Clinical Nurse Specialists (CNS) play a critical role in ensuring the implementation of high-quality evidence based care, improved patient outcomes, and reduced health care delivery costs. Professional certification is one way we distinguish our unique contributions and advanced practice nursing expertise from other advanced practice roles. This first edition of the book represents a compilation of Clinical Nurse Specialist practice knowledge contributed by respected clinicians from across the nation for certification examination preparation. The book incorporates content from the American Association of Colleges of Nursing Adult-Gerontology Clinical Nurse Specialist (AGCNS) Population Focused Competencies and the American Association of Critical Care Nurses Scope and Standards for CNS Practice. It begins with an introduction to the current AGCNS examination options, test plans and processes, as well as test taking strategies for success. The remainder of the book organizes test plan subject matter according to the three spheres of impact of CNS practice. The book includes twelve chapters presenting the overview, pathophysiology, etiology, assessment, diagnosis, treatment/management, and related pharmacology content according to each body system. It addresses the nurse and nursing practice sphere of impact. Relevant content includes age-related response to illness and adult-gerontology population specific practice standards for care and advocacy of the older adult. Emphasis is placed upon culturally competent care and safe care transitions. Nursing practice content includes consultation, collaboration, education, mentoring and communication skills. Nurse and nursing practice advocacy topics review public policy, professional practice issues, and ethical concerns. The book covers systems and systems leadership competencies of the CNS. Relevant content involves quality improvement principles, safety initiatives, financial stewardship, organizational level program development and systems change. Clinical inquiry subject matter covers evidence- based practice, research methodology, and skills for dissemination of CNS work.

Students in advanced practice programs face the monumental challenge of applying knowledge of pathophysiology to clinical practice. To do this, the student must first have solid command of the principles of physiology, translate those principles to the pathophysiology of diseases, and then translate them again to the clinical setting. Each step must be undergirded by a firm understanding of the “whys” of the physiologic mechanisms. This book guides the student through those “whys”—in a step-wise fashion that is logical and systematic. It presents the physiology of each system at the appropriate level, in easily accessible book that is complemented by clear tables and figures. Throughout, it provides relevant examples and metaphors to help the student visualize and relate to complex pathophysiologic mechanisms. Thought-provoking questions challenge the student and offer practice for long-term retention. The book explains equations—which are inescapable in physiology—in words to make them less daunting to the student; it also presents every equation in the context of its pathophysiological application. It provides a complete chapter on the basic principles of genetics and genomics with coverage of genetic variations, assessment, and genomics. The book consists of seventeen chapters. Each chapter begins with a short introduction that sets the stage for the content’s relevance to clinical practice. It introduces the common disease states of that organ system, briefly highlighting their incidence and prevalence. In each chapter, major subtopics conclude with questions to improve student mastery of information. The chapters conclude with the discussion of pediatric considerations, gerontological considerations, case studies, clinical practice, key points, and key disorders.

This book updates current trends in practice and reviews the origins, standards, and competencies of the advanced practice registered nurses (APRNs) in the United States. It discusses APRN roles within a nursing context, identifies organizational roles for APRNs, and examines ethics in guiding APRN clinical decision making. The book is organized into three parts comprising 16 chapters. It examines and addresses all four APRN roles. The book reviews useful tools in advanced clinical decision making, practice issues (regulation, certification prescriptive authority, credentialing, and liability), and the exploration of employment opportunities and strategies. It explores the role of the APRN in the team’s formation and leadership. The chapter discusses the composition of interprofessional teams that will include a variety of healthcare providers. It challenges APRNs to assume more prominent leadership roles in healthcare delivery systems. The book emphasizes the importance of leadership competencies necessary for the delivery of quality care, evidence-based practice, and patient safety. Different leadership development models and curricula related to leadership in master’s and doctor of nursing practice (DNP) programs are considered. The book describes the multifaceted roles of APRNs internationally. The Patient Protection and Affordable Care Act (ACA) has placed APRNs on the front lines of healthcare reform. The book reviews the critical events that have sculpted the APRN policy role in influencing and creating legislation and discusses how to become an engaged citizen in directing change. It discusses health information technology competencies for nurses and APRNs, as well as common information management resources that APRNs are using or likely to encounter in the near future. The book explores the multiple modalities that are incorporated into the scholarship of practice, such as sharing tricks of the trade, completing quality improvement projects, collaborating with nursing researchers, and being an active member in professional organizations.

Psychiatric-mental health advanced practice registered nurses (PMH-APRNs) are like water: they are flexible, they are fluid, and they go where they are needed. Deinstitutionalization of psychiatric patients resulted in not only more community-based treatment, but also new and expanded outpatient roles for psychiatric nurses. The third edition of Advanced Practice Psychiatric Nursing meets the practice standards developed by the American Psychiatric Nurses Association, the International Society of Psychiatric-Mental Health Nurses, and the American Nurses Association, which require all PMH-APRNs to have skills in psychotherapy, psychopharmacology, and holistic assessment. Each chapter reflects not only state-of-the-art knowledge, but decades of clinical wisdom. The book is divided into five sections: Section I provides an overview of the theoretical and evidence base for practice and an exploration of the concept of shared decision-making and reaching concordance between clinicians and clients. Section II explores the foundations necessary for the practitioner to implement integrated practice and discusses the synergistic effects of integrating practice concepts. This includes chapters presenting the overviews of psychotherapy, psychopharmacology, and complementary and alternative approaches in the context of the stages of treatment. A new chapter focuses on legal and ethical issues in treatment. Section III applies the information from previous chapters and focuses on integrative management of specific syndromes. The chapters discuss mood disorders, anxiety-related disorders, psychotic symptoms, sleep disturbances, disordered eating, disordered cognition, impulse control, disordered attention, self-directed injury, and other-directed violence. Section IV covers aspects of managing substance misuse, medical problems, pregnancy, telehealth, and forensic issues that often co-occur with psychiatric syndromes. A new chapter focuses on care for sexual and gender minority patients. Section V covers the importance of maintaining competence and quality in clinical practice. The section includes a new chapter on self-care among PMH-APRNs that focuses on resilience in practitioners, and the final chapter focuses on the global perspectives and the future of psychiatric-mental health advanced practice nursing.

Healthcare delivery system reforms initiated by the Patient Protection and Affordable Care Act emphasized the health of populations and social determinants of health. These areas are central to public and community health nursing practice. The core processes of community assessment, program planning, implementation, and evaluation remain relevant to advanced public and community health nursing practice. This book assists graduate students in public and community health nursing and other nursing specialties who focus on population health to become competent advanced practice nurses. The book is organized into six sections containing 21 chapters. Section one comprising two chapters provides the learner with an introduction to public and community health nursing specialty practice and foundations for this advanced level of practice. Section two provides the depth of knowledge needed by the advanced practice nurse to competently conduct community assessments. Section three takes the learner through the steps needed to develop coherent and high-quality program plans. Section four provides the learner with the necessary information to implement program plans at the individual, group, or community level. The section five addresses program evaluation in-depth, providing detailed content on how to develop an evaluation plan and revise programs. The final section directs the learner’s attention to graduate preparation in public and community health nursing as well as to the leadership role in creating a professional practice environment. The book suggests clinical or practicum activities that assist the learner to apply the content in a variety of ways and settings. It also presents examples of actual programs or projects conducted by advanced public and community health nurses.

This book is unique, because there are no current textbooks on the market that are aimed at communication, assessment, and treatment goals of the obese patient from the perspective of an advanced practice nurse (APN). The first part of the book focuses on the disease of obesity in the United States and worldwide. The current trends and causes of obesity are addressed in detail. Obesity terms and numerous definitions used are also discussed. The first part describes the multifaceted roles of the APN. The second part describes nursing at its best. It focuses on common “dos and don’ts” with regard to the overweight or obese patient. A section on therapeutic communication is also provided. Real patient stories are shared to allow appreciation of the patient’s perspective. The third part focuses on the technical aspects of obesity genetics and pathophysiology. The addiction of obesity and eating disorders are discussed. Physical assessments of both adult and pediatric patients from the APN point of view are seen. Exercise and dietary assessment and recommendations with examples will be of interest to clinicians. The fourth part focuses on the numerous comorbid conditions associated with obesity. This includes the assessment and treatment of each disease in both the pediatric and adult populations. Diseases addressed in the adult population include hypertension (HTN), dyslipidemia, cardiovascular disease (CVD), diabetes mellitus (DM), obesity and the pulmonary system, osteoarthritis (OA), polycystic ovary syndrome (PCOS), and metabolic syndrome. Obesity in combination with pediatric HTN, dyslipidemia, DM, obstructive sleep apnea (OSA), and asthma is also addressed. Prevention efforts for obesity, as well as methods to avoid weight cycling, are discussed. The final part of the book explains the treatment of many comorbid conditions related to obesity.

This book provides both health professional students and experienced practitioners with the cognitive strategies for clinical leadership and opportunities for applying these strategies to the realities of advanced clinical practice. It offers advanced practice providers (APPs) a clear focus on clinical leadership while providing an important differentiation between true leadership skills and behaviors and mere task-oriented management skills. The book reports on various leadership theories/models and uses meaningful leadership research evidence that relates well to real-world clinical settings while cautioning the reader to understand that research findings may not always produce predictable leadership outcomes. It is an excellent resource for the next generation of leaders in health care. The book is organized into four parts. The first part discusses clinical leadership traits and behaviors. Part two presents administrative leadership strategies for physician assistants and nurse practitioners, vis-à-vis the financial principles of clinical leadership and change strategies used by clinical leaders to achieve desired, planned change in complex health care environments. Part three describes the human aspects of clinical leadership such as the importance of clinical leaders being ethical and culturally informed in their advanced practice; the potential for and qualities of being a spiritual leader in a clinical setting; teaching others and leading other leaders in a clinical setting; and resiliency of the clinical leader in preventing burnout. The final part invites readers to look ahead to the future and ponder the possibilities of a desired future for health care.

This book introduces an innovative model of care coordination clinical reasoning that builds on past work with the Outcome-Present State-Test (OPT) model of reflective clinical reasoning. It includes contemporary knowledge, skills, and abilities required to work effectively as a member of an interprofessional care team in the current health care arena. The OPT model has been described as a third-generation nursing process model that responds to the need for patient-centered nursing care coordination challenges. The fundamental aspects of the OPT model of clinical reasoning are explained and linked to care coordination challenges at several levels—those related to patient-centered care planning, team-centered negotiation, and service or health care system considerations. The book explains the Care Coordination Clinical Reasoning (CCCR) model and discusses some of the distinctions, system dynamics, and relationship issues that emerge when health care team members have different points of view with regard to care coordination. It also presents a series of case studies to illustrate how the CCCR model is activated and applied across the lifespan and in a number of healthcare contexts. Cases across the health care continuum related to primary care, acute care, rehabilitative care, and long-term care are presented with patient scenarios that are in need of care coordination. The book further summarizes the benefits of the CCCR model and suggests future evolution and development of the model and discusses the need for health care team members to develop competencies related to ongoing innovations.