Nursing Economic$

This article outlines the core elements of the American Nurses Credentialing Center (ANCC) Pathway to Excellence® Program and key support resources available through the American Academy of Ambulatory Care Nursing’s ambulatory practice settings seeking to deepen nursing practice through mobilization of a ANCC Pathway to Excellence® designation.

Ambulatory care nurses are in an ideal position to gather social determinants of health (SODH) information from patients. Data on SDOH give nurses deeper insights into non-clinical factors affecting patient health, providing an opportunity for a more integrated approach to care. The challenge lies in turning this awareness into action. With increased visibility of issues like food insecurity, nurses seek practical solutions. Organizations may address this by partnering with food pantries or developing in-house programs, allowing staff to offer ‘food prescriptions'’ as direct interventions. This article explores the evolution of SDOH assessments and highlights evidence-based strategies from current literature to help outpatient health care providers effectively operationalize these assessments to tackle food insecurity.

To advance the science of ambulatory care nursing, the American Academy of Ambulatory Care Nursing (AAACN) has launched a research committee. Initial work included development of two national studies and a scoping review. This article describes the committee’s origins and outlines the scoping review protocol.

Workplace violence in ambulatory care is less controlled than in inpatient settings due to a variety of factors, including location, patient population, volume of visits, hours of operation, physical environment, and availability of resources. Personal knowledge, skills, and ability, as well as data and organizational resources, are needed to mitigate events. Continued research, publication of evidence-based practice, and advocacy for laws protecting health care workers in ambulatory care are necessary. The development of workplace violence risk assessments, violence screening questions, and national nursing quality indicators are needed to help move the prevention needle in ambulatory care settings.

Mobilizing health, creating access, and improving health should be the primary concerns of today’s nursing profession. This article explores the American Academy of Ambulatory Care Nursing’s utilization of the American Nurses Credentialing Center’s Magnet® Recognition Program as a means to revolutionize health care across all settings to create equity and health for all patients.

The American Academy of Ambulatory Care Nursing (AAACN) recognizes a paradigm shift represented by the volume of health care delivery flowing from episodic acute care encounters to long-term relationships. This shift presents opportunities to further recognize and prepare nurse graduates for the complex and expanded role of the ambulatory care registered nurse (RN). This position paper discusses the current state of the RN role in ambulatory care and provides a vision for the future. The paper further identifies challenges, poses possible solutions, and highlights the AAACN position on the role of the ambulatory care RN.

The opioid crisis continues to impact the United States despite efforts to reduce or remove barriers to expanding access to opioid use disorder (OUD) care and treatment. There is significant work still to be done. Given the overall financial impact to health care, the criminal justice system, and general lost productivity in the United States that continues to grow each year, it is imperative that interventions supportive approaches be implemented. As licensed clinicians, ambulatory care registered nurses have the potential to make a significant impact to the expansion of OUD services. However, overcoming the barrier of billing for their services is a hurdle that must be tackled.

The American Academy of Ambulatory Care Nursing (AAACN) Board of Directors appointed the Diversity, Equity, and Inclusion (DEI) Task Force, and charged them with engaging the AAACN membership in a larger DEI conversation and creating a safe space for open discussion and education. The task force administered a survey to give voice to and gain understanding of the current state of member demographics and opinions on the topic of DEI. The survey was developed using an evidence-based approach to collecting diversity information in a non-confrontational, open, and honest way. Using results of the survey, the task force has taken steps to build an initial platform for DEI dialogue and education.

The "Future of Nursing Report 2020-2030: Charting a Path to Achieve Health Equity" presents an overarching framework for advancing health equity over the next decade. Given their knowledge and experience, ambulatory care nurses informed the report development; however, they must embrace opportunities for further action. Examples of ambulatory care nurses' innovative work and practice are showcased as they lead efforts across diverse settings with multiple partners. Ambulatory care nurses have the expertise, tools, and leadership for decisive action. They must continue to activate other nurses, their organizations, and collaborators to achieve the report's vision.

Payment for primary care remains predominantly fee-for-service. Billing regulations are complex and often not a part of nursing curriculum. This leads to confusion and a lack of understanding. When nurses are employed by primary care practices, their nursing services that contribute to context, as well as the systems they serve and impact the RN’s billable services, are not clearly identified. This article describes frequently used codes, regulatory requirements for use, and opportunities for future payment models.