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Transcript of Independent Apn Practice
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IndependentAdvanced Nursing
PracticeRosemary Goodyear Ed.D,
APRN-BC, FAANPChair INP/APN Network
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China 1983
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Independent Advanced PracticeNursing
What is advanced practicenursing?
What is an Advanced PracticeNurse (APN)?
What is independent practice(IP)?
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Independent Practice
IS A NURSING BUSINESS
that works within the professional,legal, socioeconomic, cultural andpersonal environments
that addresses the patient/client’shealth needs for efficient, safe andcost-effective care
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Independent Practice
IS A NURSING BUSINESS
that allows the nurse to demonstrateexcellence in nursing care andprovide job satisfaction
that offers direct patient/client care,education, research, administrativeand/or consultative services.
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Independent Practice
IS A NURSING BUSINESS
where the nurse is autonomous indecision making in the practiceenvironment
where the nurse is responsible andaccountable for all outcomes in thepractice environment
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Independent Practice
IS A NURSING BUSINESS
where the nurse is anentrepreneur – a risk taker!
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Why Pursue IP Now?
BECAUSE--
Nursing knowledge is advancing
professional practiceThe national health systems are
changing their attitudes towards
nursing
Liberal global trade agreements
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Why Now?
BECAUSE--Transformation of laws and scope of
nursing practice
Patient populations are withoutaccess to care
Change in health needs of people arenot being addressed
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WHY NOW?
BECAUSE--
Many of the conditions
necessary for a successfultransition into independent
practice are present today!
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China 1983
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Preparation for IP
Reasons
Research
Readiness
ReferencesResources
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Reasons for Initiating IP
TO HAVE NURSES -- Improve the quality of health care-
Become an integral part of the healthcare system-
Demonstrate quality professionalpractice-
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Reasons cont.
TO HAVE NURSES-- Demonstrate reduced health care cost
Implement a scope of practice thatreflects current nursing knowledge
Demonstrate ethical practice andequality for nurses
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Research before IP
Research of
Health Care System
Regulations/laws that governnursing
Literature of similar ventures
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Research cont.
Health Care System:
Public or Private or mixed
Are nurses currently workingindependently within thesystem?
Does the system contract fornursing services versesemployment?
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Laws and Regulations for IP
System of regulation In place to register, monitor and protect
nurses
Is the power to regulate nurses withinthe profession or government?
Who writes the scope of practice?
Are nurses registered to practice asgeneralist?
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Literature Review for IP
Through the library and internetexplore prior studies of APNs
Information needed to submit aproposal
Successes and barriers toindependent practice
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Readiness for IP
Readiness
Business plan
Fiscal support
Collaborative support
Marketing and publicityOperations
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Readiness
Business Plan
Mission and goals
Philosophy ofcare
Services
Target market
Competition
Business history
Benefits
Marketing Plan
Facility
advantages
Management team
Financial
projections Budget
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Readiness
Fiscal SupportGrants – usually philanthropic
foundations; trust funds
Internal Personal savings
Friends/colleagues
ExternalLoans-debt or equity
Venture capital
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Readiness
Collaborative Support
Nursing colleagues and peers
Physician colleagues and peers
Professional colleagues in legaland business arena
Personal support – family,friends
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Readiness – Marketing and Publicity
Know your product
Identify the market
area
Identify thecompetition
Know the customer
needs Establish a
marketing plan
Networking withcolleagues
Word of mouth
In-kind service inthe community
Write for local paper
Brochures Business cards
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Readiness
Operations Location
Materials and personnel necessary for
operations A management plan to include contracting,
price of services, billing systems as well
as meeting the regulations for the
business operations Personnel rights, responsibilities and
benefits
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China 1983
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Reference
Brown, S A and Grimes, D E (1995).A meta-analysis of nurse
practitioners and nurse midwivesin primary care. Nursing Research,44(6), 332-338.
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Reference
Sanders, E. M. and Kingma, M. (2003).Handbook on Entrepreneurial Practice:Nurses Creating Opportunities as
Entrepreneurs and Intrapreneurs 11 International Council of Nurses
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Resources for IP
Resources
Personal entrepreneurial zeal
System of reimbursementPhysical setting
Support systemsPatient population
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A Resource - Professional Nurse
Associations
A comprehensive health systemincludes nurse entrepreneurial practice
The adoption of a scope of practice,
standards and competencies for theAPN is fundamental to protect thenurse and public
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A Resource - Professional Nurse
Associations
The legitimation of advanced nursingpractice must be written into law/rules
Inform the public about the newadvanced role of nurses
Support entrepreneurial nurses inpolicy manners such as equality of payor reimbursement
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A Resource - Professional Nurse
Associations
Educate the policy makers about APNsand the entrepreneurial projects
Encourage APNs into membershipthrough supportive activities/programs
Support advanced nursing throughperiodic research of trends and needsof health care
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Independent Practice
Types of Independent Practice mayinclude:
Solo/Private Practice
Collaborative Practice
Group Practice
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Independent Practice
Group Practice
A coalition of health care
professionals form abusiness to provide servicesto a population of patients.
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China 1983
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Independent Practice
What qualities must an APN
have to practiceindependently?
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Independent Practice Qualities
Entrepreneur – Self Assessment
‘one who organizes and manages a
business undertaking, assuming risk for
the sake of profit’… Decision-making and/or taking charge
Self discipline and self direction
Stamina Able to communicate and negotiate
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Entrepreneurship cont.
Do you enjoy competing in abusiness environment?
Can you admit when you are wrong?
Are you a self starter who can workon your own?
Do you trust people and do they trust
you?Do you know how to quickly solve
problems?
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Positive Entrepreneurial Qualities
Like to be in control
Are goal oriented
Able to manage by aims and goalsAble to analyze situations to
minimize risk
Creative thinkersCan admit they are wrong
Believe in themselves
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Negative Entrepreneurial Qualities
Lack management experience
Lack understanding of financialplanning
Poor location of facilities Poor fiscal management
Underestimates the personal time
Over expands too quickly Over spends budget
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Conclusion The future is bright to move nursing forward
Where is nursing in your nation?
Do you want to move nursing into a partner role inthe delivery of care?
Do you have the qualities of an entrepreneur?
Nurses can be more independent and
in control of their practice and patientcare when there is regulatory andprofessional support.
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Conclusion
Answers to these questions can leadnursing and health care of the people
forward. What is your answer?
Thank you
Rosemary Goodyear
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Hong Kong Harbor 1983