History of Advanced Practice Nurses and Role of Advanced Practice Wound Care Nurses - Literature review Example

Literature Review Name: Institution: Date: Introduction It is important to note that the nurse practitioner role reflects the continuing evolvement of the nursing profession while significantly expanding the career path for clinical nurses. Advanced Nursing Practice (ANP) has emerged due to changes in the healthcare fraternity (Christensen, 2010). Advanced Practice Nurses (APN’s) offer support to patients and provide their services to complement a multidisciplinary team. Wound care nurse role has emerged from the development of advanced nursing practice. Advanced practice wound care nurses play a key role in assessing and management of acute and chronic wounds in home care or hospital settings. This literature reviews and analyzes various literatures with regard to the development of the advanced practitioner role while focusing on the role of the wound care nurse in various settings. The aim of the paper is to explore the role of the wound care nurse as an example of Advanced Nursing Practice while highlighting its significance and providing suggestions for further development. Method The method used in the accomplishment of the requirement of this paper involved the use of online credible databases ProQuest, CINAHL, Medline, and relevant text books reviewing empirical studies on Advanced Nursing Practice. The search terms used included advanced practice nurse role, wound care nurse, Advanced Nursing Practice, models of nursing, and advanced practice nurse role, history of advanced practice nurse role. The research excluded all materials written in other languages apart from English. The research aimed to gain understanding in the history and role of advanced practice wound care nurse in the advancement of advanced nursing practice. History of Advanced Nursing Practice Advanced practice nurse refers to a registered nurse who has the expert knowledge, clinical competencies and complex decision-making skills for advanced practice defined by the setting from which he operates (Stanley, Werner & Apple, 2009). The advanced practice nurse role including those of the Nurse Practitioners (NP) and Clinical Nurse Specialist (CNS) was founded by the American Nurses Association in the year 1965 (Callaghan, 2008). Clinical nurse specialist role was basically developed to enhance nursing practice in settings where acute care was needed. Advanced practice nursing is an evolutionary development from the specialty practice. In the history of nursing, nurses have expanded and developed their roles to assist in meeting the unrealized needs in healthcare of specific patients’ populations. Whereas the term Advanced Practice Nurse (APN), has been in existence from the 1980s, nurse anesthetists and midwives have been in the practice of specialty roles for over a century (Albaugh, 2010). The two roles are the bedrock for advanced practice. During the early 1960s, it was proposed by the surgeon general that nurses had to be educated in order to offer primary care together with physicians to deal with the gap in accessibility of primary care. Advanced practice nursing was developed for the need of effective and efficient healthcare that serves the needs of the community. The APN role was founded in the UK in the 1980s while Australia established the APN role in the 1990s (Brooten et al, 2003). Various titles have been used for APN escalating the confusing surrounding the role of APN. A clear distinction of APN role in the current literature is clearly lacking (Griscti & Jacono, 2005). There are many overlapping explanations of roles and scope of APN hence compounding the confusion. Role of advanced practice wound care nurse In the modern healthcare industry, a wound care nurse offers expert care that ultimately decrease costs and increase the satisfaction of the patient. Incontinence and chronic wounds are issues found in the public health sector (Foster & Prevost, 2012). Incontinence can be one of the factors that make a wound not to heal. Whereas advanced practice wound nurses have been an important component of acute care teams, they are growing to be vital part to outpatient care and are often found practicing within long-term care facilities or offering in-home care (Grossman & O'Brien, 2010). This has been attributed to the growing population of the elderly and changes within the healthcare policies. Wound nurses, besides being trained and educated to offer rehabilitative and acute care, are more often than not a reliable source support and comfort, both to their patients and patients’ families (Swanson, Asimus & McGuiness, 2014). Physical problems that stomas, ostomies, chronic and acute wounds, and fecal and urinary incontinence pose for patient usually result in social and emotional issues that have to be dealt with. Therefore, nurses have the experience and are trained to address challenges of ostomy, wound, and continence issues, together with offering counseling, guidance, and support (McCaffrey, 2012). In inpatient settings, doctors, social workers, case managers, or staff nurses can refer patient to wound nurses whereas outpatient wound nursing will need referral from a physician. Wound nurses work collaboratively with other members of the healthcare team to offer a plan of care that is comprehensive (Sheer & Wong, 2008). Wound nurses who specialize in wound care are often found in long-term, acute, and in-home healthcare settings. They usually manage and treat pressure ulcers, draining and traumatic wounds, tubes and fistulas, and surgical incisions (Spross & Larson, 2009). Understanding the role of the advanced practice wound nurse has to begin with a clear explanation of the role of APN. The confusion clouding the definition of APN also affects the role and scope of advanced practice wound nurse. Advanced practice wound care nurses operate in a unique healthcare niche, that is, wound management. Wound care nurses examine, treat and manage wounds on patients and enhance health management practices that usually prevent recurrence (Youngberg, 2007). The wound nurse role assist in minimization of suffering as well as loss of function and life-threatening complications (Fawcett & Graham, 2005). A wound nurse careful examines and comes up with a treatment plan to be implemented by the care team. This can involve debridement (a process of wound cleaning removing dead tissues as well as contaminants), cleaning or bandaging (Baranoski & Ayello, 2008). The wound nurse collaborates with the physician of the patient to examine the suitability of antibiotic therapy, hyperbaric oxygen therapy or surgery. Apart from providing direct care, wound nurses educate patients, care givers and various medical professionals on the prevention and management of wounds. They are key resource people for other nurses, physicians, other members of the care team in inpatient settings and other settings (Hanson & Hamric, 2003). The wound nurses offer continuous education for nursing assistants and front-line professionals who are in charge of patients that are bedridden since bedridden patients are susceptible to complex pressure ulcers known as bedsores which sometimes are resistant to healing (Tull & Carroll, 2004). Within community settings, wound nurses educate and support people living with diabetes, those getting certain cancer treatments, patients with limited mobility and people who are susceptible for developing wounds that are chronic (Cooke, Gemmill & Grant, 2008). The role of advanced practice wound nurse can be expanded and fully developed is there is a clear distinction and definition of Advanced Practice Nursing. Recommendations for further research The search of literature about an area of expertise in the advanced nursing practice divulged many inconsistencies with regard to definition and scope from the national and international level. Overlapping roles in different areas of advanced nursing practice demonstrate sporadic development of literature and scope. There is need for clear definition and scope of various roles of advanced nursing practice. The role played by wound care nurse in multidisciplinary teams has to be elaborate to avoid conflicts and confusion to ensure better management of wounds in order to decrease costs and increase rates of healing. There is need for further research in home care use of advanced nursing practice in wound management. The current scope used seems to be expanded and overwhelming. The wounds to be tended to by a wound care nurse in a particular setting have to be explained clearly to avoid ambiguity and overstretching of roles. Future research has to focus on the scope and role on advanced practice wound care nurse as part of advanced nursing practice. Conclusion Advanced nursing practice has evolved from the need of the community for effective and better service. Advanced nursing practice has a long history from the mid 1960’s and its study helps in the understanding the evolution of the nursing practice over time. The ANP has expanded the role of nursing practice due to emerging needs in the modern society. The role of advanced nursing practice can be enhanced by ensuring clear definitions of scope and role of various areas of specialty like the wound care nurse. The wound care nurse plays an important role in the multidiscipline team involving assessing, treating and management of acute and chronic wounds. Inconsistencies in the role and scope various areas of specialty of advanced nursing practice calls further research to define clear models of implementation. References Albaugh, J. (2010). A Journey toward Clinical Nurse Specialist Recognition by Medicare. Clinical Nurse Specialist, 24(4), 219-221. Baranoski S. & Ayello, E.A. (2008). Wound Care Essentials: Practice Principles, London: Lippincott Williams & Wilkins. Brooten, D., Youngblut, J., Deatrick, J., Naylor, M., & York, R. (2003). 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