NR510 Week 1 Discussion 1 & 2 Latest 2018 January
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Week 1: Barriers to Practice Discussion
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Read the assigned Hain & Fleck article, and discuss the following:
- What are the barriers to APN practice identified in the article? Describe these barriers in your own words.
- What are your impression of the barriers to APN Practice? (Are you surprised by these barriers? Is this new information to you? Have you ever been involved at the legislative level in nursing? Do these barriers concern you or motivate you toward becoming an APN?)
- Do these barriers represent Restraint of Trade? Why, or why not?
- Your thoughts on how nurses can influence these barriers.
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Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion
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Jessica, a baccalaureate prepared registered nurse, has been practicing for 8 years. Throughout her nursing career, she has worked in pediatric, surgical, and emergency departments. She worked as a floor nurse, a charge nurse, and she was recently offered a position in Nursing Administration. A stipulation for becoming a nurse administrator is that Jessica must attain a Master of Science in Nursing degree within 2 years of accepting the position. The offer prompted Jessica to contemplate her career. She is interested in returning to college, and wants to have greater impact on patient care but isn't sure she will find that in an Administrative role, nor is she sure is ready for the responsibility of becoming a Nurse Practitioner. Jessica has decided to explore the advance practice roles available in nursing in order to determine the best MSN track for her. Jessica must choose one role (CNP, CRNA, CNS, CNM) and apply to a program, but she is unsure about the different roles and their individual scopes of practice. One colleague states, "You know, Jessica, working as an NP is great because you can diagnose and write prescriptions, and the accountability will fall on the physician you are working with."
Discussion questions:
- Is Jessica's colleague right? Why or why not?
- Explore the four APN roles, and compare and contrast the pros and cons of each role against each other in order to determine the best choice for Jessica. Consider issues such as work environment, level of accountability, patient population, salary, and scope of practice. Include each role of the APN on the list, and be certain to provide appropriate rationales and citations.
NR510 Week 2 Discussion 1 & 2 Latest 2018 January
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Week 2: Theory and the APN Role Discussion
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Karen, a registered nurse, decided that she wants to become a CNP. She applied and was accepted to the Family Nurse Practitioner program at Chamberlain College of Nursing. She received a course curriculum that outlined the courses necessary to complete her degree. One of the early courses in the program curriculum is NR501 Theoretical Basis for Advanced Nursing Practice.
You are a student colleague of Karen's enrolled in the same class. On the course Q & A Forum, Karen posted, "Nursing theory is outdated and is too broad and isn't useful for Advance Practice Nurses."
Discussion Question:
Is Karen right? Is theory important to APN practice? Why, or why not?
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Week 2: Theory and APN Role Discussion Part Two
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Karen is still not convinced that Theory has any place in APN practice. Provide a specific example of how theory is relevant to APN practice in one of the four specialties (CNM, CNP, CRNA or CNS). Provide evidence to support your arguments.
NR510 Week 3 Discussion 1 & 2 Latest 2018 January
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Week 3: Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study- Part One
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You are a family nurse practitioner (FNP) employed as a contract (1099 independent contractor) in a busy primary care practice for 2 years. The providers in the group include one physician, who is also the owner of the practice, and two other nurse practitioners, who are staff employees (W2 employees). The owner of the practice recently made comments about the need to produce more revenue. You relate with his concerns and feel that you have several strategies that could be helpful. Your contract is up for renewal in 3 months. You are highly satisfied with your job and want to stay with the group. You see 20 patients per day on average and take call every third weekend.
Discussion Question:
What negotiation strategies should you use to propose a contract renewal? How does your role as a 1099 contractor benefit the practice over the W2 employees? What evidence will you present to the practice to reinforce your value in the practice both in terms of revenue and patient satisfaction? Consider any additional services you may be willing to provide under your contract. Use logical reasoning, and provide evidence based rationales for your decisions.Keep in mind that your negotiation terms and conditions must be within the legal scope of practice for an ANP.
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Week 3: Organizational Behavior and Business Influences and Advanced Practice Nursing Case Study Part Two
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As revenue generators, NPs must be aware of how their work contributes to the overall revenue of the clinical practice. You see 20 patients per day on average and take call every third weekend. According to Buppert (2011), an NP who sees 15 patients per day at $56 per patient visit, on average, brings in $840 per day. Allowing 1 week off for continuing education, 1 week off for illness, and 4 weeks off for vacation, this NP will bring in $193,200 a year, potentially. However, not all bills are paid. With a 90% collection rate—a reasonable collection rate for an efficient practice—this NP actually will bring in $173,880 per year. An NP who sees 24 patients per day will bring in $1344 per day, or $309,120 per year in accounts receivable. With a 90% collection rate, this NP will bring $278,208 to the practice (Buppert, 2011).
Establishing a salary can be a challenge for NPs. Deducting 40% of the NP's gross generated income for overhead expenses (rent, benefits, continuing education, supplies, malpractice, lab expenses, and depreciation of equipment) leaves $104,280 for the 15-patient-per-day NP and $166,925 for the 24-patient-per-day NP. Further deducting 15% of that figure to pay a physician for consultation services leaves $88,638 in salary for the 15-patient-per-day NP and $141,887 in salary for the 24-patient-per-day NP. Deducting 10% for employer profit leaves $79,775 in salary for the 15-patient-per-day NP and $127,699 for the 24-patient-per-day NP (Buppert, 2011).
What salary would you propose for the contract renewal? How does your salary proposal fit in with the community standard for an NP in a similar practice? Use logical reasoning, and provide evidence based rationales for your decisions. Keep in mind that your negotiation terms and conditions must be within the legal scope of practice for an ANP.
NR510 Week 4 Discussion 1 & 2 Latest 2018 January
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Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part One
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You are a family nurse practitioner employed in a busy primary care office. The providers in the group include one physician and three nurse practitioners. The back office staff includes eight medical assistants who assist with patient care as well as filing, answering calls from patients, processing laboratory results and taking prescription renewal requests from patients and pharmacies. Stephanie, a medical assistant, has worked in the practice for 10 years and is very proficient at her job. She knows almost every patient in the practice, and has an excellent rapport with all of the providers.
Mrs. Smith was seen today in the office for an annual physical. Her last appointment was a year ago for the same reason. During this visit, Mrs. Smith brought an empty bottle of amoxicillin with her and asked if she could have a refill. You noted the patient's name on the label, and the date on the bottle was 1 week ago. You also noted your name printed on the label as the prescriber. The patient admitted that she called last week concerned about her cough and spoke to Stephanie. You do not recall having discussed this patient with Stephanie nor do the other providers in the practice.
Discussion Question:
What is your next logically sound course of action? Provide evidence to support your response.
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Week 4: Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study Part Two
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Upon further investigation, you learn that Stephanie spoke with the patient and called the medication into the patient's pharmacy without consulting with a provider. Stephanie claimed that the patient was insistent about needing a prescription. Because Mrs. Smith was coming into the office the following week for an appointment, she didn't think you would mind if the patient received the prescription early.
Discussion Question:
What are the ethical-legal concerns associated with this situation? What is your liability in this situation, if any? What is the practice's liability in this situation? What quality improvement strategies might you implement as an APN in this practice to safeguard your role and assure patient safety? Provide evidence to support your response.
NR510 Week 5 Discussion 1 & 2 Latest 2018 January
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Week 5: Conflict at the Office Discussion
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You are a family nurse practitioner working in an outpatient primary care office of a large hospital system. The practice has been operating for over 15 years, and many of the administrative and clinical staff were hired when the practice opened. You have been in the practice for less than 3 months. In that short amount of time, you have witnessed several of the clinical staff engaging in heated arguments with each other, sometimes in patient areas. You overhear an argument occurring today between two staff. You pick up a patient's chart and notice a very low blood pressure that the medical assistant failed to notify you about. When you confront the MA, she states that she was going to report the vital signs to you when she became engaged in the heated argument you overheard and forgot to notify you.
Unfortunately, this pattern of behavior is not unusual in this practice. Working with staff who cannot cooperate effectively can negatively influence your ability to spend time with patients, can impede the flow of patients through the office, and could impact patient safety.
Discussion Question:
What is your response to the medical assistant? What actions do you take to redirect the flow away from arguments and back to patient care?
Provide rationales and evidence to support your decisions.
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Week 5: Conflict Resolution Strategies Discussion
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Leadership is not random. It is multifaceted and must be communicated as a stated plan to effect a change. Organizational leaders provide a vision and move others toward a common goal. This vision also reinforces the importance of teamwork in the workplace.
According to Buppert (2015), quality improvement and patient safety are inextricably intertwined. A work environment that supports teamwork and respect for other people is essential to promote patient safety and quality of care. Unprofessional behavior is disruptive and adversely impacts patient and staff satisfaction, the recruitment and retention of healthcare professionals, communication, teamwork and undermines a culture of safety. Unprofessional behavior is therefore unacceptable.
Discussion Question:
In this scenario, what evidence-based organizational strategies and management skills might you employ to resolve co-worker conflict? Reflect on conflict resolution strategies specifically for healthcare. How does teamwork increase patient safety? Provide evidence and rationales to support your decisions. Provide evidence and rationale to support your decisions.
NR510 Week 8 Reflection on Achievement of Outcomes Latest 2018 January
Week 8: Reflection on Achievement of Outcomes
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Reflect back over the past eight weeks and describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #4, the MSN Essential II, and the NP Core Competencies #2.
Program Outcome #4
Integrate professional values through scholarship and service in health care. (Professional identity)
MSN Essential II: Organizational and Systems Leadership
Recognizes that organizational and systems leadership are critical to the promotion of high quality and safe patient care. Leadership skills are needed that emphasize ethical and critical decision making, effective working relationships, and a systems perspective.
NP Core Competencies
# 2 Leadership Competencies
1. Assumes complex and advanced leadership roles to initiate and guide change.
2. Provides leadership to foster collaboration with multiple stakeholders (e.g. patients, community, integrated health care teams, and policy makers) to improve health care.
3. Demonstrates leadership that uses critical and reflective thinking.
4. Advocates for improved access, quality and cost effective health care.
5. Advances practice through the development and implementation of innovations incorporating principles of change.
6. Communicates practice knowledge effectively both orally and in writing.
7. Participates in professional organizations and activities that influence advanced practice nursing and/or health outcomes of a population focus.
NR510 Week 6 APN Professional Development Plan Paper Latest 2018 January
APN Professional Development Plan
Guidelineswith Scoring Rubric
Purpose
The purpose of this assignment is to provide the student an opportunity to explore the role of the advanced practice nurse (APN) and develop an APNprofessional development plan.
Course Outcomes
Through this assignment, the student will demonstrate the ability to:
CO1:Analyze the historic development of advanced practice roles including the impact of advanced practice nursing on healthcare delivery from the perspective of selected current reports (i.e., LACE, IOM, etc.) (PO 3)
CO3: Explore how leadership styles influence healthcare delivery and organizations. (PO 4)
CO5: Reflect on personal and professional growth toward achieving competence as a family nurse practitioner. (PO 3)
REQUIREMENTS:
1. To complete this application, you will need to access to the following databases: CINAHL, MEDLINE, Cochrane Library, and the Joanna Briggs Institute. You may access these databases through the Chamberlain College of Nursing Online Library.
2. The APN Professional Development Plan paper is worth 200 points and will be graded on quality of information, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric.
3. Create your manuscript using Microsoft Word 2007 (a part of Microsoft Office 2007), which is the required format for all Chamberlain College of Nursing documents. You can tell that the document is saved as a MS Word 2007 document because it will end in “.docx”
4. Follow the directions and grading criteria closely. Any questions about this paper may be posted under the Q & A Forum.
5. The length of the paper is to be no less than 6 and no greater than 8 pages excluding title page and reference pages. Content exceeding 8 pages will not be graded.
6. APA (2010) format is required with both a title page and reference page. Use the required components of the review as Level 1 headers (upper and lower case, centered):
a. Introduction to the APN professional development plan- Discuss the goals and purpose of an APN professional development plan
b. APN Scope of Practice
c. Personal Assessment
d. Networking and Marketing Strategies
e. Conclusion
PREPARING THE PAPER
The following are best practices for preparing this paper:
1. Review Chapter 30- Role Transition: Strategies for Success in the Marketplace in
DeNisco and Barker (2015).
2. Nurse practitioners need to take into account the state rules and regulations that guide advanced practice. Research and review the Nurse Practice Act and APN scope of practice guidelines in your particular state.Identify information regarding educational requirements, licensure and regulatory requirements, as well as practice environment details. Review information regarding full, limited, or restricted practice limitations as well as prescriptive authority.
3. Review Guidelines for APN Role Transition Using Benner’s Self-Assessment Tool inCourse Resources. Identify and discuss your position on Benner’s Novice to Expert ladder. Prior to engaging in pursuit for employment, APNs should complete a comprehensive, honest, affirmative personal assessment to identify their strengths and weaknesses as well as their goals and objectives. Research assessment tools, conduct a personal assessment, and reflect upon your strengths, weaknesses, goals, and objectives.
4. To complete the transition from students to expert nurse practitioners working in the healthcare field, graduating APN students will need to secure their first position. Research local and national professional organizations that advertise employment opportunities for APNs. Identify networking and marketing strategies and provide a rationale for your selections. Be specific.
5. Write your Curriculum Vitae (CV). Refer to the template on pages 772-773 in DeNisco and Barker (2015). Your CV should not exceed 2 pages in length.
6. When concluding the paper, summarize important aspects of the APN professional development plan.
NR510 Week 7 Recorded LACE Presentation Latest 2018 January
RECORDED LACE PRESENTATION GUIDELINES
PURPOSE
The purpose of this assignment is for learners to:
- Develop professional presentation/communication skills.
- Demonstrate an advancing understanding of the political landscape of APNpractice.
- Demonstrate the ability to analyze the literature and be able to disseminate the informationorally.
- Demonstrate and practice professional communication and leadership, while advancing the education of peers.
Course Outcomes
1.Analyze the development of advanced practice nursing roles from a historical perspective including the impact of advanced practice nursing on the healthcare delivery system from the perspective of selected current reports (i.e. LACE, IOM, etc.)
2.Critically analyze how healthcare systems and APN practice are organized and influenced by ethical, legal, economic and political factors.
Requirements
For Week 7, there is no case study given to you by the faculty. Instead you will be creating a recorded presentation that demonstrates your understanding of LACE principles and their influence on APN practice. This presentation will be uploaded into the course via Kaltura (please see course resources for directions).
Address the following Topics/Questions:
• How do licensure, accreditation, certification, and education (LACE) considerations differ for APN clinical roles for these three states: California, Washington, and Illinois? Provide evidence for your response.
• Discuss what evidence-based strategies should be implemented to achieve continuity between state regulatory boards?Provide evidence for your response.
• Is independent NP practice allowed in your state? Discuss your opinion regarding independent NP practice. Provide evidence for your response.
PresentationGuidelines:
• The presentation should include a PowerPoint presentation which will be recorded via Kaltura.
• Students should create the PowerPoint presentation offline and then open it for use during the recording.
• Students may record the presentation more than once to allow for practice and mastery of the content and presentation style. Final presentation should be submitted only.
• Students should review their presentation for clarity in audio and sound as well as clarity in the information presented. Students should be professionally dressed in business casual attire for the presentation with/without lab coat. Scrubs, sweats, denim, yoga pants, and athletic wear are not considered business casual. Student’s face should be visible via the webcam during presentation.
• Thepresentation should be no more than 15-20 minutes in recorded length.
• The presentation should contain appropriate scholarly evidence to support the information presented per APA format.
• PowerPoint slides should be used as cues to topics and key concepts without lengthy sentences and paragraphs- reading information from slides is not professional and therefore not acceptable.
• A professional presentation includes an introduction both of yourself and of the topic, the touch points of information you’re going to discuss as well as a conclusion. A professional presentation should be covered in approx. 5-15 slides.
• 12 pt font Times New Roman is the recommended font size/style. Slides should include bullet points you intend to cover, 4-5 bullet points per slide. The bullet points should be expanded upon with oral information. Direct quotes and paragraphs are discouraged.
• The student’s oral presentation should demonstrate clear understanding of all concepts along with specific examples to represent concepts.
Technology Requirements
The presentation should be recorded using PowerPoint (See course resources for information about using PowerPoint in the course). Presentation should be saved in .ppt format.
