Domains of Practice in Healthcare

Activity Guidelines and Rubric
Overview
The spheres of care from the AACN Essentials (2021) represent domains of practice in healthcare, which include disease prevention, chronic disease care, regenerative or restorative care, and hospice or palliative care. As an MSN professional nurse, you will need to think beyond the primary sphere in which you work, as nursing roles can apply within any of the four spheres of care. To improve healthcare delivery, you will work with healthcare professionals from most, if not all, spheres of care. Therefore, it is important to understand the relationship between your role and the four spheres of care at the start of your career-long learning journey.

Scenario
Imagine you work alongside more than a hundred nurse professionals in a medium-sized organization. A recent survey conducted by your organization’s human resources (HR) department found that new nurse graduates are prepared for the acute care setting. However, the organization requires nurses to be prepared to practice in all four spheres of care. To address this situation, the organization’s leadership has decided to analyze the existing nursing roles and how these align with the four spheres of care. Several roles, including nurse administrators, nurse leaders, and direct care nurses will contribute to this analysis. Each contributor will identify the activities that connect the four spheres of care to their specific role. You have volunteered to contribute to this report by highlighting the connection between the various roles and the four spheres of care.

An example of a nurse informaticist role is provided to help you understand the requirement, but you will choose a role from your MSN track. The example provides the expected survey response to be recorded in a worksheet, including the identified role responsibility, activities, and the reflection of a nurse informaticist.

The following nurse informaticist role is intended to serve as guidance for how to develop the assignment and cannot be used in your individual work.

Chosen Role: Nurse Informaticist
Role Responsibility: Optimize utilization of electronic health record (EHR) and related technologies

I. Chronic Disease Management: Actions related to the identified role responsibility:

1. Program system tracers to monitor specialty appointments.
2. Work with a software vendor to develop a new process for providing staff access to printable patient education related to chronic diseases automatically identified in EHR.
3. Analyze software workflow for inpatient COPD patients.
   II. Hospice/Palliative Care: Actions related to the identified role responsibility:
4. Provide patient portal access to palliative care providers.
5. Collaborate with a newly acquired home visit nursing organization to provide access to EHR.
6. Create a new care plan in an EHR system for end-of-life care, accessible across multiple departments and specialties.
   III. Regenerative/Restorative Care: Actions related to the identified role responsibility:
7. Assess a new EHR system for the hospital to improve workflow and reduce costs.
8. Meet with the department director to discuss specialty-specific clinical system needs.
9. Work with the clinical software vendor to upgrade to latest software version.
   IV. Wellness/Disease Prevention: Actions related to the identified role responsibility:
10. Test the patient portal for a new process to allow patients or guardians to forward annual physicals and immunization records directly to local school nurses.
11. Program the patient portal to alert patients who are overdue for routine services.
12. Participate in outpatient user group meetings for quality improvement system updates.

Directions
Complete the Module One Activity Worksheet linked in the What to Submit section below. Select a nursing role to examine within the four spheres of care. This should be a future MSN role based on your MSN track. Then select a responsibility that your chosen role fulfills in each of the four spheres of care and list actions that a nurse in that role needs to perform to fulfill the responsibility.

While most of your nursing experience may be limited to only one or two spheres, this assignment requires you to think about all four spheres. Specifically, you must address the following rubric criteria:

1. Responsibility: Determine one responsibility that your chosen role fulfills in each of the four spheres of care.
2. Actions: Describe at least three actions that a nurse in your chosen role will perform to fulfill the selected responsibility. As you work, refer to the example of the nurse informaticist and describe the actions using action- oriented verbs.
3. Reflection: Explain your selected responsibility and actions within the four spheres of care. Consider the following questions to guide your response:
   A. How will the responsibility of your chosen role apply in all four spheres of care?
   B. Did you discover any actions that crossed all four spheres of care? Why, or why not?
   C. Which sphere of care did you initially think you would practice in?
   D. How did your thinking change regarding your role and how you practice within the spheres of care?

Refer to the Shapiro Library Scholarly and Professional Sources Research Guide linked in the module resources for guidance on acceptable sources.

What to Submit
Submit your work in the Module One Activity Worksheet. Include a 200- to 250-word reflection on how your chosen role applies within the four spheres of care. Also include a student title page and reference list, which are not part of the word count. Follow APA style standards.