Date Available


Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Patricia B. Howard

Clinical Mentor

Dr. Paul DePriest

Committee Member

Dr. Suzanne Prevost


The transformation of health care delivery in the United States is accelerating at unbelievable speed. The acceleration is a result of many variables including health care reform as well as the covariation occurring with adjustments in regulations related to resident work hours. The evolving care delivery model has exposed a vulnerability of the health system, specifically in academic medical centers of the United States. Academic medical centers have established a care delivery model grounded and predicated in resident presence and performance. With changes in resident work expectations and reduced time spent in hospitals, an urgent need exists to evaluate and recreate a model of care that produces quality outcomes in an efficient, service driven organization. One potential care model that would stabilize organizations is infusion of APNs with the expanded skills and knowledge to instill practice continuity in the critical care environment. A Medicare demonstration project is proposed for funding an APN expanded role and alteration in the care delivery model. Formative and summative evaluation and impact of such an expanded practice role is included in the proposed project. An evolved partnership between the advanced practice nurse and physician will serve to fill some of the gap currently existing in the delivery system of today. As the complexity and acuity of the patients in the hospital escalates, innovation is demanded to ensure a care model that will foster achievement of the quality outcomes expected and deserved.

Included in

Nursing Commons