The Roles of Critical Care Advanced Practice Nurse

Abstract

Purpose. To determine and compare the perception among nurses and doctors of the roles and tasks of critical care advanced practice nurses (APNs) in order to establish standardized and formally agreed role criteria for such critical care APNs.Method. This study measured and analyzed the necessity of each of the roles and tasks of critical care APNs, as perceived by nurses and doctors, through a survey of 121 participants: 71 nurses in 7 intensive care units (ICUs) at a general hospital in Seoul, and 50 doctors who used ICUs. Data collection utilized a questionnaire of 128 questions in the following fields: direct practice (79), leadership and change agent (17), consultation and collaboration (15), education and counseling (11), and research (6).Results. Both the nurses' and the doctors' groups confirmed the necessity of critical care APNs, with doctors who frequently used ICUs indicating a particularly strong need. As for the priority of each role of critical care APNs, the nurses considered direct practice to be the most critical, followed by education and counseling, research, consultation and collaboration, and leadership and change agent. The doctors also considered direct practice to be the most critical, followed by education and counseling, consultation and collaboration, research, and leadership and change agent. There was a statistically significant difference between how the two groups regarded all the roles, except for the consultation and collaboration roles. As for the necessity of each role of critical care APNs, the nurses considered research to be the most necessary, followed by education and counseling, consultation and collaboration, leadership and change agent, and direct practice. The doctors, on the other hand, considered education and counseling to be the most necessary, followed by research, consultation and collaboration, leadership and change agent, and direct practice. The responses of the two groups to all the roles, except for education and counseling roles, were significantly different. Conclusion.Nurses and doctors have different perceptions of the roles and tasks of critical care APNs. Thus, it is necessary for the combined nursing and medical fields to reach an official agreement on a set of criteria to standardize for the roles and tasks of critical care APNs.

Willingness to pay for family education and counselling services provided by critical care advanced practice nurses

“…Education and counselling is one of the advanced practice nursing competencies designated by the Korean Accreditation Board of Nursing Education (Korean Accreditation Board of Nursing Education, ). In ICUs, nurses and physicians regard education and counselling as a major role of critical care APNs (Sung, Yi, Kwon, & Cho, ). However, hospitals seem to consider the education and counselling services provided by critical care APNs nonproductive services in terms of financial reimbursement (Kim et al, 2011) because hospitals cannot be reimbursed for these specific education and counselling services under the fee‐for‐service model of the National Health Insurance System.…”

Perspectivas para a Prática Avançada de Enfermagem em Unidades de Terapia Intensiva: Uma Reflexão

“…The education axis includes continuing education, patient education, specialized reference in intensive care, and research activity. Continuing education carried out by advanced practice nurses focuses on training with more detailed and realistic objectives and outcomes (12) , with the capacity to involve the nursing team (17) and other health professionals (13) . This allows human and financial resources to be used more effectively (12) .…”

“…Educate the nursing or multidisciplinary team (12)(13)(14)(15)(16)(17) ; Educate and facilitate team communication (18) ; Patient education:…”

“…To be an expert reference in care (13,17,21) ; to work with patients, families, and health care professionals using evidence and best standards of care (13) ; to act in consultation and collaboration with the team (13) ; to provide consultation, facilitate ongoing implementation of the care plan, and identify outcomes (20) ; Research activity:…”

“…Acting as a researcher (13,21) ; providing systems support, research, and inpatient responsibilities (14) ; Management Care management:…”