The House Nursing Caucus and the Deans Nursing Policy Coalition, a nursing education collaborative, held a briefing July 19 to highlight the roles of advanced practice nurses in providing quality, affordable healthcare.
The briefing, held in the Rayburn House Office Building in Washington, D.C., was sponsored by the DNPC and covered issues such as the significance of nursing research in promoting and improving healthcare outcomes, the changing role of healthcare provider teams in preventive care and the importance of federal support for nursing education and workforce development programs.
DNPC members and deans Bobbie Berkowitz, RN, PhD, FAAN; Linda McCauley, RN, PhD, FAAN, FAAOHN; Kathy Rideout, PNP-BC, EdD, FNAP; and Colleen Conway-Welch, RN, PhD, CNM, FAAN, FACNM, spoke to nurses, the media and members of the U.S. House of Representatives.
Also present were the co-chairs of the 112th Congressional House Nursing Caucus: Rep. Lois Capps, D-Calif., an RN, and Rep. Steven LaTourette, R-Ohio.
Capps said the briefing was to highlight the importance of nursings role in providing healthcare to Americans. “We must shift the focus of acute care to preventive [care],” she said.
She concluded her remarks by saying the U.S. needs to expand nursing education programs to provide greater access to improved care. “Everyone has benefited from the care of a nurse,” she said. “Nurses deliver the care and are the backbone of healthcare, and therefore public health must involve nursing.”
Berkowitz, dean at Columbia University, New York City, focused on the role of APRNs in caring for underserved populations. “[Nurses] are well suited to care for [the]underserved population with complex needs either in large health systems or in community health,” she said.
Berkowitz pointed out that the country faces considerable challenges in bringing APRNs to this population. “The underserved have difficulty accessing healthcare,” she said. Those with chronic conditions, such as diabetes, particularly are affected. Currently, the “systems are not aligned,” with funding primarily provided to acute care rather than to chronic care or prevention, according to Berkowitz. She added that the healthcare system is not designed to support patients in becoming active in managing their own disease and healthcare.
Accountable Care Organizations “increase and improve the patient experience in delivery of care, decrease cost and increase quality and outcomes,” Berkowitz said. “[This] cannot be accomplished without collaboration.” APRNs should be integrating aspects of transitional care in “ways that ensure communication and seamless management of patient care.” Berkowitz said such a model has worked well at Columbia, where the Columbia Advanced Practice Nurse Associates provide collaborative, quality care with more than 2,000 physicians.
Rideout, from the University of Rochester (N.Y.), also spoke about collaborative practice and providing an interdisciplinary framework for healthcare. “Interprofessional education and practice has been proven to help decrease length of stay and therefore decrease costs. Better communication increases patient safety and [causes]less errors,” she said. An example of interprofessional education and practice, according to Rideout, was a model that used simulation to teach nursing students and medical students to work together.
McCauley, nursing dean at Atlantas Emory University, spoke to the audience about the health concerns of the geriatric population. “Older adults are major consumers of healthcare in the U.S.,” she said. “They are the drivers for change, and APRNs are in the middle of that change.”
Among the issues facing older Americans: Their numbers will outpace the number of providers available to provide adequate care. Also, because APRNs scope of practice varies from state to state, models of care are inconsistent and can cause major care delivery problems, McCauley said. Conway-Welch agreed, stating that major limitations on licensure make caring for patients difficult.
LaTourette concluded the briefing by seconding all the points made by the previous speakers. “The demand on primary care is even more now,” he said. “I believe NPs can do more than MDs. If you want to increase your customer satisfaction, put the people there who do that the best — nurses.”
To view the map regarding consumer access and APRN barriers to practice visit: http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing-Health/Figure-3-3.aspx.
For more information about CAPNA, go to http://www.cumc.columbia.edu/dept/nursing/practice/about.html.
For more information about The House Nursing Caucus, visit the American Nursing Associations page at http://www.nursingworld.org/CongressionalNursingCaucus.