Advanced Nursing Practice

Discussion Question One

The quality charism report aim at reinventing the healthcare system to nurture innovation and improve healthcare delivery (Ulrich & Kear, 2014). According to the report, stakeholders should focus on improving the health and functioning of the Citizens of the U.S. Their purpose is to decrease the burden of disability, illness, and injury. Improvement of health care performance is based on six domains, and they include the following. First, the health care need to be safe. The Institute of Medicine reports that the health care should help patients and not harm or cause injuries. Promoting safety entails ensuring safe nurse-patient ratios, training of staff on safety measures and administering safe medications. Second, the health care should be effective. Effectiveness encompasses providing beneficiaries with services based on scientific knowledge (Maru, et al., 2012). Moreover, health care institutions should refrain from offering services to individuals who have the potential not to benefit. Third, patient-centered care is essential since it involves providing patients with respectful care that align with their values, preferences, and needs. Fourth, the timely component benefits patients since it requires health care institutions to reduce waits and harmful delays. Fifth, efficiency advocates that patients should receive high-quality services. Health care facilities should avoid waste including the use of ideas, equipment, and energy (Ulrich & Kear, 2014). Sixth, equitability entails providing staff and patients with equal opportunities. Health care facilities should avoid health disparities.

Discussion Question Two

The aim of the Agency for Healthcare Research and Quality since 2003 was to provide information on healthcare quality and ways to reduce health care disparities (Vogus & McClelland, 2016). The report focusses on the trends of the quality of health care that the people of the U.S receive. Similarly, the report focusses on handling the widespread disparities in healthcare delivery. In priority population, disparities relate to socioeconomic and racial factors. The 2015 report states that the health care quality measures entail prevention, behavioral health care, management of chronic disease and emergency treatment (Vogus & McClelland, 2016). Although the quality of health care improved, quality disparities persist among blacks, Hispanics, and low-income people. The report indicated that people living in poor households has a high chance to be uninsured compared to those that were rich (Vogus & McClelland, 2016). Similarly, the odds of Hispanics and blacks be uninsured were higher compared to whites.

This significant information is essential since it helps in creating solutions and improving quality and access to healthcare. The role of nurses is to ensure effective treatment by improving the overall performance and reducing disparities (White, 2015). Patients need to receive better care; therefore, nurses and nurse practitioners should make sure that they make health care more accessible and safe. Solving the problem of disparities in access and quality among the disadvantaged population would be effective if nurses are involved in the decision-making process.

Discussion Question Three

The 2010 Future of Nursing report released by the Institute of Medicine focused on transforming the health care system (Blegen, Goode, Park, Vaughn & Spetz, 2013). Roles of nurses require rethinking to ensure safe, quality and affordable care. The 2016 report provides an assessment of the 2010 report including the progress that has been made, challenges and what they should emphasize to attain the 2010 report goals. The objective of the group led by Robert Wood Johnson Foundation was to improve health care and identify the role of nurses.

The reports will influence my role as an APN since they advocate that nurses should exercise their functions to the full level of their education. Due to variations in licensing and practice rule across states, there is an increase in health care costs, a decrease in health care access and limited health care quality (Swan, Ferguson, Chang, Larson & Smaldone, 2015). Practicing to the fullest of my education and training as an APN will ensure delivery of safe and quality care. This will reduce healthcare costs.



Blegen, M. A., Goode, C. J., Park, S. H., Vaughn, T., & Spetz, J. (2013). Baccalaureate education in nursing and patient outcomes. Journal of Nursing Administration, 43(2), 89-94.

Maru, D. S. R., Andrews, J., Schwarz, D., Schwarz, R., Acharya, B., Ramaiya, A., & Shilpakar, S. (2012). Crossing the quality chasm in resource-limited settings. Globalization and health, 8(1), 1-5.

Swan, M., Ferguson, S., Chang, A., Larson, E., & Smaldone, A. (2015). Quality of primary care by advanced practice nurses: a systematic review. International Journal for Quality in Health Care, 27(5), 396-404.

Ulrich, B., & Kear, T. (2014). Patient safety and patient safety culture: foundations of excellent health care delivery. Nephrology Nursing Journal, 41(5), 447-505.

Vogus, T. J., & McClelland, L. E. (2016). When the customer is the patient: Lessons from healthcare research on patient satisfaction and service quality ratings. Human Resource Management Review, 26(1), 37-49.

White, F. (2015). Primary health care and public health: foundations of universal health systems. Medical Principles and Practice, 24(2), 103-116.



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