NSG5000 Role of the Advanced Practice Nurse
Week 1 Discussion
AP Role
How well do you know your future role in advance practice?
The elevator door opens; you step on and find yourself face to face with a known skeptical colleague, who inquires “what are you doing in your profession”? It’s your chance to share, define and possible persuade this person about your chosen role of nursing in advance practice. You have 10 floors, roughly 90 seconds to make an impression. Draft an “Elevator Speech” (approximately 300 words) reflecting the conversation about your future role in your program of study. In three detailed paragraphs, address why you have chosen this role (your passion) and define steps to ascertain the role including certification criteria and how the role will impact patient outcomes (how you will make a difference).
Support your work with evidence based research. For example, in conversation you tell the person A recent study by Taylor in 2016 showed that NPs were efficient as MDs at treating primary care problems. (Reference at the end) Respond to at least two of your cohorts, faculty and continue the dialogue with those that responded to your initial post. Use references in your responses.
NSG5000 Role of the Advanced Practice Nurse
Week 2 Discussion
Discussion Questions
Faculty will assign you either DQ 1 or DQ 2. Please answer all parts of the DQ.
Discussion Question Response: By, post your complete response to one of the discussion questions in the appropriate threads in the Discussion Area by due date assigned.
Participation Responses: No later than the due date assigned, review and comment on the discussion question responses posted by at least two of your peers and faculty. Continue to monitor your question and responses until the end of the week.
Guidelines: Support your responses with scholarly academic references using APA style format. Assigned course readings and online library resources are preferred. Weekly lecture notes are designed as overviews to the topic for the respective week and should not serve as a citation or reference.
In your discussion question response, provide a substantive response that illustrates a well-reasoned and thoughtful response; is factually correct with relevant scholarly citations, references, and examples that demonstrate a clear connection to the readings.
In your participation responses to your peers, comments must demonstrate thorough analysis of postings and extend meaningful discussion by building on previous postings.
Discussion Question 1
Answer the following:
Coaching and mentoring should be a core competency of nurses prepared at the graduate level. Do you agree or disagree with this statement? Defend your response.
Based on your graduate specialization, identify one coaching activity that you can do in this advanced practice role. What strategies would you employ for this activity?
Describe one mentoring activity you might complete with a mentor that would help you to acclimate to your new advance practice role. Should this activity be structured or unstructured?
Discussion Question 2
Consultation is a core competency of graduate nursing. Answer the following:
Differentiate consultation from supervision?
Are consultation and collaboration synonymous? Defend your response.
Give an example on how you have seen the consultation competency practiced in your current nursing area. Explain if the practice followed the graduate competency criteria.
NSG5000 Role of the Advanced Practice Nurse
Week 3 Discussion
Ethical Dilemma
Faculty will lead the discussion by posting first.
After reviewing The Invisible Patients documentary, define/describe in detail an ethical dilemma that was experienced by the NP. Please note, there are several ethical issues, so there should be diversity in the responses. Explain how you would have handled the situation.
How is the NP in the documentary a Disruptive Innovator?
Discuss if there is a relationship between your personal beliefs and values and this ethical dilemma/barrier.
Describe at least one mechanism to overcome the barrier discussed.
Examine the potential cost and benefits to this barrier.
Remember there is no right or wrong answer for this ethical question. Suggested reference Look at the Nuremburg Code (US Department of Health & Human Services, 2005; Washington, 2012) as it was the major start of ethics in research and that can carry over to nursing practice.
US Department of Health & Human Services. (2005). The Nuremberg code.
Retrieved from http://www.hhs.gov/ohrp/archive/nurcode.html
Note: Review South University’s Online Participation Policy, Helpful Tips, and Late Work Guidelines available by clicking on the South University Policy and Guidelines navigation tab under Course Home. The late policy applies to late discussion question responses.
NSG5000 Role of the Advanced Practice Nurse
Week 4 Discussion
Health Policy: Reimbursement of NPs
Faculty will assign students one DQ and lead the discussion. Please post your original post by Day 2, and respond by Day 6 to at least 2 of your cohorts opposite question. Continue to respond to the cohorts and faculty in your original thread until the last day of the week. Follow the rubric criteria ( see below)
DQ 1 For this question, conduct an Internet search and produce at least one research article ( study design must be discussed) addressing one or more of the concepts noted.
How does APN practice demonstrate cost-effectiveness, reduction in errors and misuse or overuse of services?
DQ 2 For this question, conduct an Internet search ( including the online library as well as specialty organizations) and address the following questions relative to the Nurse Informaticists:
When would you consult with the nurse informaticists?
What role does the nurse informaticists play in primary care?
What qualifications and credentialing are held by nurse informaticists?
Suggested URLs to assist you in answering this DQ:
American Nursing Informatics Association, the NI Community of HIMSS , the Alliance for Nursing Informatics or the Nursing Informatics Special Interest Group of the American Medical Informatics Association.
NSG5000 Role of the Advanced Practice Nurse
Week 5 Discussion
Faculty will lead the discussion by posting initially.
Discussion Question Response: By the due date assigned, post your complete response to one of the discussion questions in the appropriate threads in the Discussion Area.
Participation Responses: No later than the end of the week, review and comment on the discussion question responses posted by at least two of your peers and your faculty.
Guidelines: Support your responses with scholarly academic references using APA style format. Assigned course readings and online library resources are preferred. Weekly lecture notes are designed as overviews to the topic for the respective week and should not serve as a citation or reference.
In your discussion question response, provide a substantive response that illustrates a well-reasoned and thoughtful response; is factually correct with relevant scholarly citations, references, and examples that demonstrate a clear connection to the readings.
In your participation responses to your peers, comments must demonstrate thorough analysis of postings and extend meaningful discussion by building on previous postings
Discussion Question
Considering your role specialization (nurse educator, nurse informatics, nurse administrator, and family or adult-gerontology NP), identify the top three current trends or issues that you believe to be most important with regard to your chosen role and the impact the role has one patient outcomes. Synthesize knowledge from values theory, ethics and legal regulatory statutes, and develop your personal philosophy for a career as an advanced practice nurse in DQ1.Incorporate the content of Week 5 ( audio-visuals) .
NSG5000 Role of the Advanced Practice Nurse
Week 1 Project
Instructions
Based on your selected MSN program, write your first section of your ROLE paper using the following criteria:
For this assignment, you will research an advanced nursing practice role and summarize your findings in a 3- to 5-page paper (excluding the title page and references):
Focusing on the specialty for which you were admitted to South University, select an advanced nursing role to research. (It must be one offered by South University.)
Distinguish the role as clinical or non-clinical and how it promotes patient outcomes, ie safety, access to health care or health information relative to the ANP level
Apply an Advance Nursing Practice Concept to your chosen role
Develop a minimum of ten questions that you would like to ask the advance practice clinician or non-clinician that you have chosen to interview. Identify in the paper the individual by name, credentials, position and your planned date for the interview (Interview is due Week 3)
Support your findings with at least two research articles (study, design, sample and results must be discussed). Other peer reviewed articles that are non-research and nursing organization websites may be used. All articles must be current (not more than five years old, unless it is a hallmark reference; ieAmerican Association of College of Nursing. (2010)).
Format your paper, citations, and references using correct APA Style.
NSG5000 Role of the Advanced Practice Nurse
Week 2 Project
Group Project
This week you will be assigned to a group and be given a domain to develop/discuss applying all or some of the 7 core competencies. Group members need to assume AP roles (clinical and non-clinical) either by volunteering or being assigned by the group leader. A group leader must be decided and may be a nurse manager/nurse administrator, CNS, NP (maybe more than one and from different specialties), NI, and NE.CNLs and RNs may be also be part of the group scenario. All members are expected to demonstrate leadership knowledge and skills, but also must be willing to follow.Each group will demonstrate the core competencies and principals of transformational leadership in the group work. (See rubric).To ensure understanding of leadership styles, each group member will discover their own professional leadership style by an individual self-assessment online.Assignments and responsibilities should be equally assumed by group members. The final evidence of the group work will be power point presentation that discusses the scenario addressing the assigned domain, the roles and the outcomes. Please note that although a group project, individual grading rubric will be used to determine individual grades.(See below).
The master’s prepared nurse demonstrates leadership in the four domains: the profession of nursing, clinical practice arena, health policy arena, and systems level. The impact could be found in health promotion, disease prevention/management, quality improvement and/or within management of a health system. In order to complete this assignment, each group member will complete anassessmentabout your leadership style and post to the group area their leadership style.
These are:
Cherry, K. (2016). What’s Your Leadership Style? Learn more about your strengths and weaknesses as a leader.
How to Become a Better Leader
In conclusive remarks, search and agree upon a quotation from a library article related to leadership in an advanced nursing role and include with how it applied to your clinical decision/management issue of your assigned domain. Leadership journals from SOU Library areThe Journal of Nursing Scholarship or Nursing Leadership Forum or the American Journal of Nursing, Journal of Nursing Administration, Nursing Administration Quarterly, Nursing Management or Health Care Management Review
Group Topics:
Domains: Health Promotion, disease prevention, quality improvement and health systems
Health Promotion: Healthy People 2020 have identified Metabolic Syndrome as a major health concern. Sara, lives and works as an A/GNP in rural America. Several local faith organizations have asked if she can organize a Health Fair that will address health promotion, specifically DM. What AP roles, core competencies and support are needed to make this happen?
Disease Prevention: Obesity in school age children is a significant problem. Melissa, a former elementary school teacher, is a new CNL who has recently joined her state nursing associationand is passionate about the 30% or more of the students being over-weight. The local nursing association is looking for a community project to address disease prevention. Melissa has approached the officers with her concern. What AP roles, core competencies and support are needed to make this happen?
Quality Improvement:Nancy, FNP, is the clinical director of a nurse managed health center that is connected to a School of Nursing. The center’s staff members includes of all advance practice nurse providers, a nurse educator, a nursing informaticists, 2 RNs, and paraprofessional staff. The team wants to determine patient satisfaction and capture data on patient experiences both for QI and as a learning experience for students studying nursing. What AP roles, core competencies and support are needed to make this happen?
Health Systems: Daniel, a DNP prepared ED NP identified that patients seen in the ED for various reasons had undiagnosed HTN. He observed that the patient’s chief compliant was well addressed but the HTN was not. He has approached the hospital system about the problem and suggested an outpatient clinic adjacent to the ED to address the HTN and other coincidentally found problems. What AP roles, core competencies and support are needed to make this happen
NSG5000 Role of the Advanced Practice Nurse
Week 3 Project
Professional Practice Paper
Based on the AP role of the person that you interviewed in W1 Project, in a 3- to 5-page paper (excluding the title page, references, and appendices) describe the role, the type of organization, and address all the interview questions, and include:
List the type of organization. For example: Primary care office, ED, Specialty, cardiology GI etc.
List the type of and how many clients it serves. FP would see all ages. Research in your area the number of visits in a local office per year or # of visits seen local ED, specialty office etc.
the professional fit for advanced nursing role. “Fit” refers to the Qualifications in order to be an AP provider at that agency/organization. What license, credentialing (accrediting agency, and other expectations NPI, CMS)?
Include a brief job description
Discuss board of nursing NPA or scope of practice of the state. Include what the NPA in the state allows and restrictions.
Submission Details:
Submit your document to the Submissions Area by the due date assigned.
NSG5000 Role of the Advanced Practice Nurse
Week 4 Project
Health Policy Group Project
Work with your assigned group and assigned question. Identify the historical perspective, current issues/ problems (include regulations), and what is currently being done to change or improve. Students will be graded as a group.
Please demonstrate engagement within group work.
Review the literature and address one of the following:
FNP/AGNP:Your group has been asked to present a poster on Practice Authority. Develop a power point poster template ofall statesauthority to practice for APRNS.Three categories must be address, unrestricted, limited or strict restrictions. Develop a comprehensive list and specificsof each state regulation. Please address questions below and conclude with the group’s position on thediversity in regulation and what should be done to change it. Medicare reimbursement for NPs is 85% for the same health care that MDs receive at 100% reimbursement? Please address questions below and state your position on this mandate.
Nurse Executive: Your group has been asked to present a disposition “white” paper on Value Based Care. What is value based care and how will it impact decisions made at the executive level relative to patient outcomes, reimbursement, nursing care and AP nursing? Please address and state the group’s position on the regulation.
Nurse Informaticists:Your group has been assigned to determine the impact the role of the NI has on patient outcomes. Select a topic from Ch 24 ( Hamric). What law(s) was enacted to regulate health information? Please address questions below and the position on this regulation in a narrative format.
Nurse Educator:Your group has been assigned to explore the competencies of a nurse educator. Your group will debate the preparation of DNPs versus PhD as nurse educators, stating the pros and cons of each preparation and include what agencies regulate nurse education. You will develop a comparison and contrast table and a narrative to explain.
For the above assignment, use the following guide:
Describe the current policy/status, which organization regulates and determine if it needs to change; if opposed to change, state why.
Provide the process required to make the change with key players and parties of interest; identify the groups who are opposed
Explain how AP roles (which ones) could lead the effort to make or influence the change in policy or keep the policy the same and the impact in healthcare quality.
Demonstrate group cohesiveness
NSG5000 Role of the Advanced Practice Nurse
Week 5 Project
Instructions
Overview/Description of Final Paper: The final written assignment will synthesize what you have discovered about the different advanced practice roles and scope of practice found in the master of nursing curriculum: APRNs, nurse educator, nurse informaticist, and nurse administrator/executive. You will review all roles and then examine the specialty for which you were admitted, focusing on the scope of practice, core competencies, certification requirements, and legal aspects of practice for that specific role. You will also identify the practice environment and population you will be working with, as well as peers and colleagues. In addition, you will discuss your future leadership role and participation in professional organizations.
Your paper is to be based on current literature, standards of practice, core competencies, and certification bodies for your chosen role. The paper should be 8-10 pages excluding the title and reference pages, and APA format is required.
Criteria:
Advanced Practice Roles in Nursing:
Briefly define advance nursing practice and the roles in advanced practice nursing pertaining to clinical practice, primary care, education, administration, and health information. Distinguish between ANP and the APN.
Describe the advance nursing practice role you aspire and briefly share the experiences and/or qualities you have that have influenced your decision. Include your personal philosophy.
Selected Advanced Practice Role:
Identify the AP you interviewed and summarize the interview, which should/may include (if not in the interview, please address):
Examine regulatory and legal requirements for the state in which you plan to practice/work.
Describe the professional organizations available for membership based on your selected role.
Identify required competencies (domains), including certification requirements for your selected role.
Describe the organization and setting, population, and colleagues with whom you plan to work.
Leadership Attributes of the Advanced Practice Role:
Determine your leadership style
Define Transformational Leadership and as it relates to your identified leadership attributes that you possess or need to develop
Apply the leadership style you will embrace in AP to one of the domains
Health Policy and the Advanced Practice Role
Based on your program of study, review the literature and address the following:
FNP/AGNP:Medicare reimbursement for NPs is 85%for the same health care that MDs receive at 100% reimbursement? Please address questions below and state your position on this mandate.
FNP/AGNP:What states have NP Full Practice Authority and which states have limitations or restrictions? How does this apply to your state? Please address questions below and state your position on this regulation.
Nurse Executive: What is value based care and how will it impact decisions made at the executive level relative to nursing and AP nursing? Please address and state your position on the regulation.
Nurse Informaticists:What law(s) was enacted to regulate health information? Please address questions below and state your position on this regulation.
Nurse Educator:What agency regulates nursing education? Explain in detail.
For the above category chosen, address the following:
Describe the current policy or trends and determine if it needs to change; if opposed to change state why
Provide the process required to make the change with key players and parties of interest; support opposition
Explain how you could lead the effort to make or influence the change in policy or keep the policy the same and the impact in healthcare quality.
Conclusion-Summarize your role paper by highlighting key points made in your paper.
NSG5000 Role of the Advanced Practice Nurse
Week 2 Knowledge Check
Question 1
Sallie, is an experienced Nurse Practitioner, who practices autonomously in a rural clinic. She regularly precepts students and guest lectures to several graduate NP programs, writes weekly newspaper columns on prevention and health promotion and works closely with her legislature on health care policies and bills that would ensure access to care and promote patient outcomes. Sallie’s work is best described by which of the Advance Practice Nurse competencies?
Question 1 options:
Collaboration
Consultation
Leadership
Coaching
Next Page
Question 2
The nurse in an advance practice role recognizes which statement represents a major benefit to a medical team when team members effectively collaborate and communicate?
Question 2 options:
When collaborating well, team members will be better informed with shared information, they will be better able to treat patients, and public perception of positive collaboration will help with building community trust.
Team members will experience less stress, which will create a more peaceful work environment.
The provider will reduce costs by being able to have fewer staff training sessions.
With time-saving through collaboration, shift demands on nursing could decrease.
Question 3
The nurse in advance practice understands which changes in American health care have contributed to a movement toward wellness, rather than illness management?
Question 3 options:
The provision of “boutique” health services, such as yoga and other non-traditional practices, has been a major influence on wellness promotion
Reduction in costs of health services (largely influenced by the Affordable Care Act) and a cultural value shift toward health maintenance contributed to the increased attention on wellness rather than illness.
A major decrease in pain medication treatment and overall high costs of health care have caused many Americans to turn to wellness practices, like daily exercise routines
Most employers now offer wellness programs for employees and often even provide financial benefits if employees use them regularly
Question 4
The advance practice nurse suspects that her patient is a victim of domestic violence but the patient denies. The two options wage the decision to confront with the decision to preserve the patient-provider relationship. This is considered:
Question 4 options:
Moral Distress
Moral Uncertainty
Moral Dilemma
Moral Distraction
Question 5
After a few nurses have raised operational concerns about your inpatient clinic’s medication management and administration processes, as the nurse manager, the nurse executive asks you to provide recommendations on improving the system. Which of the following reflects transformational leadership in the most suitable best practices?
Question 5 options:
Remember to ask the patient to double-check the names and dosages of medication before taking. A checklist can be posted in each patient’s room
Offer to complete a thorough audit of errors and provide one-on-one training to employees with the most errors in recording patient data.
The department is polled on ways to reduce medication errors and unanimously the nurses suggest moving all medical data to an electronic system and using bar-coding on medications. They develop evaluative standards to ensure continuously prioritization of patient safety.
An external review team s assigned to perform a needs assessment on recent medical errors and provide a report. They can be asked to return on an annual basis to evaluate compliance to their guidelines.
NSG5000 Role of the Advanced Practice Nurse
Week 3 Knowledge Check
Question 1 (1 point)
A Nurse Practitioner has an upcoming interview with a hospital. What is the most essential step for him or her to take to prepare?
Question 1 options:
The NP should review readings from previous courses and examine updated publications from professional organizations.
The NP should reach out to current employees of the hospital in her network to request tips for succeeding during the interview.
The NP should make sure to locate appropriate dress and proof of identification to bring to the interview
The NP should gather information about the hospital’s services and patient population to assess whether they are a good fit or not and demonstrate basic organizational knowledge.
Question 1 (1 point)
A Nurse Practitioner has an upcoming interview with a hospital. What is the most essential step for him or her to take to prepare?
Question 1 options:
The NP should review readings from previous courses and examine updated publications from professional organizations.
The NP should reach out to current employees of the hospital in her network to request tips for succeeding during the interview.
The NP should make sure to locate appropriate dress and proof of identification to bring to the interview
The NP should gather information about the hospital’s services and patient population to assess whether they are a good fit or not and demonstrate basic organizational knowledge.
Question 3
Which instance represents appropriate patient-centered consultation between a Nurse Practitioner and a physician from another practice?
Question 3 options:
The NP might seek a second opinion to confirm a diagnosis or proper treatment, especially if he or she has limited experience with the presented health issue.
The NP may need assistance in writing prescriptions for certain narcotic drugs, depending on current compliance regulations.
The NP might be seeking access to additional clinical studies not available in his or her practice
The NP might consult with the physician in order to network for future job prospects.
Question 4
The nurse practitioner has been assigned as a team leader on a project with physicians, physical therapists, and psychologist. Which of the following scenarios illustrates barriers to effective collaboration with a role-diverse medical team?
Question 4 options:
The Nurse Practitioner has difficulty contacting certain key members of the team and is concerned that he or she may be “stepping on toes” due to blurring of responsibilities.
Nurse Practitioners tend to have difficulty achieving a leadership role in a role-diverse team.
The Nurse Practitioner cannot find time to prioritize collaboration with team members in other departments
A role-diverse team may have difficulties in speaking a common medical language to discuss goals.
Question 5
What is one major reason that registered nurses face stressors in the transition to the role of Nurse Practitioner?
Question 5 options:
The NP may want to work in a more private work environment than the public health sector
The NP may be confused about the roles’ distinctions, with the added stress of new curriculum and peers.
The NP may be confused about who his or her supervisor is in this transition.
The NP may dislike his or her new location of work and look for a clinic that is comparable to his or her former place of work.
NSG5000 Role of the Advanced Practice Nurse
Week 4 Knowledge Check
Question 1
How can a nurse executive/nurse administrator (NE/NA) help his or her team become more motivated, collaborative, and focused on common goals?
Question 1 options:
The NE/NA should give the team space and time to create group cohesion on their own.
The NE/NA should assign training with an emphasis on personal reflection and goal-setting.
The NE/NA should have a private discussion with each team member to ensure they enjoy the company of their fellow staff.
The NE/NA should provide a vision for his or her team to serve as a guide.
Question 2
Which of the following scenarios depicts an advance nurse practicing with ethical integrity?
Question 2 options:
The APRN provides an additional round of antibiotics to a patient who requests the second treatment after running into the him/her in a public place
The APRN convinces a patient to verbally consent to a mental health assessment after initially refusing.
The APRN utilizes the prescription monitoring program to validate the patient’s request for narcotic medication for pain and refuses to provide the prescription because the patient had received the same medication 2 days before from another provider
The APRN trusts her request for a benzodiazepine-class drug to relieve anxiety from a good friend and provides a prescriptions.
Question 3
How is a Clinical Nurse Leader (CNL) different from a Clinical Nurse Specialist (CNS)?
Question 3 options:
The CNL is often not considered an advanced practice role like the CNS, though many practitioners disagree due to its master’s degree requirement.
The CNL is often in a supervisory role and frequently supervises the CNS role, especially in larger clinics and hospitals.
The CNS has significantly less patient face-to-face time than the CNL role and is oftentimes in charge of hospital administration.
The CNS role requires a doctorate and certification from state of residence.
Question 4
Which of the following scenarios depicts a practitioner practicing objective ethical decision-making as opposed to decision-making based on religious or moral convictions?
Question 4 options:
A spouse pressures the hospital to continue aggressive treatment to avoid feeling responsible for the patient’s death.
A practitioner follows a patient’s advance directive which includes a do-not-resuscitate order.
A practitioner avoids providing legal assisted suicide options to a terminally ill patient due to his or her discomfort with the process
A practitioner refuses to prescribe oral contraceptives to unmarried female patients to protect his or her reputation in the community.
Question 5
The nurse in advance practice understands which statement best represents the importance of health informatics in patient safety?
Question 5 options:
Having access to accurate patient data can help medical professionals prevent errors.
Patient data can assist in data collection for research studies on medical errors
Health informatics specialists focus on the accuracy or inaccuracy of reporting of patient safety data to improve safety regulations.
Medical staff feel more accountable when having to share information about medical errors.
NSG5000 Role of the Advanced Practice Nurse
Week 5 Knowledge Check
Question 1
Which APN role was purposely created to be broad in scope but in recent years that broadness has caused challenges understanding exactly what they can do?
Question 1 options:
CNS
CNM
CRNA
NP
Question 2
What best demonstrates the advanced practice registered nurse professional leadership?
Question 2 options:
adding clinical protocols to the advanced practice nurse’s scope of practice.
comparing the workplace roles of the registered nurse and the advanced practice nurse.
creating a task force to address scope of practice concerns.
lobbying to eliminate continuing education requirements.
Question 4
The scope of practice of an Adult/Gerontological PC NP allows evaluation of what age group of pat