Abstract
Introduction
Little information has been published regarding the actual practice, training, and
validation of basic skills and competencies needed by the advanced practice registered
nurse (APRN) in the emergency care setting. The purpose of this study was to (1) identify
skills being performed by APRNs practicing in emergency care settings (2); explore
types of training; and (3) describe competency validation. Additionally, we explored
frequency of skill use and facilitators and barriers to performing a skill to the
full extent of training and education.
Methods
An exploratory mixed-methods study was performed incorporating a self-report survey
and focus group interviews.
Results
The educational path to advanced practice nursing in emergency care settings is not
standardized. Few programs incorporate or address the need for APRNs to receive acute
care training across the life span, which is the hallmark of emergency nursing practice.
Similarly, training is reported as fragmented, and validation of skills for both nurse
practitioners and clinical nurse specialists can vary. APRN practice autonomy is affected
by the presence of other providers (specifically physicians), institutional culture,
and state boards of nursing that regulate practice.
Discussion
Integrated educational and orientation programs are needed that address high-acuity
patients across the life span. Additionally, a more nuanced approach to assessing
APRN capabilities as a combination of hard (clinical emergency) and soft (communication
and organizational) skills may be an appropriate framework within which to examine
the advanced practice role. Future research should continue to evaluate training,
competency assessment, and outcomes for APRNs in the emergency care setting.
Contribution to Emergency Nursing Practice
- •This study explored actual practice and facilitators and barriers to full advanced nursing practice in emergency settings.
- •Movement toward a standardized program curriculum in emergency nurse practitioner and clinical nurse specialist programs that encompasses resuscitative care across the life span
- •Clear metrics and assessment mechanisms for competencies
Key words
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Biography
Lisa A. Wolf, Member, Pioneer Valley Chapter, is Director, Institute for Emergency Nursing Research, Emergency Nurses Association, Des Plaines, IL.
Biography
Altair M. Delao is Senior Associate, Institute for Emergency Nursing Research, Emergency Nurses Association, Des Plaines, IL.
Biography
Cydne Perhats is Senior Associate, Institute for Emergency Nursing Research, Emergency Nurses Association, Des Plaines, IL.
Biography
Michael D. Moon, Member, San Antonio Chapter, is Associate Professor, University of the Incarnate Word, San Antonio, TX.
Biography
Margaret J Carman is Assistant Professor, Duke University, Durham, NC.
Article info
Publication history
Published online: June 01, 2017
Identification
Copyright
© 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.
