Advanced practice nurses and attending physicians: a collaboration to improve quality of care in the nursing home.

摘要

Over the past decade, in a number of countries, there has been a marked increase in the activities of advanced practice nurses (also known as nurse practitioners and clinical nurse specialists) in the long-term care setting. More than 20% of residents in nursing homes in the United States receive some of their care from advanced practice nurses (APNs). The introduction of such advanced practice roles have been advocated in many countries and where this is progressing, inter' and intraprofessional practice boundaries are becoming increasingly blurred. In the United Kingdom, current attention is on the preparation that will equip nurses to provide an advanced level of practice rather than on the establishment of APNs. The recent Department of Health (UK) position statement usefully explains universal features of nurses working at an advanced level in that they use critical thinking, complex reasoning, reflection and analysis to inform their assessments, clinical judgments, and decisions. Such advanced practitioners act as nurse leaders and have the capability to improve the quality of patient care and manage complex health care situations.