title: Opportunities for advance practice nurses in the nursing facility.
abstract: Advance practice nurses (APNs) have emerged as valuable members of the nursing facility interdisciplinary team. They function in a variety of roles, including clinical care, administration, nursing consultation, and education. Positive outcomes in key indicators of care and reduction in costs to the healthcare systems have been attributed to their practice. Barriers to implementation of the role include regulatory issues, facility resistance, and difficulty adapting to the environment. Facilitation of the role is enhanced by collegial relationships and role negotiation. There is strength in the APN-physician collaborative model. The APN is likely to concentrate on prevention, restoration, maintenance, and palliative care, allowing the physician to concentrate on complex medical problems. There is a need for APN practices to identify APN-sensitive outcomes, collect and analyze data, and disseminate findings.
authors: University of Texas Health Science Center-Houston and Geriatric Associates of America, Houston 77030, Texas, USA. Mary.p.rapp@uth.tmc.edu
authors: Mary Pat
authors: MP
authors: Rapp
mesh_terms: D002568:Certification / Q000458:organization & administration; D003299:Cooperative Behavior; D039702:Current Procedural Terminology; D004511:Education, Nursing, Graduate; D005161:Facility Regulation and Control; D005544:Forecasting; D006801:Humans; D016294:Models, Nursing; D008960:Models, Psychological; D020380:Needs Assessment; D009720:Nurse Clinicians / Q000193:education / Q000458:organization & administration*; D009722:Nurse Practitioners / Q000193:education / Q000458:organization & administration*; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D032024:Personnel Delegation / Q000458:organization & administration; D019555:Physician-Nurse Relations; D017009:Professional Autonomy; D012051:Reimbursement Mechanisms / Q000458:organization & administration; D012866:Skilled Nursing Facilities; D014481:United States