A Proposal Establishing Independent Role for Advanced Nurse
REFERENCES .............................................. 19

The health care environment in the United States is in a period of dynamic change. Changing social structures are leading to evolving approaches to the delivery of health care. The roles of the various professional providers of health care also are in a state of transition (Kocakulah, McGuire, & Klueh, 2001).

The changes in the health care environment result from a combination of factors including increasing costs of health care, changes in societal values, advances in treatment therapies, technological-innovation, changing demographics, and many other factors. Many proposed changes are politically controversial (e.g., prescription drug coverage, access issues, legal accountability, funding and provider reimbursement, privacy issues, and so forth). Thus, while preciseness in relation to the eventual structure of the health care environment remains elusive, participants in the industry, nevertheless, must develop strategies that will enable them to continue as viable players (Kocakulah, McGuire, & Klueh, 2001).

Health care organizations are implementing new patient care delivery models in the hope that such changes will improve costs, care quality, and patient satisfaction (Schweikart, 1996). Some of these changes include the redefinition of the roles of many caregiver classifications, su

 
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