Jasper L. Tolarba
Yale University School of Nursing, USA
Title: Global benchmarking on the role of the advanced practice nurse (APN) using the behavioral intervention team (BIT) as a model of care
Biography
Biography: Jasper L. Tolarba
Abstract
Background: Advanced practice nursing (APN) is broadly defined as nursing interventions that influence health care outcomes, including the direct care of individual patients, management of care for individuals and populations, administration of nursing and health care organizations, and the development and implementation of health policy (AACN Position Paper, 2004). APN has been widely successful and well received in the United States, Canada, Singapore, Japan, etc. and its practice is steadily on the rise internationally. This paper describes the emerging trend of advanced practice nursing worldwide. It discusses the significant contributions of advanced practice nurses and how they positively impact patients’ clinical outcome and explains why they are beneficial members of the health care team. Purpose: The goal of this paper was to describe the BIT model of care and the role of the APN. This was achieved through four specific aims: (1.) Describe the overall context and structure of the BIT, (2.) Describe the BIT members’ clinical and operational responsibilities, (3.) Describe the collaborative relationships among stakeholders, and (4.) Validate the overall BIT model of care and the role of APNs with a group process. Design: The conceptual framework used in this project to describe the overall framework of the BIT model of care was the Donabedian Model of Quality Health Care (Donabedian,1988). Methods: An initial description of the overall structure of the BIT and the roles and responsibilities of Advanced Practice Nurses was written. The multifocal roles of the APNs were also described as they function within the BIT model of care. The draft was validated via a group process involving all members of the BIT. Results: The draft of this paper was distributed to all members of the BIT and the group process of content validation showed an accurate description of the role of the APN in the BIT program with minor revisions. Conclusions: The BIT model of care is an evidence-based, proactive approach in providing psychiatric services to patients in a general medical inpatient setting. It has been proven effective and innovative, which has fueled replication of the BIT program in other hospitals in the United States. Results from this study can be used as template for other healthcare insitutions to replicate the program and utilize the APN role for its success.