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Practice Patterns of Advanced Practice Psychiatric Nurses

Lifestyle Professional Center in Sarasota, Florida

Carol M. Musil, RN, PhD

Frances Payne Bolton School of Nursing at Case Western Reserve University in Cleveland, Ohio

Jaclene A. Zauszniewski, RN, C, PhD

Frances Payne Bolton School of Nursing at Case Western Reserve University

BACKGROUND: Research about the nature and scope of advanced psychiatric nurse prac tice is critical to validating advanced practice and further developing the role of the advanced practice nurse.

OBJECTIVE: The purpose of this study was to describe the characteristics and the practice and prescriptive patterns of advanced practice psychiatric nurses (APPNs). Research questions included: (a) What are the characteristics of APPNs? (b) What are the prac tice patterns of APPNs? (c) What are the prescribing patterns of APPNs? (d) Do APPNs with prescriptive authority dependent on physicians differ in prescribing patterns from those APPNs with prescriptive authority independent of physicians? (e) Are APPNs with prescriptive authority dependent on physicians in the form of a protocol more likely to practice in urban areas than in rural areas?

STUDY DESIGN: This study was a descriptive cross-sectional survey of a random sample of 500 APPNs selected from the approximately 800 names included in the American Nurses Credentialing Center directory.

RESULTS: Nurses in this sample were most likely to be older (mean age 50 years) women holding a masters degree or higher and working less than 40 hours per week in at least one or more subspecialties with an average of 13 years experience in the role. Most of these nurses earned between $30,000 and $69,999. They tended to be employed by an organization at least part of the time, with the rest of their time spent in private prac tice. Most (93%) of the APPNs in this study spent their time divided between two or more outpatient activities. Prescribing patterns for major tranquilizers, mood stabilizers, and antiparkinsonian agents differed based on dependence on protocol of prescriptive authority. APPNs in this sample were no more likely to practice in urban or rural areas when their prescriptive authority was independent or dependent on a physician.

CONCLUSION: APPNs have decisions to make about the future of their role in a climate that demands more intensive treatment for a much smaller fee. (J Am Psychiatr Nurses Assoc [1998]. 4, 111-120)

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