Dementia Screening and Management Practices of APRNs
Dementia Screening and Management Practices of APRNs
The consensus model for APRN regulation is now being implemented across the US. One of the justifications for the consensus model is the need for more APRNs who are competent in the care of older adults. Historically, gerontology NPs and CNSs programs have produced some of the smallest numbers of APRN graduates at the same time when older adults were living longer and increasing as a proportion of our communities. In an effort to increase the capacity for APRNs skilled in the care of older adults, the decision was made to eliminate the gerontology-specific certifications and to strengthen and infuse more substantive gerontologic content into all certifications whose populations include adults, including FNPs and WHNPs. GNP and gerontologic CNS academic programs will no longer be available but will be merged with adult NP, ACNP, and adult CNS programs respectively. All of the recently published NP competencies include skills in assessing and modifying the plan of care for patients with dementia. The responses of the participants about their practice in this study show where curricular gaps may exist and are addressed by these competencies.
The Texas BON does not collect ethnicity, age, and sex-specific information about APRNs but includes them in data reported about all registered nurses in Texas. Registered nurses in Texas had a mean age of 46; were 89% female; and 65% white, 11% black, 12% Hispanic, and 12% other. Because these data are not specific to APRNs, it is not possible to compare the age and racial profile of the study sample with the statewide profile of APRNs.
Statewide data about APRNs reveal there were over 10,000 CNSs and NPs in Texas in 2011. Even though not all of these APRNs would be able to contribute directly to the shortage of primary care providers, they still represent a substantial resource to help meet the health care needs of the citizens of Texas.
The implications of these data are that there may be knowledge and skill gaps among practicing APRNs in Texas whose population and scope of practice includes older adults. The number of older adults and their families with a need for screening, evaluation, and management of dementia is increasing. Practicing APRNs who participated in this study were similar to the physicians surveyed by Baloch et al in their comfort and skill diagnosing and managing dementia.
The respondents who participated in this survey did support increasing content and skill demonstration by APRN students as a way to address eliminating the gap for future providers. They did not support mandatory continuing education to address this gap. As adult learners who are lifelong learners, practicing APRNs should be open to continuing education opportunities that can help them develop expertise in screening, evaluating, and managing patients with dementia.
Discussion
The consensus model for APRN regulation is now being implemented across the US. One of the justifications for the consensus model is the need for more APRNs who are competent in the care of older adults. Historically, gerontology NPs and CNSs programs have produced some of the smallest numbers of APRN graduates at the same time when older adults were living longer and increasing as a proportion of our communities. In an effort to increase the capacity for APRNs skilled in the care of older adults, the decision was made to eliminate the gerontology-specific certifications and to strengthen and infuse more substantive gerontologic content into all certifications whose populations include adults, including FNPs and WHNPs. GNP and gerontologic CNS academic programs will no longer be available but will be merged with adult NP, ACNP, and adult CNS programs respectively. All of the recently published NP competencies include skills in assessing and modifying the plan of care for patients with dementia. The responses of the participants about their practice in this study show where curricular gaps may exist and are addressed by these competencies.
The Texas BON does not collect ethnicity, age, and sex-specific information about APRNs but includes them in data reported about all registered nurses in Texas. Registered nurses in Texas had a mean age of 46; were 89% female; and 65% white, 11% black, 12% Hispanic, and 12% other. Because these data are not specific to APRNs, it is not possible to compare the age and racial profile of the study sample with the statewide profile of APRNs.
Statewide data about APRNs reveal there were over 10,000 CNSs and NPs in Texas in 2011. Even though not all of these APRNs would be able to contribute directly to the shortage of primary care providers, they still represent a substantial resource to help meet the health care needs of the citizens of Texas.
The implications of these data are that there may be knowledge and skill gaps among practicing APRNs in Texas whose population and scope of practice includes older adults. The number of older adults and their families with a need for screening, evaluation, and management of dementia is increasing. Practicing APRNs who participated in this study were similar to the physicians surveyed by Baloch et al in their comfort and skill diagnosing and managing dementia.
The respondents who participated in this survey did support increasing content and skill demonstration by APRN students as a way to address eliminating the gap for future providers. They did not support mandatory continuing education to address this gap. As adult learners who are lifelong learners, practicing APRNs should be open to continuing education opportunities that can help them develop expertise in screening, evaluating, and managing patients with dementia.
