Masters Level Competencies in Nursing - Assignment Example

Masters-level Competencies in Nursing Competencies s help the employees in knowing the level of knowledge and skill set required of them to do a particular job. Masters’ prepared nurses are at an advantage because they are able to add to the skills they gain in a baccalaureate nursing program and develop a better understanding of nursing and other sciences needed for them to redefine nursing care. These nurses are well versed in caring for diverse people with different cultures and their families in a hospital or community-based systems. The program allows the masters’ prepared nurse to combine knowledge from an assortment of fields such as humanities, health sciences, genetics, health economics and public health for constant improvement of the quality of care they deliver. They are also more qualified than their baccalaureate prepared counterparts to collect, analyze and interpret statistical data in order come up to identify problems within the health sector and design solutions to these issues. This paper discusses the competencies the masters’ prepared nurses acquire during the program and how they aid in improving the health sector. Masters Level Competencies in Nursing Nursing as an education and a profession is able to address some of the critical issues that arise in this evolving health care system. A study conducted in the USA showed that the US government could save up to 8.75 US dollars annually if hospitals used advanced practice nurses (APNs) in place of physicians for some medical cases. This way they can also plan for their career (American Association of Colleges of Nursing, 2007). They also help the consumers because they ensure that the service the patients they receive is of high quality and meets set standards. This paper will examine masters’ level competencies for determining the areas that need improvement and if they are still viable given the health care system. I will hence discuss competencies from the American Association of Colleges of Nursing (AACN), Quality, and Safety Education for Nursing (QSEN) and National League for Nursing (NLN). The AACN outlines master-level competencies for adult nurse practitioners that add to the core competencies for all nurse practitioners (American Association of Colleges of Nursing, 2007). The adult nurse is the provider of direct health care services. Within this role, the nurse applies nursing theories, scientific knowledge, and contemporary clinical knowledge to assess and manage the health and illness state of a patient. In the assessment of health, the adult nurse practitioner assesses all aspects of a patient’s health status. In treating a patient, the nurse employs evidence-based clinical practice guidelines to determine the health status of a patient, identify the likely cause of an illness and to provide informative direction to the patient to help them maintain their health. Graduates with a masters’ degree in nursing acquire knowledge in various areas in the field. They may choose to pursue paths that allow them to venture into administrative roles that champion for health care reforms and better access to health care. Other graduates may continue their education to the point where they can educate others either by being a Clinical Nurse Leader or a Nurse educator. Some may choose the indirect route of care by concentrating on health care systems rather than dealing with the patients directly. They could do this by becoming either a nursing or health program manager, dealing with informatics about public health, or clinical research coordinator. Besides acquiring the competencies in the nine Essential core areas, graduates undertake a coursework in a field of their choosing. For example for further development in gaining knowledge in the field , a masters’ prepared nurse will need Essential IV as outlined in The Essentials of Masters’ Education in Nursing. (American Association of Colleges of Nursing, 2011). This requires them to apply research outcomes within the practice setting, resolves practice problems, works as a change agent, and disseminates results. It also means managing research projects for nurse scientists or other healthcare workers. The QSEN faculty adopted the Institute of Medicine competencies for nursing, which are patient-centered care, evidence-based practice, teamwork and collaboration, quality improvement, safety, and informatics (Cronenwet, et al., 2007). Although the health care sector highly values nurses for their contribution to daily care, nurses have the extra task of improving the quality of the practice itself. Educators usually do not take time to teach improvement concepts or their demonstrations. A masters’ prepared nurse should be able to conduct faculty development and forge new partnerships with nurse managers, physicians, and other health professional colleagues in clinical settings. This is the theory behind the Quality Improvement (QI) Competency (Cronenwet, et al., 2007). It also resonates with the teamwork and collaboration Competency. They would therefore gain knowledge in order to describe strategies for learning about the outcomes of care in the setting in which one is engaged in clinical practice and explain the importance of variation and measurement in assessing quality of care. They should also be able to describe the approaches for changing the processes of the care they give and use quality measures to understand performance for example by identifying gaps between local practice and best practice. Finally, they should be able to recognize that nursing and other healthcare professionals’ collaboration is key in enhancing the care processes for the patient. The National League for Nursing adopted a document that ensures that all United States nursing programs uphold the highest standards of quality and excellence (Redma, Lenburg, & Walker, 1999). Masters’ prepared nursing students often specialize in a particular field of practice and their work reflects a scholarly critique of current evidence in nursing and related disciplines. The capacity to identify gaps in knowledge and formulate research questions shows their competence in the spirit of inquiry. They are also required to employ their advanced practice knowledge in ways that foster best practice in the field and promote personal and professional growth. Also in practicing good leadership skills, they should support positive change in systems and people in order to advance the profession. The rationale behind these competencies when it comes to Essential IV for The Essentials of Masters’ Education in Nursing is that all professional nursing practices at all levels is based on evidence-based research. The master-prepared nurse looks for evidence for every practice, translates it into practice and seeks to bridge gaps where evidence does not match current practice (American Association of Colleges of Nursing, 2011). A nurse applies these practices not only locally but also on a broader spectrum in order to advance clinical practice. They also resolve practice problems and disseminate results to others in the field. The ability of masters-prepared nurses to recognize the need for challenging the existing health practices, procedures and policies put them in a unique position to push the health agenda. Continuous Quality Improvement is part of every profession. Patient safety according to the Institute of Medicine Report requires that a patient should not be in greater risk of accidental injury in a health care facility than their own home (Institute of Medicine, 2010). A masters’ prepared nurse must be able to identify actual and potential failures in the system and processes and formulate a way to account for and possibly eliminate these errors. This is the foundation of Quality Improvement where the nurse’s ability to minimize these errors ensures patients safety along with providing quality health care. The masters’ graduate nurse should also ensure that in their effort to minimize probability of accidental injury, they create a safety net in which employees can comfortably disclose errors in the workplace, including their own. They should do so while still maintaining a high level of professionalism. According to Lembitz & Clarke, (2009), Never Events in the health profession contribute to errors that affect both the public and the health care givers. It is the duty of masters’ holding nurses to ensure that in the occurrence of these events, hospital staff maintained standard practice and competence. Globally, healthcare bears a significant burden on low-income economies and middle-income economies in various countries. This explains the inequities and disparities in the health care system. Nursing, as a profession, can help the US government achieve its goal for improving the nation’s health status by ensuring clinical prevent and disease control. In an effort to reduce unhealthy lifestyle behaviors, masters-prepared nurses take on the role of training other health professionals in the promotion of health and disease control. The people of America are of a diverse culture and of different ethnicities. It is the duty of the masters’ prepared nurse to be able to meet the various needs by each individual and ensuring their patients’ comfort. For example if a patient wearing a Do-Not-Treat bracelet arrives in a hospital from a scene of an accident in incoherent state, the nurse has to seek psychiatric counsel before proceeding with treatment. The masters’ holding nurse has to ensure measures are in place in the hospital to deal with such events. Competence in planning and management contributes to the capacity of a nurse to anticipate such events and to develop strategies to deal with them. The AACN, QSEN and NLN developed the above competencies to address the numerous health care dilemmas we are facing not only today but also in anticipation of the future. Those issues include chronic illness management, problems associated with normal human development particularly aging, health disparities that arise from socioeconomic differences such as classism, sexism and racism. Fundamentally, they arose to make strategies to promote health and prevent diseases. In former years, credentialing, certification, and accreditation focused on the students’ knowledge of processes and the time they took to complete a particular task as indicators of quality. In the past, professions awarded students on their ability to describe a process rather than skillfully undertaking the process. This does not ensure that the students can perform the tasks after graduation. With these competencies in place, not only do the educators they acquire evidence of students’ abilities, but also the knowledge of areas of improvement. This part of my paper will address the factors that contributed to the shaping of these competencies. First, the transformation of the health care is dynamic and it happens on a daily basis. One such example is a mother who brings her child into a clinic for treatment is most likely to be treated by a nurse instead of a medical doctor. A patient being readied for surgery will have a nurse administer the anesthetic instead of a physician. Also in the Operating Room, the nurses’ presence is as essential as the surgeon is because they keep an eye on the patients vitals at the same time help the surgeon with necessary operating equipment. During recovery from an acute illness, the clinical may decide that the patient no longer requires hospital facilities but is still not fit enough to return home. In doing so, they may decide the best place for them to recover would be a transitional care facility under the supervision of a clinical nurse who provides rehabilitation (Dracup, 2015). In addition, the public has been vocal about the need for a reformed and responsive healthcare system. There are also groups calling for changes in the way lecturers train masters’ level nurses. The changes the educators should implement need to meet the projected needs for a dynamic health care system that caters for contemporary health care delivery methods. However, the implementation of the proposed change need to occur at the most basic levels of education including baccalaureate level and not just at masters’ level. Nursing methods should also be culturally responsive to patients’ needs as well as include evidence-based practice (Redman, Lenburg & Walker 1999). Another issue that arises is the financial issue with the introduction of Medicare and Medicaid. Policies in hospitals need to ensure that patients received the care they need because denying service to needy poor patients compromises a nurse’s ethical and legal obligations to the health of a patient (Lembitz & Clarke 2009). Collaboration in any field is vital to the development and growth in the sector. Masters-prepared nurses bring a unique set of skills to the table because their jobs cover a wide variety of responsibilities. In consultation with other professionals in the field, new and inventive ways to address health care problems. They possess skills necessary for collaboration and negotiation. They may assume a leadership role in ensuring patient safety and quality improvement. Nurses are tasked with integrating and analyzing outcome data in order to make informed decision-making. They may also apply the information processed from the data to evaluate the optimal health outcomes. Education has a significant impact on the knowledge and the competencies of the nursing profession. There have been numerous reports that outline the benefits that patients and employers receive from nurses advancing their education. Similarly, the nurses also benefit professionally. One such report was by the Robert Wood Johnson Foundation (RWJF), which released a report titled The Future of Nursing: Leading Change, Advancing Health. This article encouraged the US government to increase the number of baccalaureate nurses in schools by 80% by 2020. The evidence they presented in this report gave an indication of the high demand for highly trained nurses there would be in the future. They cited constantly evolving healthcare system and the changing needs of patients as the reason for the high demand for nurses. In September 2013, the RWJF released a newsletter tilted The Case for Academic Progression. This article states the case for the better performance portrayed by nurses at baccalaureate and masters’ degrees level as opposed to diploma-holding nurses. It also gives a future indication of how such trends could continue to facilitate better healthcare delivery and improve the nation’s health status as a whole. The essential of Translating and Integrating Scholarship into practice recognizes the need for masters’ trained nursing professional to apply the acquired knowledge in an actual practice setting, solve problems and disseminate the results. The competencies required for maters level ensure that they do evidence-based practice. That helps in identifying areas that need questioning and finding the questions to these answers. This cyclic process revolves around doing evidence-based research to solve issues, evaluating the outcomes and assessing the room for more questions. The long-term impact of this is it not only improves health-care but also provides the professional with a chance to hone their skills (Hughes & Blegen 2008). Dr. Bernadette Melnyk published in the American Journal of Nursing and gave a problem-solving approach to the delivery of healthcare. In his article, he suggests that that the best health care practice is the type that integrates the best evidence from approved studies and combines it with patient preferences and expertise. He says in enables care to be individualized therefore improving a patient’s health exponentially. In the spirit of inquiry, he encourages a nursing professional to ask questions in the PICOT format (Melnyk, 2014). This is where the type of patients’ population is considered P before intervention I is done in areas of interest of health. Comparison C is conducted with similar cases, outcome O is analyzed and finally all these should be done in the shortest time T possible. In that spirit of gaining knowledge, as a future professional in the field, I will need to assess my career goals and match them to my community’s needs. I plan to acquire skills that are both research-based and practice focused. Research in the field would be my primary foundation in order to improve the health-care techniques in my community and the field as a whole. Alongside acquiring the knowledge required in the field, I will strive to develop leadership and interpersonal skill set to promote the spirit of inquiry. Since extended clinical work is key, it would be a priority of mine to spend less time in the classroom and more in practice. Conclusion Nursing competencies serve to transform the nursing education system and is essential in ensuring the improvement of the health care system. The health care sector is constantly changing and it is vital for a master-trained professional to keep up with the current trends. The Essentials they acquire ensure the professionals not only initiate change for quality care outcome but also promote excellence through lifelong learning. They also should manage to build and lead collaborative inter-professional care teams. It is essential for them to disseminate results across the healthcare system. They should not only design innovative nursing practices, but also observe evidence-based practice (EBP). Masters’ degree nursing programs prepare graduates with enhanced nursing knowledge and skills to address the evolving needs of the dynamic healthcare system. References American Association of Colleges of Nursing. (2007). White Paper on the Education and Role of the. Georgia: American Association of Colleges of Nursing. American Association of Colleges of Nursing. (2011). The Essentials of Masters’ Education in Nursing. American Association of Colleges of Nursing. Cronenwet, L., Sherwwod, G., Barnsteiner, J., Disch, J., Johnson, J., & Mitchell, P. (2007). Quality and safety education for nurses. Nursing Outlook, 55, 122-131. Dracup, K. (2015). Masters’ Nursing Programs. California: American Association of Colleges of Nursing. Hughes, R. G., & Blegen, M. (2008). Medication administration safety. In R.G. Hughes (Ed.), Patient safety and quality: An evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality Institute of Medicine. (2010). The Future of Nursing: Leading Change, Advancing Health. Wahington,DC: National Academies Press. Lembitz, A., & Clarke, T. (2009). Clarifying never events and introducing always events. Patient SafetyinSurgery,3, 26-31. Retrieved 2015, from http://www.pssjournal.com.content/3/1/26 Melnyk, B. (2014). Evidence-based Practice Versus Evidence-informed Practice: A Debate That Could Stall Forward Momentum in Improving Healthcare Quality, Safety, Patient Outcomes, and Costs. Worldviews on Evidence-Based Nursing. doi:10.1111/wvn.12070 Redman, R., Lenburg, C., & Walker, P. 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