Part 2 MY ROLE IS THE DNP DON IN A CLINIC THIS IS GEARED MORE TOWARDS AN RN, ALSO PLEASE CHECK THE RUBRIC AND THE SAMPLE I ATTACHED. ALSO THE INTEXT CITATION NEED TO BE UPDATED.
PEST Analysis
Political influences:
The political environment significantly impacts the DNP's role as a Nurse Practitioner (NP) in primary care. Laws and regulations regarding NP practice vary from state to state, and some states have the more restrictive scope of practice laws for NPs. This can limit the ability of DNP-prepared NPs to practice to the full extent of their education and training. In states with the restrictive scope of practice laws, NPs may not be able to prescribe certain medications or perform certain procedures without physician oversight (Trautman et al., 2018). For example, some states require NPs to have a written or collaborative agreement with a physician to practice. This can limit the ability of NPs to provide care in certain settings, such as rural or underserved areas where there is a shortage of physicians. Additionally, the political environment can also affect reimbursement for NP services. Some insurance plans do not cover services provided by NPs, which can limit access to care for patients and affect the financial viability of NP-led practices.
Economic influences:
The current economic climate significantly influences the function of Nurse Practitioners (NP) with a DNP degree in primary care. There is a rising need for affordable healthcare as the rising expense of healthcare becomes a key issue for many Americans. Here's where NPs with doctoral degrees may make a huge difference in delivering affordable, high-quality treatment. A DNP-educated NP's ability to diagnose and treat common illnesses and injuries, as well as manage chronic conditions and provide preventative care, is one method in which she may deliver care that is both efficient and affordable. As a result, NPs are able to play a more significant role in primary care, which can help curb the demand for more costly specialized services (Larocco, 2021). Furthermore, NPs with a Doctor of Nursing Practice degree have the expertise to address the socioeconomic determinants of health and to plan and carry out interventions that improve population health and reduce the prevalence of the disease.
However, paying for NP services is sometimes difficult. Patients' access to care might be constrained, and NP-led practices' financial stability might be jeopardized by the fact that some insurance plans do not cover services delivered by NPs (Trautman et al., 2018). This can be a problem for both the patients whose insurance doesn't cover NP services and the NPs who deliver them. The ability of NPs to deliver care may also be constrained by states with a restricted scope of practice rules, which prohibit NPs from prescribing specific medications or doing specific procedures without the supervision of a physician. Patients may incur further expenses as a result, such as time and gas spent getting to and from medical appointments.
Social influences:
In primary care, the DNP job as a Nurse Practitioner (NP) is significantly influenced by the surrounding social milieu. Particularly in impoverished and rural areas, primary care doctors are in high demand. This need is being fueled by demographic shifts, including an aging population and an uptick in the prevalence of chronic diseases. Because of their extensive education and training, NPs are ideally prepared to address this shortage in primary care by diagnosing and treating common illnesses and accidents, overseeing the care of chronic disorders, and promoting overall health and wellness. However, not all patients will be familiar with NPs or comprehend the breadth of their responsibilities (Zaccagnini & Pechacek, 2021). Because of this misunderstanding, patients may be confused or distrustful of NPs, making it hard for them to build a clientele. It's also important to note that not all MDs and other medical professionals regard NPs as primary care doctors. Because of this stigma, NPs may have trouble establishing collaborative partnerships with other medical professionals.
In addition, there may be misconceptions about nurse practitioners (NPs) among the general public. Despite popular belief, research shows that nurse practitioners (NPs) deliver treatment that is on par with that of physicians in terms of quality and safety. Still, these ideas may have an impact on how patients and other medical professionals receive NPs. The DNP's primary care function can be complicated by language and cultural issues. Patient outcomes can be enhanced when NPs who speak languages other than English are able to communicate effectively with their patients. Improved patient outcomes can also be achieved through the NP's capacity to comprehend cultural beliefs and behaviors that may have an impact on health and healthcare. Healthcare policy and law are influenced by both the political and social contexts in which they are enacted. A Doctor of Nursing Practice (DNP) in primary care may be impacted by changes in healthcare policy and legislation pertaining to reimbursement for NP services, the scope of practice laws, and certification prerequisites. That's why it's crucial for nurses to know the latest developments in healthcare law and policy and to push for measures that recognize and reward their contributions to primary care.
Technological influences:
The primary care NP position held by those with DNP-prepared nurses is profoundly affected by the current state of technology. New diagnostic and therapeutic options, made possible by technological progress, have the potential to enhance health outcomes for patients. In rural or underserved locations, for instance, NPs can now employ telehealth technologies to treat patients remotely, confer with specialists, and access patient medical information. Access to care that might otherwise be unavailable can greatly enhance patient outcomes in these situations. In addition, NPs are now able to treat patients in underserved and rural areas thanks to the widespread adoption of electronic health records (EHRs). Nurse practitioners (NPs) can benefit from electronic health records (EHRs) because they give them access to patients' past medical history, current test results, and other relevant data that can be used to better care for their patients (Trautman et al., 2018). In addition, they facilitate enhanced physician-to-physician contact and care coordination, both of which contribute to enhanced patient outcomes. Although there are many benefits to using technology, there are also risks that NPs must consider. In this regard, the adoption of electronic health records (EHRs) can be both time-consuming and cumbersome for NP-led clinics. This makes it harder for NPs to spend quality time with patients and can contribute to burnout. Concerns concerning patients' privacy and security may also arise from the usage of telehealth devices. This raises concerns because the current state of development prevents assurance of the same level of privacy and security as face-to-face meetings. Patients with less access to technology or less technical expertise may be at a disadvantage while seeking medical care because of the increased reliance on technology. This can be especially difficult for NPs in rural or underdeveloped areas, where there may be fewer resources, such as computers. In addition, NPs may face difficulties due to the quickening pace of technical developments, which requires them to upgrade their knowledge and skills constantly. This calls for further study and instruction, which takes time and effort.
Implementation Strategies
Implementation strategies for the new role of DNP-prepared NPs in primary care should focus on obtaining stakeholder support and addressing potential funding and cost concerns.
Stakeholder Support: To gain stakeholder support for the new role of DNP-prepared NPs in primary care, it is important to educate stakeholders about the benefits of NPs in primary care and to demonstrate the cost-effectiveness of NP-led practices. This can be done through the use of data and research studies, as well as through the development of strong relationships with key stakeholders such as physicians, healthcare administrators, and policymakers.
Funding and Costs: To address potential funding and cost concerns, it is important to identify potential sources of funding for the new role, such as grants, Medicaid and Medicare reimbursement, and private insurance coverage (Zaccagnini & Pechacek, 2021). Additionally, it is important to demonstrate the cost-effectiveness of NP-led practices through the use of data and research studies.
Theoretical Framework: A theoretical framework can assist with the implementation of the new role by providing a clear and consistent approach to the implementation process. One potential theoretical framework that could be used is the Diffusion of Innovations Theory, which suggests that the adoption of new roles and practices is influenced by the perceived relative advantage, compatibility, complexity, trialability, and observability of the innovation.
Evaluation Methods: To determine the effectiveness of the new role, it is important to establish evaluation methods that can be used to measure the outcomes of NP-led practices. This can include patient satisfaction, quality of care, and cost-effectiveness measures. Additionally, it is important to involve stakeholders in the evaluation process to ensure that the new role is meeting their needs and expectations.
In summary, the implementation of the new role of DNP-prepared NPs in primary care requires a comprehensive approach that addresses stakeholder support, funding and costs, a theoretical framework, and evaluation methods. This will ensure the success of the role and its sustainability in the long term.
Summary
Primary care providers are in high demand in the United States, especially in underserved and rural areas. Because of their education and experience, Nurse Practitioners (NPs) are able to provide a wide variety of primary care services and may work in tandem with physicians, making them ideal candidates to fill this void. DNP-prepared NPs are better equipped to address this gap than MSN-prepared NPs because of their advanced education and training in areas such as leadership, quality improvement, and evidence-based practice; deeper familiarity with healthcare systems; and proficiency in using data to optimize patient outcomes. Practitioners with a Doctor of Nursing Practice degree have honed their abilities to draw on and apply information from a wide range of sources, with an eye on improving the health of communities as a whole. A DNP-educated NP may increase positive health outcomes, patient access, and healthcare efficiency.
Conclusion
There are benefits, drawbacks, chances, and dangers associated with the Doctor of Nursing Practice (DNP) function as a Nurse Practitioner (NP) in primary care. Because of their extensive training in leadership, quality improvement, and evidence-based practice, NPs with doctoral degrees are better able to fill the primary care gap. But they can have trouble being paid for their work and being recognized as primary care doctors by other specialists. The DNP's function as an NP in primary care is significantly influenced by political and economic factors, such as legislation and regulations that govern the scope of practice and reimbursement for services. Threats to the job include the COVID-19 pandemic and the fate of the Affordable Care Act. In general, nurse practitioners (NPs) should keep up with healthcare policy and legislation developments and push for measures that would strengthen their position as primary care providers.
References
American Association of Nurse Practitioners. (2021). National Nurse Practitioner Sample Survey. Retrieved from
Chapter 5- pp 127-146. National Academies of Sciences, Engineering, and Medicine. 2021. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press. .
Health Resources and Services Administration (HRSA). (n.d.). Primary Care Shortage Areas. Retrieved from
Larocco, S. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. Arthur L. Davis Publishing Agency, Inc.
National Academies of Sciences, Engineering, and Medicine. 2021. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press. The Role of Nurses in Improving Health Care Access and Quality
Trautman, D., Idzik, S., Hammersla, M., & Rosseter, R. (2018). Advancing Scholarship through Translational Research: The role of Ph.D. and DNP prepared nurses. OJIN: The Online Journal of Issues in Nursing, 23(2). https://doi.org/10.3912/ojin.vol23no02man02
Zaccagnini, M., & Pechacek, J. (2021). The Doctor of Nursing practice essentials. (4th Ed.). Burlington, MA: Jones & Bartlett Learning.
American Association of Colleges of Nursing. (2006). Essentials of doctoral education for advanced practice nursing. Retrieved from https://www.aacnnursing.org/Portals/42/Publications/DNPEssentials.pdf
Facts about benefits of Joint Commission accreditation. (n.d.). A Trusted Partner in Patient Care | The Joint Commission.
National Academies of Sciences, Engineering, and Medicine. 2021. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. Washington, DC: The National Academies Press (US), 2021 May 11, 3 The Nursing workforce Retrieved from:
Pritham, U. A., & White, P. (2016). Assessing DNP impact using program evaluations to capture healthcare system change. The Nurse Practitioner, 41 (4), 44-53. https://doi.org/10.1097/01.npr.0000481509.24736.c8
Siddiqui, A. A. (2021). The use of Pestel Analysis Tool of Quality Management in the health care business and its advantages. American Journal of Biomedical Science & Research, 14(6), 507–512.
The nursing workforce – The future of nursing 2020-2030 – NCBI bookshelf. (2021, May 11). National Center for Biotechnology Information.
Trautman, D., Idzik, S., Hammersla, M., & Rosseter, R. (2018). Advancing Scholarship through Translational Research: The role of PhD and DNP prepared nurses. OJIN: The Online Journal of Issues in Nursing, 23(2). https://doi.org/10.3912/ojin.vol23no02man02
Zaccagnini, M., & Pechacek, J. (2021). The Doctor of Nursing practice essentials. (4th Ed.). Burlington, MA: Jones & Bartlett Learning.
