Maritza C. Alencar, DNP, MBA, APRN-BC - IWEVENTOS · Maritza C. Alencar, DNP, MBA, APRN-BC Nursing...
Transcript of Maritza C. Alencar, DNP, MBA, APRN-BC - IWEVENTOS · Maritza C. Alencar, DNP, MBA, APRN-BC Nursing...
Maritza C. Alencar, DNP, MBA, APRN-BC
Nursing Symposium and Multidisciplinary Team
2019 International Symposium of Onco-Hematology
The role of the advanced registered nurse practitioner in the United States
Disclosures
Kite Speakers’ Bureau
Where did we begin?
Late 1950’s and early 1960’s
Beginning of specialization in medicine
Resulted in shortage of primary care physicians
Rural areas impacted most
Physicians began to recruit registered nurses with clinical
expertise
Source: Kaiser Permanente History
First Nurse Practitioner Program
By 1965:
Social Security Amendments came Medicare and Medicaid
Programs
Increased access for low-income children, women, elderly and
people with disabilities
Created an increased need for primary care providers
Loretta Ford, a nurse and Henry Silver, MD at the University of
Colorado developed the first NP program
Source: Simmons University & University of Rochester Medical Center
Loretta Ford Henry Silver
Gaining independent practice
During 1970’s and 1980’s:
Lack of credentialing process and training led to:
Document patient satisfaction scores
Development of standards of practice
Monitored overall increase of primary care availability
11 NP organizations created in the US
Implemented certifications exams
Aligned practice with US regulations and reimbursement
policies
Source: Wikimedia Commons & Florida Nursing History Project
What does a Nurse Practitioner do?
Perform procedures:
Bone Marrow Biopsies
Lumbar Puncture
Intrathecal Chemotherapies, etc.
Record medical history, diagnoses and
manage symptoms
Write prescriptions
Diagnose and treat diseases
Conduct, order and interpret
diagnostic tests
Managing patients’ overall care
Provide education on:
Wellness and prevention
Medication side effects
Source: Nurse Journal: Social Community for Nurses Worldwide & American Academy of Nurse Practitioners
Specialty Areas
Nurse Practitioner
Acute Care
Adult
Gerontology
Family
NeonatalOncology
Pediatric/Child
Psychiatric/Mental
Women's
Source: American Academy of Nurse Practitioners
How to become a Nurse Practitioner?
Source: American Academy of Nurse Practitioners
BSN
• Bachelors preparation as a Registered Nurse (RN)
• 4 year degree
• Completed at a university or college
MSN
• Master’s preparation
• 2 year degree
• May be done in combination with BSN
• May require clinical RN experience
DNP/PhD
• Doctorate preparation
• 1-4 years to complete (DNP vs PhD)
• Clinical track vs research track
• Not currently required to practice as a nurse practitioner
Where are we today?
Practice Privileges
Source: Nurse.org, 2019
Current State of US NPs
>270, 000 Nurse Practitioners in
the US to date
87.1% certified in primary care,
with 72.6% delivering primary
care
95.7% prescribe medications
(~20 Rx/day)
NPs hold prescriptive privileges,
including controlled substances
in all 50 states
Mean full time base-salary
$105,903
Malpractice rates remain low;
only 1.1%
~400 academic NP programs in
the US
Source: American Academy of Nurse Practitioners, January 2019 and Clinical Advisor
Oncology Nurse Practitioners
~1.2% represent Oncology NPs of
270,000 in US
A shortage of 3,000 oncologists
or 9.5-15 million visits by 2020
Increased demands in oncology:
Rapid advancements in
cancer treatment (genetic
and immunotherapies)
Increase in survivors
Time allocated to EHR
requirements
Research responsibilities
Source: www.doximity.com/press_releases/major_us_cities_facing_shortages_of_cancer_specialists
Specialty Training Programs
Fellowship opportunities for NPs
~9 training programs in US
Provides mentorship for new NP
3 accredited fellowship in US by
ANCC
The James, Ohio State
University (Columbus, OH)
Sylvester Comprehensive
Cancer Center (Miami, FL)
MD Anderson (Houston, TX)
Certifications provided through
Oncology
Summary
Americans make more than 916 million visits to an NP annually
More nurse practitioner driven clinics
Primary care
Survivorship
Symptom Management
Ranked Best Job in America
Increases access to care for patients
Continue to work on full practice privileges in all 50 states
Can alleviate physician shortage (expected 130,000 by 2025)
Data shows NPs provide safe and quality care
More specialty training programs available:
Oncology
Emergency Medicine
Source: Medicalbillingstar.com
Thank You!