Running head: ROLE AND SETTING OF ADVANCED NURSE PRACTITIONER 1

Role and Setting of Advanced Nurse Practitioner in Acute Care Gerontology

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ROLE AND SETTING OF ADVANCED NURSE PRACTITIONER 2

Role and Setting of Advanced Nurse Practitioner in Acute Care Gerontology

The number of old people in need of nursing care has grown exponentially. Aging comes

with a myriad of health issues and requires care. There are several roles that advanced nursing

plays in ensuring that the safety of the patient increases while, at the same time, reducing the

time taken in a health facility or to recover. One of these mandates includes the diagnosis of the

acutely ill person. There is also the management of an individual from the time of their

admission to when they are discharged. Another role includes the follow-up on the patient even

after they are cleared. The process ensures a smooth transitioning to another environment, thus,

leading to quick recovery. Therefore, acute care gerontology involves extending care to this part

of the population to ensure that they spend the minimum time in recovery.

Clinical Role

The role of the advanced practice is clinical in nature. By performing the assessment,

which may include interviews, diagnosis, and taking the medical history of the patient, the

practitioner assumes a clinical role. In addition to that, there is the clinical management of the

patient during the time they are admitted to the hospital. Taking this role helps increase the safety

of the patient during the treatment process and after discharge. Assessment and diagnosis assists

in placing an individual on the right treatment process, thus, ensuring that there is no risk of

administering wrong treatment (Goldberg et al., 2016). At the same time, the nurses play a vital

role in guaranteeing that there are no chances of the patient getting an in-hospital infection.

Additionally, reducing the time spent in a hospital also brings down the chances of

getting an infection there. The follow-up they make also helps increase the safety of the patient

by ensuring that they are taking their prescriptions safely (Hirst & Cole, 2014). There is also an

assessment of the patient with the aim of taking further action when it is necessary. In the case
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that the patient has to undergo surgery, the assisting role that they take assist in eliminating

mistakes that can lead to complications.

The Process of Gerontological Competence in Delivery of Acute Care Nursing by Hirst

and Cole (2014)

Hirst and Cole (2014) emphasize the need to increase the onsite gerontological

competence for the nursing staff while, at the same time, considering their career development

plans. According to the authors, there are several benefits in advancing this approach. The first

named in the article is the reduction of the cost of avoidable complications which happen in the

hospitals that relate to acute care (Hirst & Cole, 2014). At the same time, they reduce prolonged

stays in the hospitals of the older population. There is also the decrease of the occupancy of the

hospitals, thus, creating room for others who are in need of the care (Hirst & Cole, 2014).

Moreover, there are benefits to the patients and their families when the acute care improves. The

authors argue that the staffs at the hospitals have little specialized training on gerontological care.

In fact, that is despite the growing number of people in this category.

Hirst and Cole (2014) also suggest strategies that will help correct the situation. They

include hiring a qualified nurse who has certification in gerontology, encouraging staff to get the

certification, and having a panel that has the presentation of older people (Hirst & Cole, 2014).

According to them, the older people have a better understanding of the issues that affect.

Provision of reading material on the topic to the staff is also an important step in ensuring their

understanding of the topic. The facilitation of conferences and seminars that relate to the topic is

another strategy named by the author.

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Assessment Tools for Determining Appropriateness of Admission to Acute Care of Persons

Transferred from Long-Term Care Facilities: A Systematic Review by Renom-Guiteras,

Uhrenfeldt, Meyer, & Mann (2014)

The article is a research paper on the tools used to assess the appropriateness of

admission to acute care for the patients who have been in long-term care residents. There are

sixteen tools, which were under this review. The research considered the period between 1991

and 2012. There was also an evaluation of twenty-nine articles, which were between 1991 and

2009. The authors found that the appropriateness of the tools used ranged from 2% to 77%

(Renom-Guiteras et al., 2014). The result of the study is that only four of the tools are

appropriate. Some of the reasons the authors found the tools inappropriate were that they fail to

take into account the characteristics of an individual during admission. Moreover, they lack to

apply the evidence-based approach, which makes them weak. Generalizing of the patients when

they lack similar characteristics is also a problem identified with some of the tools.

The authors then suggest ways that will help change the situation. Among those included

is the application of the evidence-based approach when evaluating the patients in the emergency

department (Renom-Guiteras et al., 2014). There is also a separation of each case where there is

no generalization. Therefore, the staff would treat the instance of a patient as a new one without

reference to prior cases.

Development of a Curriculum for Advanced Nurse Practitioners Working with Older

People with Frailty in the Acute Hospital Through a Modified Delphi Process by Goldberg

et al. (2016)

The article is written by a panel of experts in the medical profession with the aim of

improving the practice of advanced nursing in the acute care. The experts have a way of
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modifying the Delphi process in the development of a curriculum of teaching the advanced

nurses on acute care (Goldberg et al., 2016). They recognize that although there is an existing

one in place, it falls short of addressing the existing needs. Moreover, they analyze the role of

advanced nursing practitioners in the care of older people.

Additionally, the authors identify the competencies the nurses require to accomplish their

work effectively. The experts took each of the available curriculums and reviewed it identifying

its strengths and weaknesses (Goldberg et al., 2016). They then made a list of all the

competencies and related them to a curriculum that would meet the needs of acute care. The

development of the new prospectus is expected to change the approach to the advanced nursing

practitioners and the management of hospitals on how they approach the issue.

Conclusion

There is a void in acute care by the advanced nursing. At the same time, the growth in a

number of the population, which requires this care has been steady. That has led to the change in

the strategy of the approach. There are suggestions on how to approach the issue to improve the

safety of the patients and reduce the cost and the time taken to hospitals.
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References

Goldberg, S. E., Cooper, J., Blundell, A., Gordon, A. L., Masud, T., & Moorchilot, R. (2016).

Development of a curriculum for advanced nurse practitioners working with older people

with frailty in the acute hospital through a modified Delphi process. Age and

Ageing, 45(1), 48-53.

Hirst, S., & Cole, M. (2014). The process of gerontological competence in the delivery of acute

nursing care. Indian Journal of Gerontology, 28(4), 456-468.

Renom-Guiteras, A., Uhrenfeldt, L., Meyer, G., & Mann, E. (2014). Assessment tools for

determining appropriateness of admission to acute care of persons transferred from long-

term care facilities: a systematic review. BMC Geriatrics, 14(1), 80.