Acute Care Nurse Practitioner: Definition

  • The ACNP is a relatively new concept in the nurse practitioner field that was established in the early 90's. The nursing profession realized that needs of the patients were not adequately being met, they realized that nurse practitioners had a scope of practice that could be maximized to fit the medical and nursing needs of these critical and vulnerable patients (Becker, Kaplow, Muenzen, & Hartigan, 2006)
  • The ANA and AACN formed a joint task force delineate the scope of practice for adult ACNPs, they determined “the purpose of the ACNP is to provide advanced nursing care across the continuum of acute care services to patients who are acutely and critically ill.”(Becker et al., 2006)
  • The ACNP is a registered nurse who has completed an accredited graduate-level educational program that prepares him or her as a nurse practitioner with supervised clinical practice to acquire advanced knowledge, skills, and abilities (Bell, 2012).
  • Education of the advanced practice registered nurse includes  a BSN with approximately  1000 clinical  and 60 credit hours classroom time, and are masters prepared with their MSN and an additional 500-700 clinical hours, and 40-50 classroom hours (Courtney, 2014)
  • Nurse practitioners offer the best of both worlds: Nurse practitioners have a knowledge base of and manage medical and nursing problems in a multitude of settings inclduding  primary and acute care (Joel, 2013).
  • The ACNP provides direct patient care, they  can perform comprehensive health assessments;  order and interpret the full spectrum of diagnostic labs, tests and procedures; perform advanced diagnostic and therapeutic procedures and assumes accountability for patient care (Bell, 2012)
  • ACNP uses a differential diagnosis to reach a medical diagnosis; and  orders, provides, and evaluates the outcomes of interventions (Bell, 2012).
  • The ACNP's purpose  is to provide advanced nursing care across the continuum of health care services to meet the individual physiologic and psychological needs of patients (Bell,2012).
  • Practice population of the ACNP is dependent on their training, skill set, and background. Population of focus typically includes adult-gerontology  patients with acute, critical and or complex conditions, that may be physically and mentally unstable (Bell, 2012).
  • The ACNP is trained and prepared to diagnose and treat patients with undifferentiated symptoms as well as manage patient care in those with and established diagnosis (Bell, 2012)
  • Acute care nurse practitioners practice in a multitude of settings including emergency rooms, ICUs, step down or progressive care units, and medical and surgical floors (Joel, 2013).
  •  In in hospitals and other tertiary health centers the cyclic changing of medical residents has led to fragmented  and decreased continuity of care. Patient settings that are complex, and where continuous follow up on patients and continuity of care are preferred to improve patient outcomes are ideal working environments for ACNPs and are suited to their skill set (Joel, 2013).
  • America has an elderly population that is continuing to increase, with estimates that the number of elderly will increase over 70% between 2010 and 2030, coinciding with projected worsening of critical care intensivists, clinicians,  and nurses, ACNPs can step in to fill this gap (Joel,2013).
  • The ACNP was originally developed to serve in a hospital settings, but since its creation the role has continued to expand and change. While over 50 % of ACNP still practice in the tertiary settings, ACNP has moved out from the hospital and into other areas. They can be found in other settings including specialty clinics, variety of surgery services, pain management centers, palliative care and other areas (Joel, 2013).

References

  • Bell, L. (Ed.) (2012). AACN scope and standards for acute care nurse practitioner practice. Aliso Viejo, CA: American Association of Critical-Care Nurses. ISBN: 978-0-945812-01-2
  • Hoffman, L., Tasota, T., Zullo, T., Scharfenberg, C., & Donahoe, M. (2005). Outcomes of Care Managed by an Acute Care Nurse Practitioner/Attending Physician Team in a Subacute Medical Intensive Care Unit. American Journal of Critical Care, 14, 121-130. Retrieved , from ajcc.aacnjournals.org
  • Joel, L., (2013). Advanced Practice Nursing: Essentials for Role Development. (3rd ed.). F.A. Davis Company  ISBN:  9780803627857
  • Linden, C, R Reijen, and R Vos (2010). Diagnositc accuracy of emergency nurse practitioners versus physicians related to minor illness and injury. Journal of Emergency Nursing 36: 311-316. doi: 10.1016/j.jen.2009.08.012
  • Meyer, S., & Miers, L. (2005) Cardiovascular Surgeon and Acute Care Nurse Practitioner: Collaboration on Postoperative Outcomes. AACN Clinical Issues, 16, 149–158. Retrieved , from https://www.ncbi.nlm.nih.gov/pubmed/15876882
  • Becker, D., Kaplow, R., Muenzen, P., & Hartigan, C.  (2006). Activates performed by acute and critical care advanced practice nurse: American association of critical-care nurses study of practice. American Journal of Critical Care, 15, 1-20. Retrieved , from https://ajcc.aacnjournals.org
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