Advanced Practice Registered Nurses (APRNs) play a pivotal role in transforming healthcare delivery, especially in primary care and specialized areas such as stroke care, heart failure management, and mental health services. Their advanced training and expanded scope of practice enable them to provide high-quality, cost-effective care, often filling gaps left by physician shortages.
APRNs, including Clinical Nurse Specialists (CNSs), Nurse Practitioners (NPs), Certified Nurse-Midwives (CNMs), and Certified Registered Nurse Anesthetists (CRNAs), bring a unique blend of clinical expertise and patient-centered care to their roles. The American Academy of Nursing emphasizes the importance of APRNs practicing to the full extent of their education and licensure to optimize health outcomes. This includes addressing complex chronic conditions and leading system-wide innovations in healthcare delivery (Horton et al., 2024).
In Oklahoma, APRNs have demonstrated a significant impact across the continuum of care, from pre-intervention to post-discharge. A systematic review highlighted that APRNs improve clinical and patient-reported outcomes through their roles in assessment, diagnosis, treatment, and patient education. Their involvement in stroke care teams enhances diagnostic accuracy, expedites treatment, and ensures comprehensive post-discharge care, ultimately improving patient outcomes (Horton et al., 2024).
Heart failure management is another area where APRNs excel. Implementing APRN-led heart failure clinics has been shown to optimize post-discharge care, reduce hospital readmissions, and lower overall treatment costs. These clinics leverage the advanced skills of APRNs in chronic disease management, providing complex treatment strategies and comprehensive care to heart failure patients (Strachan et al., 2022).
In mental health, Psychiatric Mental Health Advanced Practice Nurses (PMHNPs) play a crucial role in addressing the shortage of mental health professionals. They are licensed to provide a full range of mental health services, including assessment, diagnosis, and prescribing. Their integration into collaborative care models can significantly increase access to mental health services, particularly in underserved areas (Swan et al., 2015).
Compensation equity for APRNs is also a critical issue. Strategies to ensure equitable and competitive compensation models are essential to attract and retain skilled APRNs. Addressing pay discrepancies and building sustainable APRN infrastructure are key steps in valuing and rewarding these advanced clinicians appropriately (Soh et al., 2021).
APRNs also play a crucial role in primary care, significantly impacting health service utilization, costs, and access to care. A scoping review synthesized evidence on the global impact of APRNs in primary care. The review found that APRNs are associated with fewer emergency department visits, hospital readmissions, and lower healthcare costs. Additionally, APRNs provide high-quality care, particularly in chronic disease management, and improve access to care in rural and underserved areas (Altermatt-von Arb et al., 2023).
In conclusion, APRNs are integral to advancing healthcare delivery through their specialized roles in various clinical settings. Ensuring they can practice to the full extent of their education and licensure, addressing compensation equity, and integrating them into collaborative care models are essential steps in maximizing their impact on patient care and health outcomes in Oklahoma.
References
Altermatt-von Arb, R., Stoll, H., Kindlimann, A., & others. (2023). Daily practices of advanced practice nurses within a multi-professional primary care practice in Switzerland: A qualitative analysis. BMC Primary Care, 24(1), 26. https://doi.org/10.1186/s12875-023-01977-y
Horton, M., Dixon, J., Turi, E., & others. (2024). Advanced practice nurses in primary care and their impact on health service utilization, costs, and access globally: A scoping review. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.17614
Soh, B. F. J. R., Ang, W. H. D., De Roza, J. G., & others. (2021). They are partners in care: A qualitative exploration of physicians’ perceptions of primary care advanced practice nurses. Journal of Nursing Scholarship: An Official Publication of Sigma Theta Tau International Honor Society of Nursing, 53(5), 542-551. https://doi.org/10.1111/jnu.12665
Strachan, H., Hoskins, G., Wells, M., & Maxwell, M. (2022). A realist evaluation case study of the implementation of advanced nurse practitioner roles in primary care in Scotland. Journal of Advanced Nursing, 78(9), 2916-2932. https://doi.org/10.1111/jan.15252
Swan, M., Ferguson, S., Chang, A., Larson, E., & Smaldone, A. (2015). Quality of primary care by advanced practice nurses: A systematic review. International Journal for Quality in Health Care: Journal of the International Society for Quality in Health Care, 27(5), 396-404. https://doi.org/10.1093/intqhc/mzv054
