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nurseAPN: Advanced Practice Nursing

Why is there a need for advanced practice nurses (APNs)? The last quarter of the 20th century taught that detection, prevention, promotion, early intervention and education are not only cost-effective but also rational. They are ideally suited to deliver this type of health care.


Advanced practice nursing entails masteral or doctorate preparedness of nurses. Critical reflective thinking, self-directed learning and leadership skills are expectations for health-care providers in the 21st century. Therefore, this branch of nursing builds on the foundation of professional nursing practice and responds to the health care needs of the country.

Are APN’s contributions unique, valuable and can be evaluated? Let us take a look at the following examples:

• Clinical Nurse Specialist (CNS): In a hospital, the CNS must be able to identify how performance contributes to the patient-focused mission and goals of the organization. Does the CNS’s practice reduce length of stay, improve patient outcomes or enhance the efficiency of staff nurses?

• Certified Nurse Midwife (CNM): The CNM’s ability to better meet patient needs, or to provide services to groups of patients at a lower cost than services provided by physicians, should be measurable.

• Nurse Practitioner (NP): In an outpatient setting, the NP would need to document both the quality and quantity of services provided to patients and the ability to reduce hospitalization rates.

• Certified Registered Nurse Anesthetist(CRNA): In evaluating anesthesia services in a chronic low back pain clinic, the CRNA would want to clearly document quality of service and patient outcomes.

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