Advanced Practice Nurse Guidance and Coaching Competency: Theoretical and Empirical Perspectives The PPACA has led payers to adopt innovative approaches to financing health care, including accountable care organizations (ACOs) and patient-centered medical homes (PCMHs; see Chapter 22). For example, the ability to establish therapeutic relationships and guide patients through transitions is incorporated into the DNP Essentials (American Association of Colleges of Nursing [AACN], 2006). Thoroughly revised and updated, the 7th edition of this bestselling text covers topics ranging from the evolution of advanced practice nursing to evidence-based practice, leadership, ethical decision-making, and health policy. Table 8-3 compares the three models of care transitions that used APNs. Research and development 8. APN coaching is analogous to the flexible and inventive playing of a jazz musician. Costeira C, Dixe MA, Querido A, Vitorino J, Laranjeira C. SAGE Open Nurs. Model of Advanced Practice Nurse Guidance and Coaching Aging and Disability Resource Center. Log In or, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window), The competency of guidance and coaching is a well-established expectation of the advanced practice nurse (APN). This description of transitions as a focus for APN coaching underscores the need for and the importance of a holistic orientation to caring for patients. 2011;27(3):161-7. Individual elements of the model include clinical, technical, and interpersonal competence mediated by self-reflection. The Interprofessional Collaborative Expert Panel (ICEP) has proposed four core competency domains that health professionals need to demonstrate if interprofessional collaborative practice is to be realized (ICEP, 2011; www.aacn.nche.edu/education-resources/ipecreport.pdf. 2. Earlier work on transitions by Meleis and others is consistent with and affirms the concepts of the TTM. In practice, APNs remain aware of the possibility of multiple transitions occurring as a result of one salient transition. An important assessment prior to the next chemotherapy cycle focused on the patients responses to treatment, and what worked and what didnt work, so that a more appropriate side effect management program could be developed. Course Hero uses AI to attempt to automatically extract content from documents to surface to you and others so you can study better, e.g., in search results, to enrich docs, and more. In medically complex patients, APNs may be preferred and less expensive coaches, in part because of their competencies and scopes of practice. Advanced Practice Nurse Guidance and Coaching Competency: Theoretical and Empirical Perspectives Referred to as the GRACE model (Counsell etal., 2006). Transitions in Health and Illness Furthermore, Hayes and colleagues (2008) have affirmed the importance of the therapeutic APN-patient alliance and have proposed that NPs who manage patients with chronic illness apply TTM in their practice, including the use of coaching strategies. APNs develop additional competencies in direct practice and in the guidance and coaching of individuals and families through developmental, health- illness, and situational transitions . The APN uses self-reflection during and after interactions with patients, classically described as reflection-in-action and reflection-on-action (Schn, 1983, 1987). Ethical decision-making 3. Guidance and coaching in the nursing practice are part of the work of nursing midwives, clinical specialist nurses, and nurse practitioners. Aging and Disability Resource Center. This chapter considers the core competency of APN guidance and coaching within the context of the nursing professions efforts to extend and advance the coaching functions of nurses. Subsequent studies of CTI have demonstrated significant reductions in 30-, 90-, and 180-day hospital readmissions (Coleman, Parry, Chalmers & Min, 2006). Situational transitions are most likely to include changes in educational, work, and family roles. The goals of APN guidance are to raise awareness, contemplate, implement, and sustain a behavior change, manage a health or illness situation, or prepare for transitions, including birth and end of life. Personal communication. Distinctions Among Coaching and Other Processes In a clinical case study, Felitti (2002) proposed that, although diabetes and hypertension were the presenting concerns in a 70-year-old woman, the first priority on her problem list should be the childhood sexual abuse she had experienced; effective treatment of the presenting illnesses would depend on acknowledging the abuse and referring the patient to appropriate therapy. Advanced Practice Nurse Guidance and Coaching and Coach Certification Clinical nurse specialists (CNSs) typically have more involvement in planning and implementing organizational transitions. Evocation requires close attention to the patients statements and emotions to uncover possible motivations that will move the patient forward; so, interventions in this stage are not directed toward overcoming resistance or increasing adherence or compliance to treatment. Click to learn more today. 8600 Rockville Pike A subtle distinction is that guidance is done by the nurse, whereas coachings focus is on empowering patients to manage their care needs. Transitions can also be characterized according to type, conditions, and universal properties. Patient teaching and education (see Chapter 7) directly relates to APN coaching. Create a marketing plan to support your value to the healthcare team. 1. Currently, the TCM is a set of activities aimed at providing comprehensive in-hospital planning and home follow-up for chronically ill high risk older adults hospitalized for common medical and surgical conditions (Transitional Care Model, 2008-2009; www.transitionalcare.info/). Tasks and activities of Advanced Practice Nurses in the psychiatric and mental health care context: A systematic review and thematic analysis. Wise APNs pay attention to all four types of transitions in their personal and professional lives. Studies have suggested that prior embodied experiences may play a role in the expression or the trajectory of a patients health/illness experience. As interprofessional teamwork becomes more integrated into health care, guidance and coaching will likely be seen as a transdisciplinary, patient-centered approach to helping patients but will be expressed differently, based on the discipline and experience of the provider. Purposeful sampling was used to select advanced practice nurses who met the following inclusion criteria: employed as a master's pre - pared advanced practice nurse with at least 1year of experience in the APN role. Precontemplation Patients know that, if and when they are ready to change, the APN will collaborate with them. This description of transitions as a focus for APN coaching underscores the need for and the importance of a holistic orientation to caring for patients. Patient-Centered Care, Culturally Competent and Safe Health Care, and Meaningful Provider-Patient Communication These ideas are consistent with elements of the TTM and offer useful ideas for assessment. Patient education involves helping patients become better informed about their condition, medical procedures, and choices they have regarding treatment. 4. APN guidance is a style and form of communication informed by assessments, experiences, and information that is used by APNs to help patients and families explore their own resources, motivations, and possibilities. Advanced Nursing Roles-guidance and coaching - Nursing Papers Online Our nursing papers online writers will handle all assignments including the Advanced Nursing Roles-guidance and coaching Manage Orders Place Order + 1 (917) 341-1923 support@nursingpapersonline.com Home Get Nursing Papers Help How It Works Pricing Order Now Contact Us Coaching and guidance are structured approaches that can be used within or alongside patient decision aids (PtDAs) to facilitate the process of decision making. PMC Dossey and Hess (2013) state that the purpose of coaching in nursing is "to advocate, identify, and focus on factors that promote health, healthy people, and healthy communities" (p. 10). For example, in the Adverse Childhood Experiences (ACE) Study (Centers for Disease Control and Prevention, 2010), adverse experiences in childhood, such as abuse and trauma, had strong relationships with health concerns, such as smoking and obesity. Patient Education Leadership For a schematic illustration of the model, see Fig. Because the GRACE model is similar to the TCM and CTI models, it will not be discussed further here. The PPACA has led payers to adopt innovative approaches to financing health care, including accountable care organizations (ACOs) and patient-centered medical homes (PCMHs; see, Patient-Centered Care, Culturally Competent and Safe Health Care, and Meaningful Provider-Patient Communication. Only gold members can continue reading. APNs interpret these multiple sources of information to arrive at possible explanations and interventions. These core competency domains are as follows: values and ethics for interprofessional practice; roles and responsibilities; interprofessional communication; and teams and teamwork. JS pointed out that the first treatment was the hardest because of unknown factors and that if the patient paid attention to his or her own experienceif and when side effects occurredthey would be in a position to work together to make subsequent treatments more tolerable. APNs also apply their guidance and coaching skills in interactions with colleagues, interprofessional team members, students, and others. The growth in programs has led to a corresponding increased demand for clinical For example, in the Adverse Childhood Experiences (ACE) Study (Centers for Disease Control and Prevention, 2010), adverse experiences in childhood, such as abuse and trauma, had strong relationships with health concerns, such as smoking and obesity. Early work by Schumacher and Meleis (1994) remains relevant to the APN coaching competency and contemporary interventions, often delivered by APNs, designed to ensure smooth transitions for patients as they move across settings (e.g., Coleman & Boult, 2003; Coleman & Berenson, 2004; U.S. This practice, by nurses and other disciplines, focuses on health, healing, and wellness; as the broad understanding of professional coaching evolves, it will influence the evolution of the APN guidance and coaching competency. Although there is variability in how this aspect of APN practice is described, standards that specifically address therapeutic relationships and partnerships, coaching, communication, patient-familycentered care, guidance, and/or counseling can be found in competency statements for most APN roles (American College of Nurse Midwives [ACNM, 2012]; National Association of Clinical Nurse Specialists [NACNS], 2013; National Organization of Nurse Practitioner Faculties [NONPF], 2012). Coaching circles are a technique used in the Duke-Johnson & Johnson Nurse Leadership Program to provide guidance and expertise to small groups of advanced practice nurse (APN) Fellows to facilitate completion of a transformational project. Guidance and coaching are part of the advance practice registered nurse (APRN) competencies, and it leads the change to a patient's healthier life. Assumptions Transition Situations That Require Coaching The interaction of self-reflection with these three areas of competence, and clinical experiences with patients, drive the ongoing expansion and refinement of guiding and coaching expertise in advanced practice nursing. (2011). Abstract Purpose: The purposes of this study were to explore coaching as a nurse practitioner (NP) strategy for improving patient health outcomes and to lay a foundation for validating coaching benefits. Similarly, in the United States, chronic diseases caused by heart disease result in 7 out of 10 deaths/year; cancer and stroke account for more than 50% of all deaths (Heron, Hoyert, Murphy, etal., 2009). The provision of patient-centered care and meaningful patient-provider communication activates and empowers patients and their families to assume responsibility for initiating and maintaining healthy lifestyles and/or adopting effective chronic illness management skills. 1. APNs can use the TTM model to tailor interactions and interventions to the patients specific stage of change to maximize the likelihood that they will progress through the stages of behavioral change. Making lifestyle or behavior changes are transitions; the stages of change are consistent with the characteristics of transition phases (, Quantitative studies, qualitative studies, and anecdotal reports have suggested that coaching patients and staff through transitions is embedded in the practices of nurses (Benner, Hooper-Kyriakidis, etal., 1999), and particularly APNs (, Brooten, Youngblut, Deatrick, etal., 2003, Advanced Practice Nurses and Models of Transitional Care, Among the studies of APN care are those in which APNs provide care coordination for patients as they move from one setting to the other, such as hospital to home. Our Service Charter. Studies have suggested that prior embodied experiences may play a role in the expression or the trajectory of a patients health/illness experience. Although guidance and coaching skills are an integral part of professional nursing practice, the clinical and didactic content of graduate education extends the APNs repertoire of skills and abilities, enabling the APN to coach in situations that are broader in scope or more complex in nature. *Referred to as the Coleman model (Coleman etal., 2004) This bestselling textbook provides a clear, comprehensive, and contemporary introduction to advanced practice nursing today, addressing all major APRN competencies, roles, and issues. APNs do this by reinforcing the health benefits of the change, and acknowledging the personal qualities and resources that the patient has tapped to make and sustain this change. To guide also means to assist a person to travel through, or reach a destination in, an unfamiliar area, such as by accompanying or giving directions to the person. In search of how people change. Coverage of the full breadth of APRN core competencies defines and describes all competencies, including direct clinical practice, guidance and coaching, evidence-based practice, leadership, . health coaching primarily falls within a nursing scope of practice, with nurses being the most commonly cited professionals administering health coaching and evaluating its effectiveness. As a result, enrollment is expanding in academic settings that prepare advanced practice nurses for primary care and acute care roles. Since the last edition, developments in public health and health policy within nursing and across disciplines have influenced the conceptualization of the APN guidance and coaching competency. All nurses and APNs should be familiar with the patient education resources in their specialty because these resources can facilitate guidance and coaching. Actions may be small (e.g., walking 15 minutes/day) but are clearly stated and oriented toward change; individuals are more open to the APNs advice. Based on studies of smokers, Prochaska and associates (2008) learned that behavior change unfolds through stages. Early studies of the model from which TCM evolved have provided substantive evidence of the range and focus of teaching and counseling activities undertaken initially by CNSs, and later NPs, who provided care to varied patient populations. and transmitted securely. The evolving criteria and requirements for certification of professional coaches are not premised on APN coaching skills. For example, the ability to establish therapeutic relationships and guide patients through transitions is incorporated into the DNP Essentials (American Association of Colleges of Nursing [AACN], 2006). Articles published in English between 2010 and 2021 were included. Situational transitions are most likely to include changes in educational, work, and family roles. Understanding patients perceptions of transition experiences is essential to effective coaching. Regardless of how difficult life becomes, patients are confident that they can sustain the changes they have achieved and will not return to unhealthy coping mechanisms. Silver Spring, MD: Nursebooks.org Beginnings, December 2019. Reflection-in-action requires astute awareness of context and investing in the present moment with full concentration, capabilities that take time to master and require regular practice. Guidance and coaching by APNs have been conceptualized as a complex, dynamic, collaborative, and holistic interpersonal process mediated by the APN-patient relationship and the APNs self-reflective skills (Clarke & Spross, 1996; Spross, Clarke, & Beauregard, 2000; Spross, 2009). Does it differentiate advanced practice registered nursing from floor RN nursing for you? Thorne (2005) has analyzed findings from a decade of qualitative research on nurse-patient relationships and communication in chronic illness care in the context of the health policy emphasis on accountable care; many findings were associated with better outcomes.
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