if the recruitment tends to identify the role of the DNP in the nursing practice. Furthermore in, research conducted by McNelis et al. (2018) identified that nursing DNP and PhD graduates pointed out that the knowledge attained from the degrees significantly enhanced and increased confidence in relation to their ability to perform research but also had limited confidence in incorporating the achieved research concepts in their teaching. This pointed out that there is a significant need for the DNPs and PhD to be provided with additional academic knowledge to enable them to effectively fulfil the teaching role. In general, to ensure that the essential nursing knowledge is effectively passed from one nurse generation to another, it is important to make sure that the PhD or DNP nurses in nursing schools are offered adequate knowledge to enhance their teaching skills (McNelis et al., 2018).
Swot Analysis
The SWOT analysis below offers an effective presentation of the various strengths and weaknesses that are linked to having a DNP nurse as a faculty member in a nursing school. Additionally, it will also identify the various opportunities and threats which are linked to having DNP as a faculty member and the other benefits or risks that may impact nursing education and the nursing practice.
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Strengths · Allows the promotion of evidence-based practice knowledge among new nurses, which contributes to promoting quality care (National Academies of Sciences, Engineering, and Medicine., 2021). · DNPs tend to have considerable experience within the clinical setting, and this may function as an excellent guide to prepare the new nurses to overcome the various challenges within the nursing practice. · Having a DNP as a faculty member will ensure that the new nursing students are able to effectively understand the different policies and how they may utilize them to achieve quality and positive health outcomes. |
Weaknesses · If the concept of DNP and PhD is not adequately addressed, they may be increased confusion on the ultimate role each nurse has within the nursing field. · Increased recruitment of DNP in nursing education may contribute to threatening the future education investment of the PhD as it may be regarded to be irrelevant in the field of nursing (National Academies of Sciences, Engineering, and Medicine., 2021). |
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Opportunities · Enormous clinical and nursing educational knowledge among the DNP nurses will prepare the new nurses to meet the nursing goals when they are recruited as faculty members. · Having a DNP as a faculty member in a nursing school also promotes a better understanding of the role that nursing practitioners play within the healthcare delivery system (National Academies of Sciences, Engineering, and Medicine., 2021) |
Threats · Increased recruitment of DNP in nursing education will lead to confusion regarding the key role that a DNP plays in the nursing field for new nurses (Zaccagnini & White, 2021). |
PEST Analysis
Pest analysis has been conducted to offer a prediction of how the role of a DNP as a faculty member in a nursing school will benefit nursing education, the nursing field, and the general healthcare delivery system. The PEST analysis will focus on addressing the various external aspects that will impact the overall performance of the nursing practice.
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Political How does it affect political policies. Let’s talk about rules/eradication of collaborative agreements. Also rules/law that governs nursing practice. · The constant increase of DNP nurses as nurse educators within nursing education may promote an extensive collaboration among all the team members within the health delivery system and, as a result, enhance the culture within the nursing field. · The incorporation of DNP nurses as faculty members in a nursing school tend to influence the effectiveness of the health systems. |
Economic · Understanding the role of nursing practice aids in promoting effective health systems, health economics and health insurance by contributing to clinical practice. · Promotes cost-effectiveness through assessing the patient care strategies and quality care improvement teams’ coordination. · Promotes reduced care costs as the new nurses will be offered adequate nursing knowledge, which contributes to reduced patient stay in hospitals and minimal cases of readmission. · The significant DNP’s knowledge and experience setting may promote positive patient health outcomes when passed on to new nurses. |
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Social Lets talk about social determinant of health and how it relates · The new nurses tend to achieve exposure to evidence-based practice and understand the essentialness of evidence-based practice in the health care delivery. · Attaining knowledge from DNP nurses will ensure that new nurses are able to differentiate themselves and demonstrate their contribution towards enhancing the health care delivery system. |
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