Mundinger MO, Kane RL, Lenz ER, et al. An integrated review of literature in the paper examines the purpose of the Hamric model in assisting and organizing belief systems and knowledge on Advanced Practice Nursing. Evidences from literature indicate that the models have structures that depict the generic characteristics of advanced nursing practice. Author Affiliations: Department of Nursing Research, City of Hope Medical Center, Duarte, California. She mentions that she will talk with the Child Life Specialist herself to see if she can learn strategies to help the children. Tom and Janice have a good relationship and both feel that this decision is the best hope for a future together as a family. Accessed 16 Dec 2019, Consensus Model for APRN Regulation: Licensure, Accreditation, Certification & Education. We cannot process tax exempt orders online. 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.
Edited and written by a "Who's Who" of internationally known thought leaders in advanced practice nursing, Hamric and Hanson's Advanced Practice Nursing: An Integrative Approach, 7th Edition provides a clear, comprehensive, and contemporary introduction to advanced practice nursing today, addressing all major APRN competencies, roles, and issues. The impact of posthospital home care on patients with cancer. The emergence of forensic nursing and advanced nursing practice in Switzerland: an innovative case study consultation. In: Hamric A, Spross J, Hanson C, editors. Working with the nursing staff for educational needs in the clinic, Case discussion with Child Life Specialist for skill enhancement, Preparation of evidence-based teaching program, Use of evidence-based literature interpretation for clinical practice, Expert communications skills in meeting with the MD, Clear commitment to the patient and family and their issues, Positive culture of partnership with the physician and social worker which impacts the MD treatment for depression and the social work support of the patient and family, Moral agent: creating an ethical environment following principles of beneficence and fidelity, Adherence to the therapeutic contract or relationship Mary had with the family, Advanced Practice Nurse, Transplant, Intervention research. WebHamric's Model of Advanced Nursing Practice identifies several core competencies: direct clinical practice, expert coaching and advice, consultation, research skills, clinical and }. She also reviews any questions regarding the right atrial catheter care at home. A specialized home care intervention improves survival among older post-surgical cancer patients. These competencies are the following: direct clinical practice, expert coaching and advice, consultation, research skills, clinical and professional leadership, collaboration, and ethical decision-making.1 This article chronicles a typical patient's journey through a post hospital discharge nursing research study involving APNs as intervention nurses and discusses the various aspects of the APN core competencies throughout the process. Right atrial catheter care, medications), 2) monitor and respond to the occurrence of complications, 3) carry out a recommended exercise and nutrition program, and 4) adapt to post transplant status implementing a variety of resources depending on the problem or need identified. Mary talks about post-traumatic growth and the literature that indicates that some people are able to grow, deepen and see gifts from the transplant experience that are unexpected. Oberle, K., & Allen, M. (2001). J Nurs Adm 14(1):2430, European Specialist Nurses Organizations (2015) Competences of the clinical nurse specialist (CNS): common plinth of competences for the common training framework of each specialty. to maintaining your privacy and will not share your personal information without This model possesses a foundational approach to advance both the general and specific aspects of nursing practice. Accessibility Mary was present and helped him and his family make tough decisions such as developing an Advanced Directives, addressing end-of-life concerns, writing letters to the kids on special occasions, making a video tape for closure for the family, and setting up funeral arrangements. FOIA eCollection 2020. She, perhaps, more than other health care professionals is able to stand with the patient and encourage the communication of wishes across disciplines. He is disappointed that he can barely do his right atrial catheter care, drink his 3 liters a day, eat 6 small meals, rest, and get in 2 short walks. She also discusses the screening and preventative practices for transplant patients and teaches him and his wife follow-up health care practices that Thomas should coordinate for himself after transplant. In other words, it acts as a framework for organizing beliefs and knowledge regarding APN (Oberle & Allen, 2001). Department of Nursing Research, City of Hope Medical Center 1500 E. Duarte Rd Duarte, Calif. 91010 Work phone number: 626-256-4673, ext 63820, Department of Nursing Research, City of Hope Medical Center 1500 E. Duarte Rd Duarte, Calif. 91010 Work phone number: 626-256-4673, ext 63843, Department of Nursing Research, City of Hope Medical Center 1500 E. Duarte Rd Duarte, Calif. 91010 Work phone number: 626-256-4673, ext 63483. Within a few weeks, Thomas begins to notice that he is getting stronger, his taste buds are back, his energy is beginning to reinfuse, and he feels more like himself. DePalma J, McQuire D. Research. This site needs JavaScript to work properly. In: Funk S, Tornquist E, Champagne M, Archer Copp L, Wise R, editors. Naylor M, Brooten D, Jones R, Lavizzo-Mourey R, Mezey M, Pauly M. Comprehensive discharge planning for the hospitalized elderly. After completion of conditioning, his brother's stem cells are infused. Hence, it entails the primary criteria for APNs and seven key competencies (Rounds et al., 2013). Wilson R, Godfrey CM, Sears K, Medves J, Ross-White A, Lambert N. JBI Database System Rev Implement Rep. 2015 Oct;13(10):146-55. doi: 10.11124/jbisrir-2015-2150. She also provided training for a second intervention nurse, in order to maintain the content, approach and integrity of the teaching intervention. The site is secure. It is important to note that Hamrics primary criteria of APN are targeted towards the core goal of nursing and the overall health of patients (Hamric et al., 2005). Therefore, it is worth noting that the Hamric integrative model lays a lot of emphasis on the competencies and roles of Advanced Practice Nursing. Lenz ER, Mundinger MO, Kane RL, Hopkins SC, Lin SX. Operationalizes and applies the APRN core competencies to the major APRN roles: the Clinical Nurse Specialist, the Primary Care Nurse Practitioner, the Acute Ferrell B, Grant M, Schmidt GM, et al. She also coordinates the names of people they both still need to see such as the dietician, pharmacist, case manager, and physical therapist. StudyCorgi. However, she advises that he not drive for at least a few weeks, and discusses other ways he can feel useful. The model stipulates that contextual and environmental factors usually influence the performance of APNs. Clinical Nurse Specialist Role and Practice, https://doi.org/10.1007/978-3-319-97103-2_2, https://www.cna-aiic.ca/en/nursing-practice/the-practice-of-nursing/advanced-nursing-practice/clinical-nurse-specialists, https://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf, http://www.esno.org/assets/harmonise-common_training_framework.pdf, https://international.aanp.org/Practice/APNRoles, Tax calculation will be finalised during checkout. Core Competencies in Evidence-Based Practice for Health Professionals: Consensus Statement Based on a Systematic Review and Delphi Survey Core Competencies in Evidence-Based Practice for Health Professionals: Consensus Statement Based on a Systematic Review and Delphi Survey All the content covered is given to them in a notebook for later review. Please. leadership competencies In: Hamric A, Spross J, Hanson C, editors. However, the remaining features are directly related to the central competencies. August 14, 2022. https://studycorgi.com/hamric-integrative-model-purpose-and-structure/. Conceptualizations of advanced practice nursing. Besides, this model has provoked the spirit of inquiry thereby facilitating a more theoretical understanding of the framework. 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. It is to this population that the advanced practice nurse can bring considerable knowledge and skill. These competencies are the following: Part 1. As usual, Mary seems to be one step ahead of him. She also is exercising a leadership role in partnership with the MD by being willing to confront the issue of safety. WebMutual respect, trust, and the appreciation and recognition of diverse, complementary knowledge are also considered essential elements of collaboration; however, these characteristics develop over time (Hamric, Hanson, Tracy & OGrady, 2014). In addition, this model has been very influential in the development of nursing practice. Mary is able to give her information from various agencies that offer booklets for children to read and process with their parents about having a parent go through cancer treatment. The content National Library of Medicine Sign in to view your account details and order history. Semin Oncol Nurs. Coverage of all APN core competencies defines and describes all competencies, including direct clinical practice, guidance and coaching, consultation, evidence-based practice, leadership, collaboration, and ethical decision-making. The https:// ensures that you are connecting to the Hamric History, Family Crest & Coats of Arms Informal caregiving in Hematopoietic Blood and Marrow Transplant patients. In: Hamric A, Spross J, Hanson C, editors. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Kalb KA, O'Conner-Von S. Ethics education in advanced practice nursing: respect for human dignity. She discusses information such as infection precautions, reportable symptoms, clinic follow-up days, how to manage oral intake, food precautions, medications and side effects, and a normal schedule at home the first week. He remembers Mary's instructions to call the MD for certain symptoms, and how to call off hours and on non-clinic days. The overall goal of the parent study is to improve outcomes for patients undergoing allogeneic transplant by testing a Standardized Nursing Intervention Protocol (SNIP) that integrates interdisciplinary patient teaching content.12 The NCI-funded study involves testing an intervention provided by an APN and based on evidenced-based content regarding the patient's ability to 1) carry out the medical aspects of self care (e.g. Gaston-Johansson F, Foxall M. Psychological correlates of quality of life across the autologous bone marrow transplant experience. Existing models explaining CNS role and practice are limited; many current models are developed to explain advanced practice nursing and are not role specific. FOIA She directly hits on the guilt, and irritability emphasizing the fatigue as a potential factor. and transmitted securely. JBI Database System Rev Implement Rep. 2015. Addressing all major advanced practice nursing competencies, roles, and issues, Advanced Practice Nursing: An Integrative Approach, 5th Edition provides a clear, comprehensive, and current introduction to APN today. "Hamric Integrative Model: Purpose and Structure." Two weeks pass at home with bi-weekly visits to the transplant clinic. StudyCorgi, 14 Aug. 2022, studycorgi.com/hamric-integrative-model-purpose-and-structure/. "Hamric Integrative Model: Purpose and Structure." With her nursing perspective she offers the patient and family complex information specific to their needs involving not only medical aspects of care, but psychological, social and existential support. Hanson C, Spross J. The latter is a basic necessity for APN. Please try after some time. (See Table 1). Mary's expertise impacts not only the patient, but other nurses as she models and mentors professional behavior. Hoffmann T, McKenna K, Worrall L, Read SJ. Author, Harrisburg, PA, National Association of Clinical Nurse Specialists (2019) Statement on clinical nurse specialist practice and education, 3rd edn. Advanced Practice Nursing: An integrative approach. Moreover, it is beyond reasonable doubt that the other theories have been very influential in the formulation of this model. He feels guilty that his wife has to do so much, and struggles with guilt when he sees her taking out the trash cans for trash delivery, a chore he has always done. There are currently no reviews for "Hamric & Hanson's Advanced Practice Nursing", Copyright 2023 Elsevier, except certain content provided by third parties, Cookies are used by this site. He and Janice were able to be intimate, and he realizes how touch-deprived he has been. Mary flexes her schedule to make the teaching session late enough in the day for Mrs. Hill to be there after work. Collins J. Corresponding Author: Liz Cooke, MN, RN, AOCN, ANP, Department of Nursing Research, City of Hope Medical Center, 1500 E Duarte Rd, Duarte, CA 91010 ([emailprotected]). WebCompetencies describe the entry-level competencies for all graduates of masters and doctorate of nursing practice (DNP) programs, and postgraduate programs preparing the Musto PK. This explains why the model aims to improve the central competencies of APN (Oberle & Allen, 2001). For the best experience on our site, be sure to turn on Javascript in your browser. Representatives, Elsevier's Novel Coronavirus Information Center. WebThese core competencies are an essential part of the education and clinical experience required to practice as a nurse practitioner. Design considerations for a personalised patient education system. This conceptual model plays a vital role in guiding nursing practice. doi: 10.1371/journal.pone.0228458. Nursing Outlook, 49 (3), 148-153. The impact of bone marrow transplant on quality of life. He feels awful. It is important to note that the circle is stable and flexible. APN intervention research is a relatively new area of research with cancer patients.1822 The APN core competencies provided the framework for the current study. official website and that any information you provide is encrypted In addition, the model starts with the basic competencies that are patient-focused. VitalSource Bookshelf gives you access to content when, where, and how you want. A model explaining CNS role structure describes the elements and characteristics of the role and the relationships between and among those elements. (2022, August 14). (2022, August 14). NURSING PAPER Identified core competencies in the health policy domain were the guiding and initiating of leadership in policy-related activities, to practice influence in health care and the articulation of the value of nursing to key stakeholders and policymakers on the (inter)national level. Bethesda, MD 20894, Web Policies She is worried about a clear message being sent to the patient regarding his driving restrictions. This session highlights the expert coaching and education competency of the APN. Collaboration: is demonstrated by partnerships and utilization of other health care team members to impact care for the patient's benefit. Minarik P, Zeh M, Johnston L. Collaboration with pscyhiatricts in Connecticut. An official website of the United States government. Adams S. Integration of the mental health services withi OB/GYN private practice: a collaborative model. Clin Nurse Spec. Your message has been successfully sent to your colleague. His brother, Sam is a complete match. With the growth in Advanced Practice Roles such as the Clinical Nurse Specialist and Nurse Practitioner titles there is more recognition and interest in the potential benefits that APNs may bring to the care of patients. After a few minutes the kids go out to play in the backyard leaving Thomas and his wife alone with Mary. The latter is a key indicator in developing positive initiatives. Hamric Retrieved from https://studycorgi.com/hamric-integrative-model-purpose-and-structure/, StudyCorgi. The competency to highlight at this stage is clinical and professional leadership which according to Hanson and Spross (2005) involves roles such as advocate, change agent and group leader.31 Mary's presence and participation in tandem with the MD visit demonstrates her clear role as advocate for her patient. Part of Springer Nature. For instance, it effectively serves the purpose of facilitating understand and gaining additional knowledge about Advanced Practice Nursing (APN). Moreover, it acts as a foundation for further research on advanced nursing practice. This session deals with re-integrating back into life. StudyCorgi. 2011 Dec;25(4):661-70. doi: 10.1111/j.1471-6712.2011.00876.x. Even though she has her mother in town to help, he sees her worry and continues to struggle with his feelings of inadequacy that he can not help more. After the meeting she emails the social worker (sends a copy to the MD) for the Hills and asks her to follow-up with the disability questions before discharge. The consensus model for regulation of APRNs: Implications for nurse practitioners. core After Session six, Mary continues to telephone Thomas and his family monthly. Requests, Sales These competencies are the following: direct clinical practice, expert coaching and advice, consultation, research skills, clinical and professional leadership, collaboration, and ethical decision making. Sitemap. may email you for journal alerts and information, but is committed Evolution of the clinical nurse specialist role and practice in the United States. GreatHouse J. Tailor education plans to the stages of change. Numerous conceptual frameworks offer guidelines for Advanced Practice Nursing (APN). The Advanced Practice Nurse Role Multiple models are needed to provide deeper understanding of the unique characteristics of the CNS role and core CNS practice competencies. PubMed Ethical decision making: integral to the role of the advanced practice nurse. Thanks in advance for your time. After 3 days, more than one organism is identified. Janice and the children do not experience complicated grief, and with the help of a great deal social support are able to carve out a healthy life after his death. "component": "Magento_Customer/js/view/customer" J Nurs Scholar 41(2):193201, Benner P (1984) From novice to expert: excellence and power in clinical nursing practice. Hughes LC, Robinson LA, Cooley ME, Nuamah I, Grobe SJ, McCorkle R. Describing an episode of home nursing care for elderly postsurgical cancer patients. Associate Professor, Assistant Dean for the PhD Program and Director of Graduate Studies, School of Nursing, University of Minnesota; Nurse Scientist, University of Minnesota Medical Center, Minneapolis, Minnesota, Certified Nurse Practitioner and Wellness Coach; Founder, The School of Wellness, McLean, Virginia, Associate Dean - Clinical Affairs, University of California Irvine, Irvine, California, Hamric & Hanson's Advanced Practice Nursing, Authors: Mary Fran Tracy, Eileen T. O'Grady, Susanne J. Phillips, Part I Historical and Developmental Aspects of Advanced Practice Nursing, Chapter 1 History and Evolution of Advanced Practice Nursing, Chapter 2 Conceptualizations of Advanced Practice Nursing, NATURE, PURPOSES, AND COMPONENTS OF CONCEPTUAL MODELS, CONCEPTUALIZATIONS OF ADVANCED PRACTICE NURSING: PROBLEMS AND IMPERATIVES, CONCEPTUALIZATIONS OF ADVANCED PRACTICE NURSING ROLES: ORGANIZATIONAL PERSPECTIVES, CONCEPTUALIZATIONS OF THE NATURE OF ADVANCED PRACTICE NURSING, MODELS USEFUL FOR ADVANCED PRACTICE NURSES IN THEIR PRACTICE, Chapter 3 A Definition of Advanced Practice Nursing, DISTINGUISHING BETWEEN SPECIALIZATION AND ADVANCED PRACTICE NURSING, DISTINGUISHING BETWEEN ADVANCED NURSING PRACTICE AND ADVANCED PRACTICE NURSING, CORE DEFINITION OF ADVANCED PRACTICE NURSING, SIX CORE COMPETENCIES OF ADVANCED PRACTICE NURSING, DIFFERENTIATING ADVANCED PRACTICE ROLES: OPERATIONAL DEFINITIONS OF ADVANCED PRACTICE NURSING, CRITICAL ELEMENTS IN MANAGING ADVANCED PRACTICE NURSING ENVIRONMENTS, IMPLICATIONS OF THE DEFINITION OF ADVANCED PRACTICE NURSING, Chapter 4 Role Development of the Advanced Practice Nurse, PERSPECTIVES ON ADVANCED PRACTICE NURSE ROLE DEVELOPMENT, ROLE CONCEPTS AND ROLE DEVELOPMENT ISSUES, Chapter 5 International Development of Advanced Practice Nursing, ADVANCED PRACTICE NURSING ROLES WITHIN A GLOBAL HEALTHCARE CONTEXT, FACILITATING THE INTRODUCTION AND INTEGRATION OF ADVANCED PRACTICE NURSING ROLES, NEXT STEPS IN THE GLOBAL EVOLUTION OF ADVANCED PRACTICE NURSING ROLES, Part II Competencies of Advanced Practice Nursing, DIRECT CARE VERSUS INDIRECT CARE ACTIVITIES, SIX CHARACTERISTICS OF DIRECT CLINICAL CARE PROVIDED BY ADVANCED PRACTICE NURSES, FORMATION OF THERAPEUTIC PARTNERSHIPS WITH PATIENTS, DIVERSE APPROACHES TO HEALTH AND ILLNESS MANAGEMENT, HELPING PATIENTS MANAGE CHRONIC ILLNESSES, THEORIES AND RESEARCH SUPPORTING APRN GUIDANCE AND COACHING, BUILDING RELATIONSHIPS FOR APRN GUIDANCE AND COACHING, APRN PRACTICE PRINCIPLES FOR SUCCESSFUL GUIDANCE AND COACHING, GENERATING EVIDENCE: HISTORICAL PERSPECTIVE, FROM POLICY TO PRACTICE: TIPS FOR ACHIEVING MEANINGFUL CHANGES IN PRACTICE BASED ON CURRENT BEST EVIDENCE, LEADERSHIP: DEFINITIONS, MODELS, AND CONCEPTS, CHARACTERISTICS OF APRN LEADERSHIP COMPETENCY, DEVELOPING LEADERSHIP IN THE HEALTH POLICY ARENA, OBSTACLES TO LEADERSHIP DEVELOPMENT AND EFFECTIVE LEADERSHIP, STRATEGIES FOR IMPLEMENTING THE LEADERSHIP COMPETENCY, CHARACTERISTICS OF EFFECTIVE COLLABORATION, IMPACT OF COLLABORATION ON PATIENTS AND CLINICIANS, CONTEXT OF COLLABORATION IN CONTEMPORARY HEALTH CARE, PROCESSES ASSOCIATED WITH EFFECTIVE COLLABORATION, OVERVIEW OF ETHICAL APPROACHES TO RESOLVING ETHICAL CONFLICTS, GOALS OF CARE: A CLINICAL-ETHICAL FRAMEWORK TO ENHANCE APRN PRACTICE, NAVIGATING BARRIERS TO ETHICAL PRACTICE AND STRATEGIES TO OVERCOME THEM, Part III Advanced Practice Roles: The Operational Definitions of Advanced Practice Nursing, CLINICAL NURSE SPECIALIST PRACTICE: COMPETENCIES WITHIN THE SPHERES OF IMPACT, Chapter 13 The Primary Care Nurse Practitioner, CURRENT AND HISTORICAL PERSPECTIVES ON PRIMARY CARE AND THE NURSE PRACTITIONER ROLE, EMERGENCE OF POSTGRADUATE TRAINING IN PRIMARY CARE, PRIMARY CARE WORKFORCE AND THE CONTEXT OF PCNP PRACTICE TODAY, Chapter 14 The Acute Care Nurse Practitioner, ACNP SCOPE OF PRACTICE: LEVELS OF INFLUENCE, PROFILES OF THE ACNP ROLE AND PRACTICE MODELS, SPECIALIZATION OPPORTUNITIES WITHIN THE ACNP ROLE, THE NURSE-MIDWIFERY PROFESSION IN THE UNITED STATES TODAY, IMPLEMENTING ADVANCED PRACTICE NURSING COMPETENCIES, Chapter 16 The Certified Registered Nurse Anesthetist, BRIEF HISTORY OF CRNA EDUCATION AND PRACTICE, ROLE DEVELOPMENT AND MEASURES OF CLINICAL COMPETENCE, Part IV Critical Elements in Managing Advanced Practice Nursing Environments, Chapter 17 Maximizing APRN Power and Influencing Policy, POLICY: HISTORIC CORE FUNCTION IN NURSING, UNITED STATES FUNDAMENTALLY DIFFERS FROM THE INTERNATIONAL COMMUNITY, CURRENT ADVANCED PRACTICE NURSING POLICY ISSUES, APRN POLITICAL COMPETENCE IN THE POLICY ARENA, EMERGING ADVANCED PRACTICE NURSING POLICY ISSUES, Chapter 18 Marketing Yourself as an APRN: Contracting and Negotiation, CHOOSING BETWEEN ENTREPRENEURSHIP/INTRAPRENEURSHIP, Chapter 19 Reimbursement and Payment for APRN Services, BILLING FOR APRN SERVICES: UNDERSTANDING THE PROCESS, Chapter 20 Understanding Regulatory, Legal, and Credentialing Requirements, THE CONSENSUS MODEL FOR APRN REGULATION: LICENSURE, ACCREDITATION, CERTIFICATION, AND EDUCATION, ADVANCED PRACTICE REGISTERED NURSE MASTERS AND DOCTORAL EDUCATION, BENCHMARKS OF ADVANCED PRACTICE NURSING AND EDUCATION, ADVANCED PRACTICE REGISTERED NURSE COMPETENCIES, ELEMENTS OF APRN REGULATION AND CREDENTIALING, LANGUAGE ASSOCIATED WITH THE CREDENTIALING OF APRNS, STANDARDS OF PRACTICE AND STANDARDS OF CARE FOR APRNS, ISSUES AFFECTING APRN CREDENTIALING AND REGULATION, Chapter 21 APRN Outcomes and Performance Improvement Research, CONCEPTUAL MODELS OF CARE DELIVERY IMPACT, PERFORMANCE (PROCESS) IMPROVEMENT ACTIVITIES, FUTURE DIRECTIONS FOR USING OUTCOMES IN APRN PRACTICE, Chapter 22 Future Technologies Influencing APRN PracticeDebora SimmonsPamela Salyer, MAKING SENSE OF COMPLEXITY IN HEALTH INFORMATION TECHNOLOGY, DIAGNOSTIC, THERAPEUTIC, AND PROCEDURAL DEVICES AND APPS, DATA, CLINICAL DECISION SUPPORT, AND ADVANCED ANALYTICS, FUTURE IMPLICATIONS OF TECHNOLOGY-ENABLED ADVANCED PRACTICE REGULATION AND GROWTH: A CALL TO PARTICIPATE, Chapter 23 Using Healthcare Information Technology to Evaluate and Improve Performance and Patient Outcomes, INFORMATICS AND INFORMATION TECHNOLOGY SUPPORTING IMPROVED PERFORMANCE AND OUTCOMES, REGULATORY REPORTING INITIATIVES THAT DRIVE PERFORMANCE IMPROVEMENT, RELEVANCE OF REGULATORY REPORTING TO ADVANCED PRACTICE NURSING OUTCOMES, FOUNDATIONAL COMPETENCIES IN MANAGING HEALTH INFORMATION TECHNOLOGY, FOUNDATIONAL COMPETENCIES IN QUALITY IMPROVEMENT, STRATEGIES FOR DESIGNING QUALITY IMPROVEMENT AND OUTCOME EVALUATION PLANS FOR ADVANCED PRACTICE NURSING.
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