management, expert clinical practice, consultation, research, and administration. (ANCC, 2008) The gerontological nurse practitioner (GNP) practices in acute or long-term care settings and in collaborative practice with physicians who maintain large geriatric practices. GNPs make regular visits to nursing homes where patients in their collaborative practice reside. GNPs practice in rehabilitation facilities, working in outpatient clinics for rehabilitation patients after discharge or with specialty TABLE 1-1 Web Sites for Test Content Outlines http://www.nursecredentialing.org/NurseSpecialties/Gerontological.aspx 55805_CH01_0001_0025.qxd 2/19/09 1:01 PM Page 12 Scope and Standards of Practice 13 physicians, managing caseloads, and diagnosing and treating geriatric syndromes. The ANCC describes the role of the gerontological nurse practitioner as follows: The Gerontological Nurse Practitioner (GNP) is a registered nurse prepared in a graduate level gerontological nurse practitioner program to provide a full range of health care services on the wellness-illness health care continuum at an advanced level to older adults. The GNP practice includes independent and interdependent decision making, and is directly accountable for clinical judgments. The graduate level preparation expands the GNP’s role to include differential diagnosis and disease management, participation in and use of research, development and implementation of health policy, leadership, education, case management, and consultation. (ANCC, 2008, p. 1) SCOPE AND STANDARDS OF PRACTICE The scope of nursing practice is defined by state regulation, but is also influenced by the unique needs of the population being served in a given setting. The needs of older adults are complex and multifaceted, and the focus of nursing care depends on the setting in which the nurse practices. Gerontological nursing is practiced in accordance with standards developed by the profession of nursing. In 2001, the ANA Division of Gerontological Nursing Practice developed the second edition of the Scope and Standards of Gerontological Nursing BOX 1-1 Web Exploration Explore the following Web sites for further information on certification and gerontological associations of interest to nurses. Educational Web Sites Hartford Geriatric Nursing Initiative, About HGNI www.gerontologicalnursing.info Hartford Geriatric Nursing Initiative, ConsultGeriRN.org www.consultgeriRN.com American Nurses Association (ANA) www.nursingworld.org Associations U.S. Administration on Aging www.aoa.dhhs.gov American Geriatrics Society www.americangeriatrics.org American Nurses Credentialing Center (ANCC) www.nursecredentialing.org Gerontological Society of America www.geron.org Hospice and Palliative Nurses Association (HPNA) www.hpna.org John A. Hartford Foundation Institute for Geriatric Nursing www.hartfordign.org National Adult Day Services Association www.nadsa.org National Association of Geriatric Nursing Assistants (NAGNA) www.culturechangenow.com/ stories/nagna.html National Association of Professional Geriatric Care Managers www.caremanager.org National Council on the Aging www.ncoa.org/ National Gerontological Nursing Association www.ngna.org National Institute on Aging www.nia.nih.gov 55805_CH01_0001_0025.qxd 2/19/09 1:01 PM Page 13 14 Chapter 1: Introduction to Gerontological Nursing Practice, in collaboration with the National Gerontological Nursing Association, the National Association of Directors of Nursing Administrators in Long Term Care, and the National Conference of Gerontological Nurse Practitioners. Standards are provided both for clinical care and for the professional role of the nurse. These standards include assessment, diagnosis, outcome identification, planning, implementation, and evaluation. The standards of professional gerontological nursing performance include quality of care, performance appraisals, education, collegiality, ethics, collaboration, research, and research utilization. Students should note that these are the basic standards for professional nursing, but here they are applied to the care of the older adult. Core competencies, discussed in the