Clinical Scholarly Introduction
Nursing practitioners play a vital role in promoting primary health care through a holistic approach that emphasizes
on a preventative heed. With advanced research and technology, the time has defined a lot on so many career paths, and the nursing field has seen its share of radical changes leading to improved medical care. My Clinical Scholarly Project (CSP) focus is to coordinate a variety of health care specialists to alleviate their workload and assist in providing patients with adequate medical care and intervention. AACN (American Association of College Nursing) printed out ‘The Essentials of Doctoral Education for Advanced Nursing Practice’ in 2006. The book outlined essentials required by all DNP (Doctor of Nursing Practice) programs to tackle competencies at the core of advanced practice. (Zaccagnini & Pechacek 2019). The DNP Essentials summarized in eight foundational categories are crucial requirements by all DNP graduates regardless of their area of expertise. In my CSP, with the incorporation of the AACN essentials, I emphasized the provision of educational services, coordination, delivery of care services, and teamwork with the multidisciplinary team for improved patient outcomes. I realized that this outcome could not be achievable in some of the nurses if they fail to adapt and adhere to the most recent forms of practice.
Further, in my CSP, I concentrated on understanding why the nurses did not want to adapt to the new introduction of massage therapy as management for muscle cramps during hemodialysis, and the intervention of AACN essentials to solve the issue. Haemodialysis is a medical procedure done in the lab to get rid of waste products from the bloodstream and correct electrolyte imbalances. The process accomplished using a dialyzer and a machine known as an artificial kidney is effective in treating acute and chronic kidney failures. Through the AACN essentials, I realized that nurses have a critical role in ensuring they proficiently fulfill their mandate, guided by evidence-based research as it leads to more positive outcomes. (Zak 2016) They should also be willing to embrace the study and the responsibility of providing leadership and guidance to the rest of the caregivers. (Butler 2015). The AACN essentials address initial competencies core to advanced nurse practitioners’ roles and prepare the DNP to alleviate the emerging challenge of convincing technicians and nurses to embrace reformed methods of practice.
The number of DNP programs is steadily growing as more schools are switching from advanced nursing practice programs to the doctoral level. (Howard & Williams 2017). A recent study by the AACN Board of Directors echoed on the rise. Regardless of these findings, inconsistency still exists among DNP programs offered. (Zak 2016) The challenge is well addressed by the first four essentials, which has a significant influence on the practice as an Advanced Practice Registered Nurse (APRN). In this project, we are going to discuss the last four of the essentials:
Essential V: Health Care Policy for Advocacy in Health Care
This essential generates an outline that facilitates the process of health services delivery, not limiting if the policy created meets organization standards, government actions, or institutional decision making. The policy development process is vital in creating a user efficient health system. Essential V controls numerous care delivery issues such as ethics, cultural sensitivity, health care financing, quality of care given, access to care, internalization of health care, and many others. Opinionated activism and loyalty to policy development are primary components of professional nursing practice. The DNP graduate can assume a significant leadership role on behalf of the public and the nursing profession. (Donley & Kiraly 2016). This essential describes the importance of involving nurses in policymaking processes, encourage backing through organizational leadership, and focus on the analysis of proposals and policies from multiple viewpoints and participation of board and committees.
.
Applicability of the Health Care Policy for Advocacy in Health Care
The embracing of health care policy for advocacy in health care is essential for the DNP nurse practitioner. In the current scenario where the nurses do not want to adopt the massage therapy as a patient’s caring approach, essential V is applicable. I understood that if the nurses were involved in the policymaking and made to comprehend the importance of massage therapy, they would have embraced it positively. (Zak 2016) Through this essential, DNP graduates are equipped with the skills to design, influence, and implement health care policies that address equity and social justice issues in health care. They graduate as leaders in the practice field and display a vital crossing point between research, theory, and practice.
As a future DNP-prepared APRN, I realized that to become a leader in the development of health policy, the graduate has the opportunity to differentiate between the significant appropriate factors and policy triggers that influence policymaking at all levels. They get trained to integrate these practice experiences with two additional skill sets: the ability to engage in politically competent action and the ability to analyze the policy process. (Pierson & Cowell 2016) To connect actively in the health care policy, the DNP graduate must learn to identify issues within the health care delivery system and to forefront legislation through negotiating and compromise. This essential aims at critically analyzing health policy to advocate for social justice and the nursing profession as a whole.
Essential VI: Interprofessional Collaboration for Improving Patient and Population
Health Outcomes
Interprofessional Collaboration for Improving Patient and Population Health Outcomes are fundamental factors necessary for positive health outcomes. (Zak 2016) The success of the current composite health care environment relies on the joint forces from learned and highly skilled individuals from numerous professions in the field. For the nursing practitioners to accomplish the mandate on timely, equitable, effective, efficient, and safe patient-centered care measures in a complex environment, healthcare experts must function highly as a team.
Essential VI prepares the future APRN for collaboration with other professionals within a diverse healthcare environment. It focuses on the growth of expertise necessary for assuming leadership responsibilities on collaborative teams. (Pierson & Cowell 2016) The DNP members who practice this essential have the upper hand in the advanced preparation in the inter skilled dimension of health care as they are empowered to focus on collaborative team functioning and prevailing over-perils that affect the health practice.
Applicability of the Interprofessional Collaboration for Improving Patient and Population
Health Outcomes
Essential VI prepares the DNP to utilize collaborative skills and effective communication in the creation and execution of peer review, practice guidelines and models, health policy, standards of care, and other scholarly products. In my career as a future APRN, I learned that the essential guides medical professional teams in the breakdown of compound practice and organizational issues. (SABLES-BAUS & ARMSTRONG 2019) In the current case study, the focus lies on the importance of various medical practitioners working as a team for a positive outcome. The nurse and the technician did not collaborate with other professionals to embrace the new massage care plan. As a DNP, one has the liability to engage in consultative and leadership expertise with other professionals for positive outcomes in health care and healthcare delivery systems.
The nurses got introduced to the Interprofessional Collaboration for Improving Patient and Population Health Outcomes, which emphasizes effective communication and teamwork to provide improved treatment outcomes for the patients. (SABLES-BAUS & ARMSTRONG 2019) Consequently, the nurses were trained on the importance of embracing the treatment approach and concurrently working with other professionals in enhancing the patient’s condition. I came to understand that even if the nurses opposed the change, understanding these challenges to change is vital as they empower one on how to deal with the situation to ensure quality healthcare, accountability, and safety for patients.
This essential trains the DNP graduates to lead inter-professional teams in the analysis of versatile practice and systems issues through effective communication and collaborative skills. They also take a leadership role in the development and implementation of practice models, standards of care, and other scholarly projects.
Essential VII: Clinical Prevention and Population Health for Improving the Nation’s Health
The success of clinical prevention and population health activities is critical in
realizing the national goal of improving the health status of the population of the United
The states of America. Clinical prevention is referred to as health promotion and illness prevention
to all, while Population health is distinct from incorporating community, aggregate, occupational, and cultural/socioeconomic dimensions of health. Groups of individuals with similar characteristics such as diagnosis, age, gender are identified as aggregates. Nursing career has its foundation on health promotion and risk reduction; on the other hand, the DNP degree auxiliary trains graduates to assess and interpret biostatistical, epidemiological, occupational, and environmental information essential to improving the health of both individuals and communities. (SABLES-BAUS & ARMSTRONG 2019) As a future APRN, this exposure is very significant as it prepares one to the success of clinical prevention and population health actions that lead to improved health status for all. From this essential, doctors of nursing practice are as well equipped with the skills to blend the cultural impacts and psychosocial dimensions to population health.
In the US, over 50 percent of preventable deaths are caused by unhealthy lifestyle ways. Prevention interventions have been underutilized in the health care set up for a long time.
In 2010, Healthy People, a diverse cluster of organizations in the US in an attempt to address this national tragedy, supported the revolution of clinical education and came up with a plan. Healthy People were dedicated to promoting and executing Healthy People 2020 across the nation. Healthy people 2020 is a federal government’s prevention program for building a healthier society. The Healthy People plan was to raise the number of medicine/nursing schools and other health professionals with an elementary curriculum that includes the core competencies in health promotion and disease prevention. (SABLES-BAUS & ARMSTRONG 2019) The DNP graduate will have a concrete base in clinical prevention and population health from such steady national calls for action and the disreputable focus on health promotion and disease prevention in the nursing program.
Applicability of Clinical Prevention and Population Health for Improving the Nation’s Health
Essential VII applies to the nurse’s refusal to adopt a new method of care for patients, using massage therapy. Through research, Intradialytic Massage had shown a reduced level of muscle cramping on dialysis patients. Cramps most experienced on the lower extremity can be easily reduced through a massage on the affected muscle part, not forgetting as well the pain that comes with it. Kidney ailments are some of the killer diseases caused by an unhealthy lifestyle. If an individual practices proper dieting and a safe exercise regime, chances of getting kidney issues would be minimal. (SABLES-BAUS & ARMSTRONG 2019) As a result, the percentage of patients using massage therapy would be close to null. Clinical prevention and population health for improving the nation’s health is an essential tool for future practice as a DNP-prepared APRN. Exploiting this essential, I have learned how to take up health promotion and risk reduction through a nursing perspective to improve the health of individuals.
As a solution, the nurse and technician got educated on the effectiveness of clinical prevention in ensuring the attainment of quality outcomes among patients. The approach involved illustrating the studies which have either reviewed the effectiveness of the prevention regime or conducted a review on the subject. (OYLE-LINDRUD & KWONG 2018) As DNP graduates, one is engaged in leadership to incorporate and institutionalize evidence-based clinical prevention and population health services for aggregates, individuals, and populations. For my future practice, I have realized that with this knowledge, I am a significant influence on clinical prevention and population health to my patients, colleagues, and the nation at considerable for positive health outcomes. I am prepared to evaluate population data to develop and put into practice prevention strategies and assess population health.
Essential VIII: Advanced Nursing Practice
Advanced increased knowledge and complexity of healthcare have resulted in DNP graduates taking nursing as a specialty to ensure competence. DNP programs offer preparation within diverse specialties that require advanced knowledge, expertise, and mastery in one area of nursing practice. (SABLES-BAUS & ARMSTRONG 2019) The authenticity of the growth of specialization in nursing practice is that no graduate can master all advanced roles and the requisite knowledge, thus the great need for specialization. Through this essential, a DNP graduate gets empowered on how to practice in an area of specialization within the broader domain of nursing.
Essential VIII identifies the initial practice competencies that cut across specialties seen as obligatory for DNP practice. DNP graduates projects to express refined assessment skills and base practice on the application of psychosocial, biophysical behavioral, cultural, sociopolitical, economic, and nursing science as suitable in their area of specialization. Improving patients outcome remain a vital goal in the nursing field. (SABLES-BAUS & ARMSTRONG 2019) Thus, through this essential, a DNP demonstrates advanced levels of systems thinking, clinical verdict, and delivery of evidence-based care. It also focuses on conducting comprehensive needs assessments, mentoring other nurses, and steering patients through intricate situational transitions.
Applicability of Advanced Nursing Practice
As a future practice APRN, there is a need for a guide in areas of specialization within the nursing domain to ensure competence. From this essential, I have come to realize that DNP programs are learning platforms based on diverse patient care settings such as home care, long term care, hospitals, or even community settings.
(OYLE-LINDRUD & KWONG 2018) The graduate may hold a variety of different roles, so task preparation for specialty nursing like regulatory and legal issues should be addressed in the DNP study program. Through this essential, I also learned that a DNP graduate is prepared to develop therapeutic relationships with patients and other professionals to improve patient outcomes. It also encourages the utilization of highly developed clinical decision-making skills and mentoring of others in the nursing field and patient education.
In our case study, where the nurses and technicians objected to the use of massage therapy for dialysis patients, there was a need to develop a therapeutic relationship between the nurses, patients, and colleagues for a positive outcome. The massage therapy effectiveness has been well researched, and its utilization would have been a basis of improvement to dialysis patients if it had been mentored to them well. (Williams 2017) I have also realized that essential helps a DNP to plan, implement, and evaluate curative interventions based on nursing science and also how to perform all-inclusive and systematic judgment on health parameters in complex situations.
Conclusion
For positive health outcomes, a DNP-prepared APRN must discharge their duties supported by evidence-based research techniques. Through DNP programs, graduates go through the highest nursing practice level and demonstrate the fusion and application of the DNP essentials. The essentials differentiate research-focused and practice-focused programs by denoting that the latter include integrative practice experiences and an extreme practice concentration experience. The adoption of the essentials has positive repercussions on nursing as a discipline and as a profession. (Zak 2016) Through them, a DNP graduate garners proficiency in the differentiation and application of nursing knowledge. Thus, the graduate will have the final position to link the theory-practice breach, an enduring objective of nursing.