Credentialing for Advanced Nurse Practice (APN) Essay

Credentialing is a medical professional practice of instituting the qualifications to the nurses and other medical practitioners through assessing their legitimacy and background. Most of the healthcare organizations and provider networks perform their individual credentialing through electronic services and credentialing specialists. The credentialing process ought to be reviewed by the committee of experts to ensure elaborate credentialing process. The credentialing process often involves reviewing and granting precise clinical privileges as well as allied health staff members. The credentialing of APRNs (Advanced Practice Registered Nurses) in a sensitive medical setting is an indispensable practice and care ought to be taken to warrant the full realization of the capacity and the scope of regular medical practices. The procedure of privileging and credentialing engross the verification process of required licensure, certification and education to become a medical practitioner. The recognition of a person's APRN practices based on education, practice setting, and training is also a necessary element of credentialing in the medical profession. Nursing bureaucrats are often tasked with responsibilities of ensuring that APRNs are privileged and credentialed and that apposite mechanisms exist among the members of an institution for the purposes of enhancing recognition in the scope of APRNs practice (Hamric et al. 2013). The paper elaborates concepts that adhere to the privileging and credentialing process for APRNs with special attention to medical acute care situations. Important practices should always be highlighted to create surety in the credentialing processes with the aim of promoting APRNs practices within their scope of the medical profession.

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Examining the level of education and the areas covered in the education process is one of the steps in the credentialing process. This involves confirming if APRN completes the time required to cover a given topical area of study. It may involve going deep into the transcripts and different records attained during the study. Complete grasp of educational theoretical and practical content is an essential consideration in the credentialing process. In most cases, the general public has the right to quality and safe healthcare delivered medical experts with proper training, education as well as experience. The Joint Commission on healthcare accreditation usually takes the credentialing seriously to ensure that different medical facilities are equipped with professionals capable of handling the emergency situation as well as providing excellent medical care to the patients (Hamric et al. 2013). In the credentialing process, an individual need to have practical training to be able to qualify as a practicing nurse, it is also necessary for those willing to take medical professions to acquire experience in order to become fully credited. Experience is an essential part of one's profession; it involves having expertise in different practices within the medical organization. In the credentialing process, the experience is necessary for an individual to become fully credited by the medical agencies. The commitment to credentialing often broadens to the patients that are entitled to healthcare services through the use of technology or telemedicine as well as the patients that are in need of emergency care resulting from disasters, trauma, and terrorism.

In the credentialing process, medical agencies often ensure that a medical practitioner or Acute Care Nurse Practitioners are well equipped with safeguards and knowledge to operate in the emergency or acute medical situations. During the process of credentialing, the committee of experts often ensures that Acute Nurse practitioners have a complete grasp of the medical regulations and guides as stipulated in the credentialing guide. The medical practitioners should thus have clinical privileges in various venues. All medical practitioners including NPs who treat and diagnose patients through the use of technology are subjects to privileging and credentialing procedures in different medical facilities. The receiving organizations may decide to use the credentialing criterions applied by other agencies as the standards and guides are almost the same so long as the receiving organization adheres to the decisions outlining privileges. The Arizona Board of Nursing, on the other hand, does not always make references to telemedicine and NPs. Advanced practice registered nurse ought to be knowledgeable of systems whereby their extent of the practice is regulated and defined, and through which specialized competence is guaranteed. The processes whereby health facilities determine practice and scope parameters is through the delineation of medical privileges and credentialing. Acute-care nurses should always be encouraged to negotiate for clinical privileges and delineations that are consistent with their legal and professional course of practice, individual and educational abilities as well as safe delivery of quality care to the patients. Additionally, it is always essential that the credentialing process should not be used to create barriers to the medical practices that result in the undeserving of the organizational needs and patients.

After analyzing different credentialing procedures, there are several questions, concerns, and several views that an individual can anticipate to encounter when pursuing the medical course. Some of the questions include: if an individual fails to meet the credentialing requirements, is there an appeal? What will help the appeal to be accepted by the credentialing panel? The appeal normally depends on the panels and location from which credentialing takes place. If a person possesses unique specialty and speaks different languages, most of the insurance organizations are able to accept the appeals and allow an individual to the panel. When a person qualifies for the credentialing process, what are some of the documents required by the panel and the insurance companies? Again, most credentialing panels require several documents to prove the legibility of medical professionals; some of the essential documents for this process include a resume that explains different gaps in the professional history. A copy of present liability insurance is also necessary for the credentialing process; in addition, academic certificates are compulsory. Apart from questions that a person can anticipate in the credentialing process, there are also concerns that an individual preparing to appear before the credentialing panes should expect. In some cases, physicians often disregard the fact that credentialing procedures are structural legal processes that can penalize the careless and ambush the unwary (Hamric et al. 2013). Physicians often make mistakes as well as the advice on how to prevent such mistakes. The misrepresentation is always an objective and a clear-cut violation of credentialing process usually committed by some credentialing agencies. The applications for the credentialing process are frequently accompanied by series of questions or statements about the prior unpleasant peer review activities. If a panel fails to disclose the credential criterions used, then the nondisclosure is a complete violation of the credentialing process. In case there is an occurrence of peer review actions, then it is necessary for the credentialing panel to review the applications of the medical staff as well as the participation agreements that have been signed. To further make the process better, there is the need to have a list of applicable requirements. The medical practitioners should possess a copy of NPDB report before applying for credentialing process. If necessary, an individual needs to submit the supplemental statements.

Reference

Hamric, A. B., Hanson, C. M., Tracy, M. F., & O'Grady, E. T. (2013). Advanced Practice Nursing-E-Book: An Integrative Approach. Elsevier Health Sciences.