Fagerström A Caring Advanced Practice Nursing Model

Theoretical Perspectives And Competency Domains
1. Auflage 2021
ISBN: 978-3-030-53555-1
Verlag: Springer International Publishing
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 250 Seiten, eBook

Reihe: Advanced Practice in Nursing

This book introduces readers to the basics of Advanced Practice Nursing (APN), which offers expanded clinical competence that can help improve the quality of health and care services. The book offers a range of perspectives on APN, APN models, APN education, challenges in the implementation of APN in new countries, as well as a description of the APN role, including areas of expertise. These core areas of the Caring APN model (clinical nursing practice; ethical decision-making; coaching and teaching; consultation; collaboration; case management; leadership; research and development) are described, together with the role of APN in acute care and primary healthcare service contexts. The book also explores the connection between epistemology, a three-dimensional view of knowledge (epistêmê, technê and phronesis) and a caritative perspective, as well as central theoretical aspects of nursing, e.g. health, holism and ethics/ethos. All research should be grounded in theoretical perspectives, and here we highlight the value of a caring and person-centered philosophy in advanced practice nursing. Through its specific focus on the central, generic theoretical features of nursing science that deepen the role of APN and the scope of practice and APN research and education, the content presented here will help any researcher, teacher or student understand the importance of epistemological issues for research, education and clinical practice in this field. Moreover, it can be used when designing Master's programs in Advanced Practice Nursing, making the book a valuable resource for the international nursing community.


Professor Lisbeth Maria Fagerström is professor in caring science at Åbo Akademi University in Vaasa, Finland and affiliated professor in Nursing science at University of Southeast-Norway. Her main research areas are advanced practice nursing, nurse staffing, nursing intensity, gerontological nursing, and health promotion. She has extensive experience of nursing education on all levels and of leadership in clinical health care with special focus on leading changes in healthcare, health education and research. She introduced systematic patient classification by the RAFAELA system in the beginning of 1990's as a tool for nurse leaders in Finland and had since then conducted extensive research regarding nurse staffing, nursing intensity and outcomes. During the last fifteen years Fagerström has developed master programmes in advanced practice nursing according to international standards for Nurse Practitioner role and contributed substantially to the implementation of advanced practice nursing in Finland, Norway and Sweden. Fagerström published the first Swedish book in advanced practice nursing in 2011 ('Advanced Practice Nurse - theory and clinical praxis', Publisher Studentlitteratur), and recently the first book in Norwegian (Advanced Practice Nursing', Publisher Gyldendal Akademisk). She is leading several research projects in advanced practice nursing, with special focus on evaluation of advanced nursing roles and education. She was for many years a member of the ICN/APN Network and by networking on national, Nordic and international level Fagerström has inspired and motivated colleagues, leaders and students for advanced practice nursing.

Zielgruppe

Professional/practitioner

Autoren/Hrsg.

Fagerström, Lisbeth Maria

Inhaltsverzeichnis

1;Foreword;6
2;Preface;9
3;Contents;11
4;1: Advanced Practice Nursing: A Justified Need;12
4.1;1.1 Advanced Practice Nursing as an International Phenomenon;13
4.2;1.2 Advanced Practice Nursing Yields Positive Effects;17
4.3;1.3 Access to Nursing, Care, and Treatment Must Be Improved;20
4.4;1.4 Available Resources Must Be More Effectively Used to Meet the Increased Demand for Healthcare Services;23
4.5;1.5 Clinical Career Paths Support the Recruitment of Future Nurses;24
4.6;1.6 Advanced Practice Nursing Contributes to the Sustainable Development of Healthcare;24
4.7;1.7 Key Messages to Policy-Makers;28
4.8;References;28
5;2: Nurses as Advanced Specialists and Advanced Generalists;34
5.1;2.1 Progression from Generalist Nurse to Advanced Practice Nurse;35
5.2;2.2 From Nurse Specialists to Nurses with a Master’s Degree: Examples from the Nordic Countries;38
5.3;2.3 A Bi-continuum Model of Specialist Versus Generalist Nurses;39
5.4;2.4 The Advanced Practice Nurse as a T-Shaped Professional;41
5.5;2.5 Nurses’ Clinical Practice on the Generalist, Specialist, and Advanced Levels;42
5.6;References;43
6;3: What Is Advanced Practice Nursing?;46
6.1;3.1 The Concept of Advanced Practice Nursing: An International Perspective;47
6.2;3.2 Characteristics of the Advanced Practice Nursing Role;50
6.3;3.3 Definition of Advanced Practice Nursing: A Conceptual, Caring Model;51
6.4;3.4 What Is the Difference Between Nurse Practitioners and Clinical Nurse Specialists?;55
6.5;3.5 The Advanced Practice Nurse’s Knowledge Base and Broad Competence;58
6.6;3.6 Degree of Autonomy in Clinical Work;58
6.7;3.7 The Nurse’s Personal Characteristics;59
6.8;3.8 Conclusion;59
6.9;References;60
7;4: The View of Knowledge in Advanced Practice Nursing;63
7.1;4.1 The Tree-Dimensional View of Knowledge in Advanced Practice Nursing;65
7.2;4.2 The Three-Dimensional View of Knowledge as a Synthesis of Knowledge, Skills, and Wisdom;66
7.3;4.3 The Three-Dimensional View of Knowledge as Related to Kim’s Knowledge Domains;68
7.4;4.4 Knowledge Synthesis in Advanced Practice Nursing;69
7.5;4.5 Nurses’ Advanced Clinical Competence as Knowledge in Action;70
7.6;References;72
8;5: The Caring Advanced Practice Nursing Model;74
8.1;5.1 The Caring Advanced Practice Nursing Model;75
8.2;5.2 The Nurse-Patient Relationship;76
8.3;5.3 Central Theoretical Perspectives;76
8.4;5.4 Contextual Factors;78
8.5;5.5 “The Foundation for Caritative Caring” for Nursing on the Generalist, Specialist, and Advanced Levels;79
8.6;5.6 Advanced Practice Nursing in the Dialectical Tension Between the General and the Specific;80
8.7;References;81
9;6: Theoretical Perspectives on Advanced Practice Nursing;83
9.1;6.1 A Historical Perspective;84
9.2;6.2 Health;85
9.2.1;6.2.1 The Ontological Model of Health;86
9.2.2;6.2.2 The Dialectic of Health as a Synthesis of Pathogenesis and Salutogenesis;87
9.3;6.3 A Person-Centered Health Perspective in Advanced Practice Nursing;88
9.4;6.4 A Holistic Approach to Advanced Practice Nursing;90
9.5;6.5 Ethos as a Person-Centered Fundamental Ethical Approach;92
9.5.1;6.5.1 Dignity and Respect for the Patient as a Person;92
9.5.2;6.5.2 Caritas as Compassionate Love and Mercy;93
9.5.3;6.5.3 Virtue as a Force;94
9.6;6.6 Caring as the Core of Advanced Practice Nursing;95
9.7;References;96
10;7: Core Competency Domains in Advanced Practice Nursing;100
10.1;7.1 Competency Domain 1: Direct Clinical Care;102
10.1.1;7.1.1 Clinical Assessment and Knowing the Patient;104
10.1.1.1;7.1.1.1 Health Assessment, Part 1: Health History;105
10.1.1.1.1;Collecting Information for the Patient Health History;106
10.1.1.2;7.1.1.2 Health Assessment, Part 2: Assessment of Patient’s Current Health Condition and Physical Examination;107
10.1.2;7.1.2 Clinical Decision-Making;109
10.1.3;7.1.3 Nursing Care and Management of Patients’ Health Issues;111
10.1.4;7.1.4 Health Promotion and Disease Prevention in Advanced Practice Nursing;113
10.1.5;7.1.5 Three Perspectives on Health Promotion in Advanced Practice Nursing;115
10.1.5.1;7.1.5.1 Health Promotion When Health Is Understood as the Absence of Disease;116
10.1.5.2;7.1.5.2 Health Promotion When Health Is Understood as Well-Being;116
10.1.5.3;7.1.5.3 Health Promotion When Health Is Understood as a Resource;117
10.2;7.2 Competency Domain 2: Ethical Decision-Making;118
10.2.1;7.2.1 Ethical Problems/Issues in Advanced Practice Nursing;119
10.2.2;7.2.2 Elements of Ethical Decision-Making;120
10.2.3;7.2.3 The Importance of Cultural Competence for Ethical Decision-Making;124
10.3;7.3 Competency Domain 3: Coaching and Guidance;125
10.3.1;7.3.1 Health Education Concepts Associated with Coaching and Guidance;126
10.3.2;7.3.2 Advanced Practice Nurses as Coaches;127
10.3.3;7.3.3 Coaching as Person-Centered Guidance;128
10.3.4;7.3.4 Coaching Patients During Transitions Between Life Phases;130
10.3.5;7.3.5 Coaching Realized as Motivational Conversations;131
10.3.6;7.3.6 Coaching and Guidance Key Summary Points;132
10.4;7.4 Competency Domain 4: Consultation;133
10.4.1;7.4.1 Consultation in Its Various Forms;134
10.4.2;7.4.2 Functions Associated with Consultancy in Advanced Practice Nursing;134
10.5;7.5 Competency Domain 5: Collaboration;136
10.5.1;7.5.1 Definition of the Concept of Collaboration;137
10.5.2;7.5.2 The Characteristics of Effective and Good Collaboration;138
10.5.3;7.5.3 Collaboration as a Part of Advanced Practice Nursing;139
10.5.4;7.5.4 Reasons Underlying Lack of Collaboration;140
10.5.5;7.5.5 Strategies for Successful Collaboration;142
10.6;7.6 Competency Domain 6: Case Management;143
10.6.1;7.6.1 Case Management as a Concept;143
10.6.2;7.6.2 Advanced Practice Nurses as Case Managers;144
10.6.3;7.6.3 Case Management Models in Advanced Practice Nursing;145
10.7;7.7 Competency Domain 7: Research and Development;146
10.7.1;7.7.1 Evidence-Based Practice;147
10.7.2;7.7.2 Evaluation of Advanced Practice Nursing Practice;148
10.7.3;7.7.3 Participation in Research and Development;149
10.8;7.8 Competency Domain 8: Leadership;149
10.8.1;7.8.1 Historical Factors That Have Influenced Nurses’ Position in Healthcare;150
10.8.2;7.8.2 Advanced Practice Nurses as Leaders;151
10.8.2.1;7.8.2.1 Clinical Leadership;152
10.8.2.2;7.8.2.2 Professional Leadership;153
10.8.2.3;7.8.2.3 Leadership on the Systems Level;153
10.8.2.4;7.8.2.4 Health Policy Leadership;153
10.8.3;7.8.3 The Characteristics of Leadership Competency in Advanced Practice Nursing;153
10.8.4;7.8.4 Personal Characteristics for Leaders of Advanced Practice Nursing;155
10.8.5;7.8.5 Barriers to the Development of Leadership on the Advanced Level;156
10.8.6;7.8.6 Strategies for Developing Leadership Characteristics;158
10.8.6.1;7.8.6.1 Prerequisites for Advanced Practice Nurses’ Leadership;158
10.9;7.9 Critical Factors in Advanced Practice Nursing;159
10.10;References;160
11;8: Advanced Practice Nursing in Acute Care;169
11.1;8.1 Advanced Practice Nursing in Acute Care: International Experiences;170
11.2;8.2 Advanced Practice Nursing Outcomes in Acute Care;172
11.2.1;8.2.1 Care Quality;172
11.2.2;8.2.2 Patient Satisfaction;172
11.2.3;8.2.3 Patient Flow and Wait Times;173
11.2.4;8.2.4 Cost Efficiency;173
11.2.5;8.2.5 Approach;174
11.3;8.3 The Adult-Gerontology Acute Care Advanced Practice Nurse;174
11.4;8.4 Developing New Advanced Practice Nursing Models in Norwegian Acute Care;176
11.5;References;178
12;9: Advanced Practice Nursing in Primary Care;182
12.1;9.1 The Development of Expanding Nursing Roles in Primary Care;184
12.2;9.2 Summary of Advanced Practice Nursing Outcomes in Primary Care;187
12.3;9.3 Examples of Advanced Practice Nursing Roles in Primary Care;189
12.3.1;9.3.1 Patient Flow and Continuity of Care;189
12.3.2;9.3.2 Holistic Home Rehabilitation;190
12.3.3;9.3.3 Geriatric Mental Health Nursing;191
12.3.4;9.3.4 Person-Centered Care Used to Reduce Restraining Measures;191
12.3.5;9.3.5 Identifying Delirium and Improving Functional Ability;191
12.3.6;9.3.6 Home Healthcare Oncological Nursing;192
12.3.7;9.3.7 Continence Nursing;192
12.4;9.4 Advanced Practice Nurses as Compliments to Physicians in Nursing Homes;193
12.4.1;9.4.1 Integrated Nursing Teams;193
12.4.2;9.4.2 Advanced Practice Nursing Clinics;193
12.5;References;195
13;10: The Right to Prescribe Medications as an Advanced Practice Nurse;197
13.1;10.1 International Overview;198
13.2;10.2 Examples of the Development of Nurses’ Prescriptive Authority in the Nordic Countries;201
13.2.1;10.2.1 Sweden;201
13.2.2;10.2.2 Norway;202
13.2.3;10.2.3 Finland;202
13.3;10.3 What Are the Benefits of Nurse Prescribing?;204
13.4;10.4 Factors That Inhibit Nurse Prescribing;206
13.5;10.5 Conclusion;207
13.6;References;208
14;11: Core Factors for the Sustainable Development of Advanced Practice Nursing;211
14.1;11.1 Effects of the Inadequate Planning of New Advanced Practice Nursing Models;213
14.2;11.2 Leadership’s Importance for Implementation;214
14.3;11.3 The PEPPA Framework and the Development and Evaluation of Advanced Practice Nursing;215
14.4;11.4 National Guidelines and Certification Schemes;219
14.5;References;220
15;12: Leading Change When Implementing Advanced Practice Nursing;222
15.1;12.1 Advanced Practice Nursing as Management’s Vision;223
15.2;12.2 Change as a Phenomenon and Concept;224
15.3;12.3 Theoretical Perspectives on Leadership During Change;226
15.4;12.4 The Eight Steps of the Change Process;227
15.5;12.5 The Three-Dimensional Model of Leading Change in Healthcare;228
15.6;12.6 Understanding Change and Resistance to Change;231
15.7;12.7 Advanced Practice Nurses as Change Leaders;232
15.8;References;234
16;13: Advanced Practice Nursing Education;237
16.1;13.1 An Optimal Balance Between Theoretical and Clinical Studies;238
16.2;13.2 International Advanced Practice Nursing Educational Programs;239
16.3;13.3 International Standards for Advanced Practice Nursing Educational Programs;241
16.4;13.4 Overall Structure of Advanced Practice Nursing Educational Programs;244
16.5;13.5 Assessment of the Development of Clinical Competence;245
16.6;13.6 Objective Structured Clinical Examination for Assessment of Clinical Competence;247
16.7;References;248

Advanced practice nursing – a justified need.- Registered nurses as advanced specialists or advanced generalists.- What is advanced practice nursing?.- Perspectives of knowledge on advanced practice nursing.- A caring advanced practice nursing model.- Theoretical perspectives on advanced practice nursing.- Core competence domains of advanced practice nursing.- Advanced practice nursing in acute care.- Advanced practice nursing in primary care.- The right to prescribe medication as an advanced practice nurse.- Core factors for the sustainable development of advanced practice nursing.- Leading change when introducing advanced practice nursing.- Education for advanced practice nursing.

Über Autor(innen)

Professor Lisbeth Maria Fagerström is professor in caring science at Åbo Akademi University in Vaasa, Finland and affiliated professor in Nursing science at University of Southeast-Norway. Her main research areas are advanced practice nursing, nurse staffing, nursing intensity, gerontological nursing, and health promotion. She has extensive experience of nursing education on all levels and of leadership in clinical health care with special focus on leading changes in healthcare, health education and research. She introduced systematic patient classification by the RAFAELA system in the beginning of 1990’s as a tool for nurse leaders in Finland and had since then conducted extensive research regarding nurse staffing, nursing intensity and outcomes. During the last fifteen years Fagerström has developed master programmes in advanced practice nursing according to international standards for Nurse Practitioner role and contributed substantially to the implementation of advanced practice nursing in Finland, Norway and Sweden. Fagerström published the first Swedish book in advanced practice nursing in 2011 (‘Advanced Practice Nurse – theory and clinical praxis’, Publisher Studentlitteratur), and recently the first book in Norwegian (Advanced Practice Nursing’, Publisher Gyldendal Akademisk). She is leading several research projects in advanced practice nursing, with special focus on evaluation of advanced nursing roles and education. She was for many years a member of the ICN/APN Network and by networking on national, Nordic and international level Fagerström has inspired and motivated colleagues, leaders and students for advanced practice nursing.