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Essentials of Advanced Nursing Practice Enrico Silvestre Giron Western Governors University ESSENTIALS OF ADVANCED NURSING PRACTICE 2 Essentials of Advanced Nursing Practice Educated to be innovative agents of change, Advanced Practice Nurses are continuously analyzing ways to improve the overall nursing process and quality of care within their healthcare facility. Advanced Practice Nurses act as consultants for their organization by evaluating policies and procedures driven by evidence-based practices, and aim to improve safe, effective, quality patient-centered care, as well as the overall workflow for the nurses. Purpose and Overview The purpose of this consultation was to interview a nurse leader, particularly a clinical nurse specialist, and to analyze a healthcare organization, with the end goal of identifying a change or improvement needed by the organization. At Natividad Trauma Center, in Salinas, California, the Stepdown Unit has been noted to have a steady decline in their Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores related to its hospital environment, particularly the “quietness at night” question. HCAHPS provide a subjective account of the quality of care provided to each patient while admitted to the hospital, which insurance companies use to quantify reimbursement rates, which in-turn determines how much revenue the hospital has acquired. A direct correlation between HCAHPS and reimbursement rates set high standards on staff expectations and the level of care provided for each patient. Therefore, the purpose of the consultation was to assess current policies and procedures related to maintenance of noise levels throughout the day. Data was collected for the CNS, Staff Nurses, organizational reports provided by the CNA, research of benchmarking purposes, and peer reviewed articles from the WGU library database. The Clinical Nurse Specialist interviewed for the purpose of this consultation was Rachael Petritsch, MSN, RN, ACNS-BC. Rachael is the CNS for both the Stepdown and Med- ESSENTIALS OF ADVANCED NURSING PRACTICE 3 Surg Telemetry floors at Natividad Trauma Center. The interview was conducted face-to-face, which consisted of question-and-answers, with opportunities for both parties to elaborate on and provide any clarification on questions and their associated responses. During the interview, the topic of HCAHPS arose, which provided an opportunity for Rachael to discuss the issue of low scores in the domain of hospital environment related to “quietness on the unit.