Building Acute Care Capacity: Transforming Primary Care NPs into Acute Care Providers

Building Acute Care Capacity: Transforming Primary Care NPs into Acute Care Providers

Over the last 25 years, acute and critical care has changed dramatically. Services previously provided only in inpatient settings have migrated to community environments. Patient acuity in hospitals is higher. Changes in physician training limits resident work hours. Shorter lengths of stay coupled with increased expectations for safe, high quality care challenge patient care systems. Providers must anticipate and prevent complications and quickly respond to rapidly changing patient needs. All of these factors increase the demand for Acute Care Nurse Practitioner services.

Until 1990, very few nurse practitioners (NPs) practiced in inpatient settings. Soon thereafter, the development of unique adult and pediatric acute care NP competencies, educational programs, and certification examinations contributed to the rapid expansion of this practice focus. Today, 15 % of NPs work with acutely and critically ill individuals, but only one-half that number are acute care certified. Many institutions have adopted hospitalist and intensivist care models. Other market forces (medical malpractice, CMS conditions of participation, etc.) are focusing increased attention on NP's credentials to manage acutely and critically ill patients. The Consensus Model for APRN Regulation, which aligns competencies, educational preparation, certification and practice, is being implemented across the country. Nurse practitioner faculty need to find ways to streamline the transformation of NPs who were originally certified in primary care, into acute care NPs.

This armchair discussion will provide NP faculty the opportunity to examine innovative curricula that allow primary care NPs to attain acute care competencies quickly. Senior faculty from several leading schools with postgraduate acute care options will describe programs designed to meet this challenge, how they addressed accreditation and certification issues, and overall program outcomes. Questions for discussion will include analysis of competency gaps, alternative methods for content delivery, options for clinical experiences, integration with existing graduate courses, and innovative methods to evaluate student competency. Discussion panel members will share the experiences, insights, successes and challenges encountered providing postgraduate education to augment NPs primary care credentials to include acute care.