Adult/Gerontology — Acute Care Specialty
Overview and Population of Interest
The Adult/Gerontology – Acute Care Advanced Practice Registered Nurse is educated at the Master's level with expertise in the care of the adult/gerontology population with high intensity nursing and medical needs, including acute, critical, and complex chronic health conditions. The population of interest is adults, from late adolescence through senescence, who have acute, critical and complex chronic health needs. The age and patient status, not the location of the patient, is key; students may care for patients in a variety of settings, including the patient's home, outpatient clinics, medical/surgical wards, critical care units, or emergency/urgent care units.
Nurse Practitioner Role and Preparation
Acute Care Nurse Practitioners provide advanced nursing care across the continuum of healthcare services to meet the specialized physiological and psychological needs of adult/gerontology patients with acute, critical, and complex chronic health conditions. They perform comprehensive health assessments, order and interpret the full spectrum of diagnostic tests and procedures, use differential diagnosis to reach a medical diagnosis, construct and order a plan of care, and evaluate the outcomes of interventions for patients.
Clinical Nurse Specialist Role and Preparation
Acute Care Clinical Nurse Specialists intervene in the individual patient/family sphere, a nurses-nursing practice sphere, and the organizations-systems sphere to influence patient outcomes. Their activities span 8 dimensions of care: clinical judgment, clinical inquiry, facilitation of learning, collaboration, systems thinking, advocacy/moral agency, caring practices, and response to diversity. Clinical Nurse Specialists perform comprehensive health assessments, interpret diagnostic tests and procedures within their areas of expertise, and provide evidence-based interventions and expert consultation to other healthcare providers. Clinical Nurse Specialists support organizational goals, develop programs, utilize and develop best practice models, design and implement system changes, and evaluate and apply research to clinical practice. Clinical Nurse Specialists provide formal and informal multidisciplinary education and provide leadership, mentoring, and guidance to staff nurses.
Adult-Gerontology Acute Care Learning Outcomes
The goal of the UCLA School of Nursing Adult/Gerontology-Acute Care program is to prepare nurses to assume an advanced practice role in the care of adult/gerontology patients with acute illnesses or with exacerbations of chronic illness and with high-intensity nursing and medical needs. While all students are expected to gain proficiency with care of adult/gerontology patients in acute care general medicine settings, students may also select an area of focus within the adult/gerontology population. Students specializing in oncology may select from a variety of oncology settings.
Types of Care provided by the Advanced Practice Registered Nurse:
- Continuous and comprehensive care in a variety of inpatient and outpatient settings
- Episodic care for acute and critically ill patients
- Management of chronic conditions or terminal illness
- Management of long-term care or sub-acute/rehabilitation patients
- Monitoring and case management of medical and cardiac diseases
- Multidisciplinary and comprehensive care
Key elements of the Acute Care Nurse Practitioner include:
- Advanced clinical expertise
- Development of differential diagnoses
- Use of medical diagnostic reasoning to formulate the plan of care
- Order and prescription of pharmacologic and other therapeutic therapy
- Planning and management of patient care across the acute care continuum
- Utilization and performance of invasive and non-invasive interventions
- Evidence-based and research-based clinical practice
- Advocacy or patient agency
- Clinical leadership
- Promotion of health
Key elements of the Acute Care Clinical Nurse Specialist include:
- Advanced clinical expertise
- Comprehensive, holistic wellness and illness assessment
- Design, implementation, and evaluation of innovative individual, aggregate, and/or population-based programs of care
- Identification and measurement of nurse-sensitive patient outcomes
- Multidisciplinary collaboration
- Diagnosis of systems-level problems and development and evaluation of systems-level changestrategies
- Evidence-based practice at the patient, nursing, and systems level
- Patient and nursing advocacy
- Clinical and professional leadership