These competencies are comprised of: (1) a nursing practice based on knowledge of science and humanities, (2) population health, (3) health policy and advocacy, (4) informatics and technology, (5) communication and collaborative practice, (6) systems-based leadership, (7) quality and safety, (8) evidence-based practice, and (9) advanced nursing practice. With a growing interest in the improvement of patient care outcomes to demonstrate the quality of care, advanced practice nurses must apply these competencies to assure they are integral to the achievement of their organization’s goals.
Expanded nurse leadership skills
The nine competencies presented above require an expanded level of leadership as advanced practice nurses establish their careers. How can advanced practice nurses build on these competencies to meet organizational goals — and the goal of improving patient care outcomes? Here are some areas in which advanced practice nurses can expand their skills to make improvements in patient care outcomes.
Scholarship
The translation of research to improve the delivery of care is vital to achieving benchmarks for patient care outcomes. With so many project findings disseminated by DNP graduates, replication of those studies in terms of population, methods, and/or interventions are propelling evidence-based practices to the forefront. Advanced practice nurses should be leaders in translating research — and in asking the questions that require further investigation. They need to build on the skills they learned from the DNP project and become inquisitive — asking why and why not. They must use data to answer questions related to what is happening, why is it not working, what is the effect on patients/nurses/staff, what must be done to address the patient, process, and procedures that lead to better outcomes.
Entrepreneurship
Entrepreneurs are risk-takers who can think out-of-the-box to solve problems by creating new services or products. Advanced practice nurses face resource challenges everyday — as do their patients. They must explore how they can turn these challenges into opportunities to create new methods to serve their patients. Entrepreneurs embrace technology to deliver care, maintain patient records, and create tools to survey patients for health indicators. The exploration of required services to open or expand clinical services often leads to entrepreneurial roles, especially if the costs of these services can be offset with grants or external funding.
Change influencer
There are numerous factors that are currently driving the need for change in the US healthcare system. Access problems, high costs, disparities in care, new quality indicators, a growing elderly population, and a pandemic that overtook the healthcare system. The success of any change will be the ability of the change agent to influence successful change. Planning the change and getting the team ready for change is just half the equation. The change must be implemented, monitored, measured, evaluated, and then sustained. Advanced practice nurses should develop successful strategies for sustaining change when it is demonstrating it contributes to improved patient care outcomes.
Innovation
Innovative thinking can lead to new ways to improve healthcare delivery and emphasizes how thinking “out of the box” can promote necessary change. Disruptions prompt advanced practice nurses to think of alternate ways of delivering care, ways to cut costs, and ways to improve care delivery. For example, the pandemic and the need for social distancing led to greater reliance on technology. Many APRNs now see patients exclusively via telehealth — especially if there are barriers to access. As leaders, advanced practice nurses should create a culture at work that appreciates innovative thinking from all team members if the US is to improve the patient care experience, the health of populations, and reduction in the cost of healthcare.
Carolyn Hart and Pegge Bell are the authors of Advancing Nursing Practice: Exploring Roles and Opportunities for Clinicians, Educators, and Leaders, 1e.
