WOC nursing and the evolution to advanced nursing practice.
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Biomedical subjects
Publications and source records attributed to A B Hamric.
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Thirty-three advanced practice nurses (APNs) in 25 different primary care sites in one state participated in a study of the safety and effectiveness of APN prescriptive authority. Data were analyzed on 1,708 patients seen during a 2-month period. Outcomes of care were studied using three different measures as well as patient satisfaction. Evaluation of patient outcome by APN and physician indicated that in 76% of the cases, the patient's condition stabilized or improved. Patients evaluated their own outcomes positively. Participating physicians were unanimous in their evaluation of APN prescriptive authority as beneficial to their patients.
The need for sound research data to support regulatory decisions related to advanced nursing practice has never been greater. Although advanced practice nurses (APNs) are frequently exhorted to engage in research and to become involved in the political arena, there is little published evidence that nursing research has been used to influence health policy. This article presents two case examples of the effective use of research findings to influence regulatory policy in two different states. Factors involved in using research to shape policy are discussed, including recommendations for nursing policymakers and researchers. Research is a powerful tool that APNs can and should use to make a difference in regulatory legislation.
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Clinical ladders were designed to recognize, reward, and retain professional nurses who chose to remain in direct clinical practice. One institution implemented a clinically focused advancement system that addresses many of the pitfalls that have historically caused clinical ladders to fail. The authors describe unique features of the advancement system, along with the process for advancement, budgetary considerations, and transition to the new advancement system.
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Evaluating clinical nurse specialists (CNSs) has perplexed both administrators and CNSs. Realizing that a key structural variable of CNSs' role is time use, the authors developed an instrument for examining how CNSs spend their time. The authors discuss the elements of this instrument and its utility as a component of CNS evaluation.
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