330 ■ III: ROLE FUNCTIONS OF DOCTORAL ADVANCED NURSING PRACTICE
AMERICAN COLLEGE OF NURSE- MIDWIVES
The American College of Nurse- Midwives (ACNM) in their publication Position
Statement: Appropriate Use of Technology in Childbirth (2014) emphasizes, “the use of
technology in childbirth based on the evidence of benefit” (p. 1). Their official posi-
tion is limited to the “use of appropriate technological interventions where the ben-
efits of such technology outweigh the risks” during the childbirth process (ACNM,
2014, p. 1).
■ OTHER FACTORS INFLUENCING EXPECTATIONS
OF THE DOCTORAL APN
Although professional organizations play a key role in influencing expectations of
the doctoral APN, there are other entities that are also playing an important role.
The TIGER Informatics Competency Collaborative was created to develop infor-
matics competency expectations and recommendations for all practicing nurses and
graduating nursing students (TIGER Informatics Competency Collaborative, 2009).
They espouse that the doctoral APN will need to be competent in the following three
primary areas: basic computer competencies, information literacy, and information
management.
The Robert Wood Johnson Foundation (RWJF) funded the Quality and Safety
Education for Nurses (QSEN) project with the broad objective of “preparing future
nurses with the knowledge, skills, and attitudes necessary to continuously improve the
quality and safety of the health care systems in which they work” (Cronenwett et al.,
2007, p. 122). The QSEN has defined six competencies for the professional nurse. These
include: professional development, patient- centered care, teamwork and collaboration,
evidence- based practice, quality improvement, and safety and informatics. Within each
competency “there are specific domains of knowledge that must be mastered, skills that
must be developed, and attitudes that must be cultivated if a nurse is to deliver high-
quality, safe, patient- centered care as a member of a health care team” (Hall, More, &
Barnsteiner, 2008, p. 417).
The evidence- based practice movement has significant impact for the doctoral
APNs. In the clinical expert role, it is imperative for the doctoral APN to promote
the use of evidence- based practice, not only in one’s own practice, but also as a cat-
alyst for change. The doctoral APN is expected to assume a leadership role within
his or her organization and, in this capacity, to spearhead the development of an
evidence- driven organization. This requires an in- depth understanding of the orga-
nizational components including infrastructure, processes, and behaviors, which
must be integrated into efforts to incorporate evidence into all aspects of clinical
practice. “Evidence- driven practice is no longer optional and is now a fundamen-
tal leadership requisite in all clinical settings” (Porter- O’Grady & Malloch, 2008,
p. 176). Recall that Essential IV: Translating and Integrating Scholarship Into Practice
requires that the doctoral prepared APN must possess informatics and technology
competencies as well as information management skills in order to effectively “lead
continuous improvement processes based on translational research skills” bring-
ing “evidence- based practice to both individual patients for whom they directly
care and to those patients for whom they are indirectly responsible” (AACN, 2010,
p. 16).