Current Practice Setting

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Current Practice Setting

Current Practice Setting

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  • Briefly describe your practice setting and the typical patient population.
  • Provide examples of key subjective and objective data points you collect.
  • Describe how you document your findings. Is there technology involved?
  • Describe your process of data analysis. What is the end result of this process? (i.e., Do you formulate nursing diagnoses and care plans, collaborate with others and/or make referrals?)
The Affordable Care Act of 2010 (ACA) will place numerous demands on health professionals while also providing numerous opportunities for them to establish more patient-centered system. 
The bill has started the long process of moving the US health-care system’s focus away from acute and specialist care. 
Chronic illnesses, primary care, including care coordination and transitional care, prevention and wellness, and the avoidance of adverse events, such as hospital-acquired infections, have all become more critical as result of this shift in focus. 
Furthermore, because of the aging population, the demand for long-term and palliative care will continue to rise in the future years (see Chapter 2). 
The growing insured population, as well as the rapid growth of racial and ethnic minority groups who have previously faced barriers to health care, will necessitate care that is tailored to more socioeconomically and culturally varied population.


This chapter looks at how allowing nurses to practice to the full extent of their education and training (important message #1 in Chapter 1) can help to address these issues. 
The first section illustrates why changing nursing practice to improve care is so vital, with three examples of how harnessing nurses’ full ability has improved care quality while also increasing value. 
The chapter then delves into the roadblocks to this transformation, such as regulatory barriers to expanding nurses’ scope of practice, professional resistance to expanded roles for nurses, fragmentation of the health-care system, outdated insurance policies, high nurse turnover rates, difficulties in the transition from education to practice, and demographic issues. 
The third portion explains how the ACA, as well as technology, has enabled new structures and opportunities. 
The committee’s conclusions about the nursing profession’s critical contributions to the success of these initiatives, as well as the overall transformation of the health-care system, are summarized in the final section, along with what needs to be done to transform practice to ensure that this contribution is realized. 
The role of advanced practice registered nurses (APRNs) in chronic illness management and greater access to primary care, as well as the legislative constraints that prohibit them from doing so, are highlighted. 
This isn’t to mean that general registered nurses (RNs) shouldn’t have the chance to advance their careers and take on new responsibilities; the chapter includes examples of this.




As discussed in Chapter 2, the changing landscape of health care and the changing demographics of the population necessitate fundamental shift in the system to provide patient-centered care, deliver more primary care rather than specialty care, deliver more care in the community rather than in the acute care setting, provide seamless care, allow all health professionals to practice to the full extent of their education, training, and competencies, and foster innovation. 
The health-care system will be able to provide higher-quality care, minimize errors, and improve safety if this transformation is made. 
Providing care in this manner and in these areas plays to the nursing profession’s traditional strengths. 
By virtue of their numbers, scientific knowledge, and adaptive capacity, nurses are well positioned to meet these needs, according to this chapter, and the health-care system should take advantage of their contributions by taking enhanced and reconceptualized roles.


Nursing is one of the most adaptable professions in the health-care industry.


Modern nursing has reinvented itself several times as health care has improved and altered in the 150 years since Florence Nightingale founded and advocated the concept of an educated workforce of carers for the sick (Lynaugh, 2008). 
New career paths for nurses have emerged as result of the nursing profession’s versatility and adaptability, drawing wider and more diverse candidate pool and leading to enlarged scopes of practice and duties for nurses. 
Nurses have been driving force for change in health care in variety of ways (Aiken et al., 2009). 
Among the many advancements made possible by versatile, adaptable, and well-educated nursing profession are:


the development of the high-tech hospital; the ability for physicians to combine office and hospital practice; hospital stay lengths that are among the shortest in the world; reductions in resident physician work hours to improve patient safety; expansion of national primary care capacity; improved access to care for the poor and rural residents; respite and palliative care, including hospice; care coordination for chronically ill and elderly patients


Nursing has become an increasingly important aspect of health care services with each passing decade, to the point where future without huge numbers of nurses is unthinkable.
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