Question

How can an advanced nurse or APRN improve access and health outcomes for marginalized populations and communities?

What individual knowledge, skills , and attitudes are necessary to improve health inequities?

Answer 1

The registered nurses who have advanced education certification and clinical training are the Advanced Practice Nurses (APNs. They can work as health care providers in different aspects or levels of care such as primary care, acute care and outpatient settings. APN roles are the ideal choice for implementing primary healthcare services to enhance universal health coverage and access to health. The APN role faces some implementation barriers including lack of role clarity, legislation/regulation, education, funding, and physician resistance. Strong and vivid policies on common APN issues are essential to building a healthy and successful role implementation. As working towards independent practice, The APNs face external challenges from medicine and internal barriers within the domain of nursing.

Evidence from international researchers shows that enhancement of primary health care (PHC) services for underserved populations are essential in reducing health care disparities. The gap between the primary healthcare needs and demand of healthcare workers can be reduced by improving the training of existing healthcare workers such as RNs. The special training will enhance their role in the primary health sector and which will, in turn, improve the serviceability.

There are many barriers that prevent the full utilization of APNs. The paper presented by “The advanced practice nursing (APN) movement” reflects the major practice issues raised at the 7th International Nurse Practitioner/Advanced Practice Nursing Network Conference, a subgroup of the International Council on Nursing (ICN), in London in August 2012. The vital issues labelled at the conference are independent practice, barriers to practice, educational standards, and the APN role in research and evidence-based practice.

The scope of APNs practice is mainly provided and direct an advanced level of quality healthcare. APNs must develop a strong practice model and exist as a more unified force in the quest for independent practice. The problems such as the right to prescribe a wide range of medications, lack of payment by healthcare providers for the care rendered by the APNs, medical staff privileges, and laws governing practice should be addressed effectively to obtain maximum benefits from the APNs.

In the primary healthcare scenario, the improvement in health care literacy, availability of services, efficient care, acceptance of APNs as service providers are very important in strengthening the primary health care system.

APNs requires unique knowledge, competencies, and skills. The contemporary public health nurses must practice in collaboration with agencies and community members. As the primary healthcare provider, APNs can address complex, multi-causal, community problems.