Advanced practice nurses (APN) are nurses with additional training and academic knowledge, which enables them to perform examinations, make assessments and diagnoses, as well as treat and prescribe medicine for patients. They serve as a leading chain link between patients and doctors, as they make referrals for those whose health issues could not be easily diagnosed or differentiated (Younas & Quennell, 2019). They are integral to different aspects of patient care and influence medical outcomes. Therefore, it is paramount to measure and monitor the quality of provided care and the outcomes associated with APNs.
One of the primary means of measuring and monitoring the quality of care is subjective reviewing. Patients and nurses alike can evaluate their performance and estimate the quality of care provided. Since most healthcare facilities in the West practice patient-centered care, the insights provided by the patients are extremely valuable, as they are considered experts in how they feel (Younas & Quennell, 2019). Nevertheless, these measures are not exhaustive, as objectively poor care provided by a particularly nice nurse would be graded higher than it deserves (Kleinpell, 2021). Nurse reviewing, likewise, has issues with objectivity since humans are likely to not notice or downplay their own mistakes to avoid trouble (Kleinpell, 2021). Therefore, subjective reviews have to be supplemented by objective evaluations.
Outcomes achieved by advanced practice nurses are considered some of the objective metrics that could be used in evaluating and monitoring the quality of care. To qualify, they have to be quantifiable, measurable, and appropriate for the specific area of nursing (Kleinpell, 2021). The most common metric utilized in most facilities involves rehospitalization rates. If the quality of care were high, the chances of being readmitted to the hospital because of mistakes, poor treatment, and other factors would be low (Younas & Quennell, 2019). A common reason for being readmitted into care includes hospital-acquired infections (HAI), which could be the result of poor hygiene of the facility, errors in nursing care, and a plethora of other reasons connected to advanced nursing practice.
The productivity of nurses and its relation to quality is another way to measure outcomes. For example, a nurse in charge of blood transfusions can be evaluated based on the number of transfusions done in a month versus the standard for the period (Zhang & Cui, 2018). Some outcomes have an objective quality to them, making them desirable goals to be achieved. For example, the decrease in nosocomial infections, wait times, patient self-hurting indexes, and facilitating perfect lengths of stay (LOS) times can be used to improve the quality of care (Zhang & Cui, 2018). They also enable the estimation of the collective performance of doctors, registered nurses RNS, APNs, and other specialists involved (Zhang & Cui, 2018). In a perfect scenario, these standards are achieved, but in reality, in the nursing profession, there are always parameters that require working on. Being able to evaluate and monitor them is critical for the continuous journey of self-improvement.
To summarize, APNs make an integral part of any healthcare facility’s clinical effort. They are necessary for connecting different parts of the process and performing functions that require superior knowledge of RNs. The quality of care and outcomes produced by APNs can be evaluated both objectively and subjectively. Subjective evaluation relies on the experiences of both patients and nurses. Objective monitoring requires measurable and quantifiable parameters, such as rehospitalization rates, HAI rates, and others.
References
Kleinpell, R. M. (Ed.). (2021). Outcome assessment in advanced practice nursing. Springer Publishing Company.
Younas, A., & Quennell, S. (2019). Usefulness of nursing theory‐guided practice: An integrative review. Scandinavian Journal of Caring Sciences, 33(3), 540-555.
Zhang, J., & Cui, Q. (2018). Collaborative learning in higher nursing education: A systematic review. Journal of Professional Nursing, 34(5), 378-388.