Ambulatory Nursing Certification Review (Ambulatory Care Nursing Certification Review Book 1)
The Ambulatory Practice RN role is so varied and wide it is difficult on a day-to-day level to try to frame it in numbers. Leading Change, Advancing Health. There is and will be an urgent need for nurses to understand and to grow their practice if they are to adequately respond to these significant social changes. Data from this exploratory survey are specific to the scope of practice of ambulatory care RNs as identified by the nurses in one health care system in Southern California.
Objective measures of activities and outcomes were not part of the study. Although the instrument was newly designed for this exploration, results provide timely and compelling baseline information for improvement of internal organizational practice and recent external influences for the RN scope of practice examination, as seen in the Institute of Medicine report.
The activities that most ambulatory care nurses reported as occurring most frequently were related to assessment.
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Only one other most frequent activity, conducting advice during message management, was an intervention. Assessment and triage activities reflect the nursing process, 15 , 29 with message management aligning with telephone communication. It also helps define the unique contributions of the RN, as assessment and surveillance are not part of the scope of practice for a nursing assistant or medical assistant.
However, assessment is only the first step of the nursing process. Nursing intervention and evaluation completes the process for RN practice. The findings in this group of nurses generate the formation of additional questions: If the tradition in nursing practice in ambulatory care has been to hand off to another clinician such as an advanced practice nurse, a physician assistant, or a physician, how are nurse and operational leaders going to assist staff RNs in practicing to the full scope of regulatory activities?
Ambulatory Care Nursing Exam Review
Movement in health care to chronic care models and the team approach requires that all team members practice collaboratively. Most activities described in this study also align with the American Nurses Credentialing Center certification for ambulatory care nursing for the conceptual domains of clinical practice and communication. Chronic disease management, therefore, is an opportunity to expand areas for collaboration as ambulatory care staff RNs become integrated in the health care team.
Outcomes reported in this study reflect the cited literature on patient satisfaction, 20 , 22 increased patient knowledge, and prevention of complications or admissions. If nursing is not seen as having an impact on those measures, the members of the discipline will not be seen as important to the outcomes achieved in their practice setting. Noteworthy findings for the structural characteristics include those regarding sex and education. If one circles back to the activities-related findings, in which it was identified that most of these nurses spend the majority of their time in assessment activities, one disconcerting conclusion might be that, indeed, these nurses are not being used to their fullest capacity.
Patients and families who often are struggling in the complex ambulatory care environment require the presence of and care provided by these highly educated clinical professionals. The advent of e-mail messaging systems has introduced an added dimension to nurse-clinician-patient communications.
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Both primary and specialty care nurses reported a high percentage of message management as part of their role as an ambulatory care staff RN, either as a phone call or e-mail. Message management is still not clearly defined, and the concerns surrounding it may be idiosyncratic to a particular clinical setting. It is also possible that these findings may be unique to an integrated health care system. However, it would not be surprising in any extensions of this work to find that the substantial workload secondary to message management volume is increasingly becoming a reality for nurses practicing in ambulatory care.
Further research is recommended on message management definitions, processes, patient outcomes, and impact on the ambulatory care staff RN role. The ambulatory care staff RNs in this study reported simultaneous management of multiple and varied clinical activities in the same time frame. Acute emergency response activities for stabilization were more common than expected. The additional coordination of message management with patient encounters and walk-in patients supports the overarching theme of daily, diverse, and complex patient care.
Diverse 21st century ambulatory care practice environments demand experienced RNs who can navigate these complexities. Sample demographic data demonstrates that the survey respondents are just such an experienced group, with an average of approximately 10 years in the ambulatory care setting and approximately 10 years of previous experience elsewhere.
The survey results support the premise that the respondents have an astute familiarity with their nursing practice that is acquired over time. This exploratory survey contributes to the discussion concerning the role and professional practice of the ambulatory care staff RN. The survey supports what ambulatory care RNs say they are doing: Nurses perceived that they influenced multiple relevant patient outcomes on a daily basis. The sharing of common characteristics, activities, processes, and outcomes contributes to the body of knowledge related to the specific role of the ambulatory care staff RN.
The knowledge gained from this study has the potential to enhance the quality of ambulatory care for patients in the community setting. Future research studies could reveal best practices related to message management, as well as activities and outcomes unique to specialty care populations. The authors also thank the nurses who participated in the survey.
Their willingness to voice their perceptions made this research study and subsequent article possible. National Center for Biotechnology Information , U.
Ambulatory Nursing Certification Review (Ambulatory Care Nursing Certification Review)
Journal List Perm J v. Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Introduction The ambulatory setting is where most individuals in the US receive health care. Background Currently, knowledge exists that describes the impact of nursing activities on outcomes relevant to inpatient settings.
Study Framework The Nursing Role Effectiveness Model 23 — 25 provides the conceptual structure for this investigation. Methods This study employed a descriptive, self-report survey design. Results After surveys from advanced practice nurses and managers were deleted, a total of designated staff ambulatory care RNs completed usable survey questionnaires.
Open in a separate window. Characteristics of ambulatory practice environment. The Emergency Department had no survey respondents. Activities of Ambulatory Care Staff Registered Nurses Process questions captured the perceived frequency that RNs were involved in assessment, intervention, teaching, evaluation, care coordination, and execution of medical orders. Reported frequency of activities of ambulatory care staff registered nurses.
The responses listed are from the most frequently reported and less frequently reported categories only. Results are reported by sample percentage and number of respondents in parentheses. Perceived Influence by Ambulatory Care Staff Registered Nurses Respondents were asked to choose the perceived frequency in which they influenced select patient outcomes during one shift. Reported frequency of influence.
Self-Reported Activities and Outcomes of Ambulatory Care Staff Registered Nurses: An Exploration
Reported frequency of outcomes influenced a Influenced 15 times a shift or more Rank for 15 times or more Influenced 1—5 times a shift Rank for 1—5 times Marked zero or not applicable Overall patient satisfaction The responses listed above are from the most frequently reported and less frequently reported categories only.
Content Analysis of Open-Ended Questions Many respondents took the opportunity to articulate any additional outcomes and activities related to their role. Acute Aspects of Ambulatory Care Respondents discussed emergency situations that could happen anywhere and anytime in ambulatory care practice. Daily Diverse and Complex Activities Numerous comments were made concerning additional activities not covered by the survey.
Open Preview See a Problem? Thanks for telling us about the problem. Return to Book Page. Provides key information you need to know to pass the board and certification exam. All questions have explanations with keywords linked to additional online references. Correct answer is on the next page after the question with explanations and links to further research the key point s covered in eac Ambulatory Care RN Certification Review, multiple choice questions. Correct answer is on the next page after the question with explanations and links to further research the key point s covered in each question.
Published November 11th by Knowledge Testing, Inc. Topics are offered in an interactive, problem-solving format to enhance your critical thinking. Please note, this course does not grant certification in ambulatory care nursing. Requirements for Successful Completion: Complete the learning activity in its entirety and complete the online CNE evaluation. Presenter s have no disclosures to declare. Commercial Support and Sponsorship: No commercial support or sponsorship declared. Accreditation of activities for contact hours does not imply approval or endorsement of any product, advertising, or educational content by Anthony J.
This educational activity is jointly provided by Anthony J.