A Narrative Review of Advanced Practice Nurses' Function in Managing Multimorbidity

Abstract

                                      

INTRODUCTION This narrative review examines the role of Advanced Practice Nurses (APNs) in managing patients with multimorbidity. Multimorbidity, the presence of multiple chronic conditions in an individual, presents unique challenges for healthcare systems. This review explores the contributions of APNs in providing comprehensive care, coordinating treatment plans, and improving health outcomes for patients with multimorbidity. The findings highlight the critical role of APNs in managing complex patient needs and suggest strategies for optimizing their impact in clinical practice[1]. According to Watson's hypothesis, compassion is a crucial aspect of nursing, and that in order to foster healing and well-being, nurses must establish a strong connection with their patients. Multimorbidity, defined as the coexistence of two or more chronic conditions in an individual, is increasingly prevalent due to aging populations and advances in medical care. This complex health status challenges healthcare systems, requiring comprehensive and coordinated care to manage multiple conditions effectively. ADVANCED PRACTICE NURSES (APNs), including Nurse Practitioners (NPs), Clinical Nurse Specialists (CNSs), nurse anesthetists, and nurse midwives, are well-positioned to address the needs of these patients. This review aims to explore the role of APNs in managing multimorbidity and to identify strategies that enhance their contributions to patient care [2]. Multimorbidity complicates patient care by increasing the risk of adverse drug reactions, requiring complex treatment regimens, and leading to higher healthcare utilization. Effective management requires a holistic approach that considers the interplay between different conditions, patient preferences, and social determinants of health. APNs, with their advanced clinical training and patient-centered approach, are uniquely equipped to provide this type of care. DESCRIPTION APNs are trained to offer comprehensive assessments, develop and implement care plans, and provide ongoing management for patients with chronic conditions. Their roles often include prescribing medications, ordering and interpreting diagnostic tests, and coordinating care among various healthcare providers. These capabilities are particularly valuable in managing multimorbidity, where integrated care is essential[3]. APNs also play a crucial role in patient education and self-management support. They empower patients by providing information about their conditions, teaching self-management skills, and supporting lifestyle modifications. This patient-centered approach is vital for managing multimorbidity, where patient engagement is key to achieving positive health outcomes. Despite the demonstrated benefits, there are challenges in integrating APNs into healthcare teams. These include regulatory barriers, scope of practice limitations, and varying levels of acceptance among healthcare providers. Addressing these challenges requires policy changes and efforts to standardize APN roles and education across different regions. APNs conduct thorough assessments that consider all aspects of a patient's health, including physical, emotional, and social factors. They develop individualized care plans that address multiple conditions simultaneously, ensuring coordinated and holistic care. Advanced practice nurses (APNs) play a crucial role in conducting comprehensive assessments and developing individualized care plans for patients with multimorbidity. Their advanced training enables them to perform detailed evaluations that encompass a patient's physical, emotional, and social health aspects. This holistic approach is essential for identifying all the factors that contribute to a patient's overall health status. APNs begin by gathering extensive medical histories, including information about all chronic conditions, medications, allergies, and previous treatments. They also assess current symptoms, lifestyle habits, and social determinants of health, such as living conditions, family support, and economic factors. This thorough data collection helps in understanding the complexity of each CONCLUSION Advanced practice nurses are pivotal in managing patients with multimorbidity, offering comprehensive, coordinated, and patient-centered care that improves health outcomes. Their role in the healthcare system should be supported and expanded through policy changes and increased recognition of their contributions. By leveraging the expertise of APNs, healthcare systems can better address the complex needs of patients with multiple chronic conditions, ultimately leading to improved care quality and patient satisfaction. Further research is needed to explore the long-term benefits of APN-led interventions and to identify best practices for integrating APNs into multimorbidity management frameworks. REFERENCES 1. Yancey NR. Why teach nursing theory?. Nurs Sci Q. 2015; 28(4):274-278. 2. Yu C. Reinforcement learning in healthcare: A survey. ACM Comput Surv. 2021; 55(1):1-36. 3. Fawcett J. On nursing theories and evidence. J Nurs Scholarsh. 2001; 33(2):115-119. 4. Im EO and Ju Chang S. Current trends in nursing theories. J Nurs Scholarsh. 2012; 44(2):156-164. 5. Flaming D. Nursing theories as nursing ontologies. Nurs Philos. 2004; 5(3):224-229.