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Advanced Practice Roles for Nurses in Tomorrow's Healthcare Systems

Berger, Ann; Eilers, June; Pattrin, Lynneé; Rolf-Fixley, Mary; Pfeifer, Barbara; Rogge, Joyce; Wheeler, Lynette; Bergstrom, Nancy; Heck, Catherine

Executive Practice

ADVANCED PRACTICE NURSES (APNs) have traditionally been a diverse group in terms of titles, education, credentials, and roles. The classification of APN usually encompasses the nurse practitioner (NP), certified nurse midwife (CNM), certified registered nurse anesthetist (CRNA), and clinical nurse specialist (CNS). NP, CRNA, and CNM roles have been more clearly delineated than the CNS roles. In light of healthcare reform, the CNS roles have been critically reviewed and analyzed. Attempts have been made to clarify responsibilities and outcomes, and to quantify the financial impact of this role. In this article, seven APN roles clearly defined in terms of minimal qualifications and competencies critical to accomplishment of the duties, responsibilities, and expected outcomes are presented. Comparison of competency requirements are also presented. The roles presented are designed to facilitate healthcare institutions in meeting the demands for serving patients with increasingly complex needs, as well as cost-containment goals.

ANN M. BERGER is a Ph.D. candidate and clinical nurse specialist in the General Oncology Department at the University of Nebraska Medical Center, Omaha, Nebraska.

JUNE G. EILERS is a Ph.D. candidate and a clinical nurse specialist in the Oncology and Hematology Department at the University of Nebraska Medical Center, Omaha, Nebraska.

LYNNEÉ PATTRIN is a patient care manager at the University of Nebraska Medical Center, Omaha, Nebraska.

MARY ROLF-FIXLEY is the director of clinical care services at the University of Nebraska Medical Center, Omaha, Nebraska.

BARBARA A. PFEIFER is an assistant coordinator, healthcare resources, nursing service, at the University of Nebraska Medical Center, Omaha, Nebraska.

JOYCE A. ROGGE is a clinical nurse specialist and liver transplant coordinator at the University of Nebraska Medical Center, Omaha, Nebraska.

LYNETTE M. WHEELER is a patient care manager at the University of Nebraska Medical Center, Omaha, Nebraska.

NANCY I. BERGSTROM is a professor and interim associate dean at the University of Nebraska Medical Center, Omaha, Nebraska.

CATHERINE S. HECK is an educational specialist at the University of Nebraska Medical Center, Omaha, Nebraska.

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