NURS 6565: Synthesis in Advanced Practice Care of Complex Patients

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NURS 6565: Synthesis in Advanced Practice Care of Complex Patients in Primary Care Settings

NURS 6565 Week 1: The Emerging Role of Nurse Practitioners in Diverse Clinical Settings

NURS 6565 Entire Course Weekly Discussions And Assignments

In the 1940’s and 1950’s, Loretta Ford, known as the pioneer for nurse practitioners (NPs), was a public health nurse in rural Colorado. During that time period there was a shortage of physicians to care for children and families. In 1965, Loretta Ford and Dr. Henry K. Silver started the first pediatric nurse practitioner program at the University of Colorado Medical Center. Since this time, nurse practitioners have been in great demand to meet the health care needs of individuals, families and communities. The year 2015, marked the 50th year of NPs providing care to a variety of patients across the lifespan in primary, acute, and subspecialty care areas.

The role of nurse practitioners has evolved over the years. Nurse practitioners are prepared to prevent diseases, promote health, treat diseases, and support health maintenance. Nurse practitioners are well known and equipped to provide safe, quality, cost-effective, and accessible care.

This week you will focus on the emerging role of nurse practitioners and review the history and practices of nurse practitioners. Also, you will explore the emerging role of nurse practitioners in clinical settings, conduct a professional self-assessment, and you will develop goals for mastery of clinical skills.

Learning Objectives

By the end of this week, students will:

  • Create professional goals to support your transition from RN to NP practice to promote positive social change
  • Evaluate mastery of NP clinical skills
  • Evaluate professional strengths and weaknesses
  • Analyze practices of advanced practice nurses

NURS 6565: Synthesis in Advanced Practice Care of Complex Patients

Developing professional goals is critical to guiding your career and transitioning to become a practicing NP. The goals that you develop should be SMART. SMART goals are: Specific, Measurable, Attainable, Relevant, and Time-specific (Massachusetts Institute of Technology Human Resources, n.d.). Keeping your goals SMART will increase your chances of meeting or exceeding your professional career goals.

For this Assignment, you will identify three short-term and three long-term goals. You also will explain how each goal relates to your professional career development and how you might achieve each of these goals.

Massachusetts Institute of Technology Human Resources (n.d.). SMART goals. Retrieved from http://hrweb.mit.edu/performance-development/goal-setting-developmental-planning/smart-goals

To prepare:

  • Review the SMART Goals Learning Resources
  • Consider professional goals that you might select to help focus on your transition from RN to NP practice.

By Day 7

For this Assignment, write a paper that is no more than 2 pages long that addresses the following:

  • Identify at least three short-term goals (1-2 years)
  • Identify at least three long-term goals (3-5 years)
  • Explain why you selected each goal and how they relate to your professional career development
  • Create a strategic plan that explains how you might achieve each of these goals

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Assignment 2: Practicum Assignment 1: Self-Assessment of Clinical Skills

A self-assessment is an opportunity for you to review what you have learned in the program, evaluate your clinical skills, and develop goals before exiting the NP program. For this assignment, you will complete the Risk Control Self-Assessment Checklist for Nurse Practitioners and identify your areas of strength and weakness. You also will explain how you plan to improve on these weaknesses, as well as how you plan to master clinical skills you have not obtained prior to exiting NP program.

To prepare:

  • Complete the Risk Control Self-Assessment Checklist for Nurse Practitioners
  • Review preceptor and faculty evaluations in Meditrek for all completed clinical courses
  • Consider your strengths and weaknesses
  • Review types of patients treated and clinical procedures performed

By Day 7

Write a 2- to 3-page paper that addresses the following:

  • Identify at least three strengths
  • Explain why you consider these strengths and what you can do to maintain them in your practice
  • Identify at least three weaknesses
  • Explain how you plan to address each weakness
  • Examine at least three clinical skills you need to obtain prior to exiting the program
  • Explain how you plan to master the clinical skills before exiting NP program
  • Analyze the history of advanced practice nurses and the emerging role of your specialty area, and discuss what contributions you plan to make to advance the nursing profession

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NURS 6565 Week 2: Consequences of Ethical Issues in Advanced Nursing Practice

“Ethics is not definable, is not implementable, because it is not conscious; it involves not only our thinking, but also our feeling.”

— Valdemar W. Setzer
Brazilian anthropologist, Department of Computer Science, University of São Paulo, Brazil

Advanced Practice Nurses are constantly challenged with ethical issues and dilemmas in clinical practice. Indeed, ethics requires NPs to use their knowledge, wisdom, critical thinking, and decision making skills to do what is right for individuals, families, and communities. There is a process that is used to make ethical decisions. A primary question to ask in every patient encounter is, “Am I doing what is right and good for the patient?”

The NP Core Ethics Competencies include integrating ethical principles in decision making, evaluating the ethical consequences of decisions, and applying ethically sound solutions to complex issues related to individuals, populations and systems of care. This week you will examine the process of using ethical principles in decision making and meeting the NP Core Ethics Competencies.

Learning Objectives

By the end of this week, students will:

  • Analyze salient ethical issues in Advanced Nursing Practice
  • Compare ethical dilemmas with state health laws and regulations
  • Outline the process of ethical decision making

NURS 6565: Synthesis in Advanced Practice Care of Complex Patients

Assignment :Analyzing an Ethical Decision

In your role, as an advanced practice nurse, you will encounter several situations that will require your ability to make sound judgments and practice decisions for the safety and well-being of individuals, families, and communities. There may not be a clear cut answer of how to address the issue, but your ethical decision making must be based on evidenced based practice, and what is good, right, and beneficial for patients. You will encounter patients who do not hold your values, but you must remain professional and unbiased in the care you provide to all patients regardless of their sociodemographic and ethnic/racial background. You must be prepared to critically analyze ethical situations, and develop an appropriate plan of action. For this Assignment, you will review the literature and discover the various ethical dilemmas advanced practice nurses encounter and how these issues are typically addressed in your state.

To prepare:

  • Review literature for moral/ethical issues encountered by advanced practice nurses in clinical practice.
  • Select an article that was published within the last five years.

By Day 7

Write a two page paper that answers the following questions:

  • Summarize the moral/ethical issue in the article (no more than 1 paragraph)
  • Describe the moral and ethical dilemmas surrounding the issue
  • Analyze the ethical issue and compare them to the State Health Laws and Regulations in your state
  • Outline the process of ethical decision making you would use to address this ethical dilemma

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NURS 6565 Week 3: Ongoing Performance Evaluation

The quality of health care provided by NPs is under constant scrutiny. Many physicians are hesitant of NPs ability to provide quality and cost-effective care. It is critical for NPs to see themselves as full partners in health care. NPs are challenged to improve the quality and measurement of health care delivery and patient health outcomes. NPs must be recognized for the care that they provide. Thus NPs must constantly ask the question, how do we ensure measurement of the care that we provide?

Ongoing monitoring and continuous improvement is vital for all practicing NPs to ensure patients receive safe, competent, and quality health care (Hamric, Hanson, Tracy & Grady, 2014). It is imperative for advanced practice nurses to have strategies to measure, report, and reward excellence in health delivery. Advanced practice nurses are well situated to provide quality, cost effective, and patient-centered care (IOM, 2015). This week, as you examine quality measures, consider how standards of care are developed and implemented.

Learning Objectives

By the end of this week, students will:

  • Analyze importance of quality measures
  • Evaluate the use of incentive payment for care
  • Analyze external motivators for incentive payment for care
  • Apply comprehensive knowledge of nurse practitioner practice

NURS 6565: Synthesis in Advanced Practice Care of Complex Patients

As nurse practitioners continue to expand their role in delivering health care, it is imperative for NPs to provide the data and evidence to demonstrate the impact of NP care on patient outcomes. There are several challenges that advanced practice nurses face to provide quality care and meet productivity goals of an organization. This week it is important to explore the connection of quality care and performance measures. Some questions to consider as we discuss this topic are:

  • Why are quality measures important?
  • What is the difference between quality measures and performance indicators?
  • What performance measures are used for NP productivity?
  • Why are incentive plans used in clinical organizations?

To prepare:

  • Read the article, An Incentive Plan for Advanced Practice Registered Nurses: Impact on Provider and Organizational Outcomes, by Catherine A. Rhodes, Mavis Bechtle, and Molly McNett (2015)
  • Explore quality measures and identify at least one clinical performance measure, such as the Agency for Healthcare Research and Quality (AHRQ)

By Day 3

Post an explanation of the importance of quality measures using the clinical performance measure you identified as an example. Then, identify the performance measures used for NP productivity in Rhodes, Bechtle, and McNett (2015) article. Finally, share your opinion on incentive payment for care, including external motivators and at least one business model.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who shared a different perspective than you did. Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or contrasting perspectives.

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NURS 6565 Week 4: Legal Issues (Negligence/Malpractice/Risk Management)

Our current health care system is in a fluid state. Change is constant. As health care providers, we strive to deliver optimal, safe care. Ongoing health care research, evidenced-based care, and effective guidelines for practice offer a stabilizing force. Our duty, as health care providers, is to “do no harm.” As providers, Nurse Practitioners (NP) provide preventive, acute, and chronic care, which entails complex management. Understanding legal terminology is essential to the role. Terms such as standard of care, malpractice, and negligence are inevitable and essential components for understanding the legal challenges advanced practice nurses will experience during their careers.

Only 1% of patients actually sue for malpractice in the U.S. and NPs are the least likely to be sued of all providers (Buppert, 2018). Just because an NP is sued does not mean the provider will be reported to the State Board of Nursing. Remember, the State Board of Nursing’s focus is not to protect the NP; their role is to protect the public. In many instances, the NP will be named in a Malpractice Lawsuit and later removed. Unfortunately, their name will be forever in the National Practitioner Data Bank, which we will discuss in further detail during this week’s Discussion.

This week, as you examine legal issues related to Nurse Practitioner Practice, focus on the implications of the legal terms you will be introduced to and how they will impact your day-to-day decisions in regard to patient care and safety. Consider strategies to improve your clinical practice skills and maintain current with legislative issues in your state.

Buppert, C. (2015). Nurse Practitioner’s Business Practice and Legal Guide (5th ed..). Burlington, MA: Jones & Bartlett. Chapter 7, (pp. 271-284).

Learning Objectives

By the end of this week, students will:

  • Analyze key components of malpractice policies
  • Analyze legal implications that exist for failure to adhere to a standard of care
  • Compare differences in malpractice policy options
  • Evaluate professional strengths and weaknesses
  • Evaluate mastery of NP clinical skills

NURS 6565: Synthesis in Advanced Practice Care of Complex Patients

Assignment : Recognizing the Role of Adhering to the Standard of Care

When providing health care, there are standards of care which a reasonably prudent provider should follow. Providers at all levels are held to these standards of care. Failure to provide competent care to your patients will put you at risk for malpractice. Remaining current with the evidenced-based guidelines and providing optimal care will minimize the risk of liability.

For this Assignment, you will create a PowerPoint presentation that explains any legal implications that exist for failure to adhere to a standard of care, the key elements of malpractice, and compare the differences in malpractice policy options.

To prepare:

  • Consider the importance of using professional resources such as the National Guideline Clearinghouse to guide care delivered

Create a PowerPoint presentation no more than 15 slides in length that addresses the following:

  • Explain, in your own words, what regulatory and coding compliance for APRNs means to your practice
  • Compare coding compliance issues within the state you intend to practice and federal regulations
  • Identify and explain any legal implications that exist for failure to adhere to a standard of care
  • Identify and explain the key elements of malpractice
  • Compare the differences in malpractice policy options

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NURS 6565 Week 5: Interprofessional Practice

It is critical for nurse practitioners to view themselves as partners with physicians and other health care practitioners to improve the health and well-being of patients, families, and communities. “Interprofessional practice occurs when multiple health workers from different professional backgrounds work together with patients, families, and communities to deliver the highest quality of care (NONPF, 2012).” It is imperative for nurses to collaborate with other health care practitioners to meet the complex needs of patients and communities (Institute of Medicine [IOM], 2015. Research has demonstrated that when there is a collaborative approach to patient care, patients’ outcomes are better and patients report greater satisfaction in care. Interprofessional practice requires having the knowledge, skills, and confidence as an advanced practice nurse to work with other health care practitioners to better serve patients.

Patients are at the center of care, and health care practitioners must see themselves as partners in health care to improve the health of individuals, families, and communities. This week we will focus on interprofessional practice and why it is critical for NPs and physicians to work together as a team to care for patients.

Learning Objectives

By the end of this week, students will:

  • Analyze interprofessional practice
  • Apply concepts of interprofessional practice in a clinical setting
  • Create professional cover letters, resumes, and portfolios

NURS 6565: Synthesis in Advanced Practice Care of Complex Patients

Interprofessional practice requires that health care practitioners recognize that patient outcomes are better when there is a collaborative team approach in addressing patient health issues. Also, there are barriers to interprofessional practice that must be addressed among health care practitioners. The Interprofessional Education Collaborative (IPEC) is an initiative including multiple professions designed to advance interprofessional education so that students entering health care professions are able to view collaboration as the norm and seek collaborative relationships with other providers (IPEC, 2011).

This week your Discussion will focus on interprofessional practice. This Discussion is an opportunity for you to examine your perspective and experiences with interprofessional collaborative practice and to apply your knowledge to managing patient care.

To prepare:

    • Identify a professional nursing organization and review their position on interprofessional practice
    • Review the following case study:

Case Study:

Ms. Tuckerno has been diagnosed with multiple sclerosis (MS). The patient receives care at an internal medicine clinic. Her internist is not in the office today and she is being treated by the nurse practitioner. The patient is on two medications for her MS, three different blood pressure medications, one medication for thyroid disease, one diabetic pill daily, insulin injections twice a day, she uses medical cannabis, and uses eye drops for glaucoma. Upon assessing the patient, the nurse practitioner (NP) decides her treatment plan should be adjusted. The NP discontinues some of the patient’s meds and discontinues medical cannabis. She orders the patient to follow up in two weeks.

The patient returns and is seen by her internist. The internist speaks with the patient and reviews her medical chart. The internist states to the patient, “I am dissatisfied with the care you received from the nurse practitioner.” The internist places the patient back on originally prescribed medications and medical cannabis.

By Day 3

Post an explanation of your understanding of interprofessional practice. Also, explain the position on interprofessional practice for a professional nursing organization that you are a member of or of which you plan to become a member. Then, explain what you think is the best collaborative approach to manage Ms. Tuckerno’s care.

Read a selection of your colleagues’ responses.

By Day 7

Respond to at least two of your colleagues on two different days who shared a different perspective than you did. Based on your personal and/or professional experiences, expand on your colleagues’ postings by providing additional insights or contrasting perspectives.

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NURS 6565 Week 6: Certification, Licensure, and Scope of Practice

Nationally recognized competencies and practice standards ensure our profession is meeting the benchmark for excellence in health care delivery to include acute, chronic, and preventive care. Research has proven that the care provided by NPs improves patient outcomes significantly. The National Organization of Nurse Practitioner Faculties (NONPF) developed NP Competencies to use as a guide for ensuring NPs have mastered their program of study and are ready to transition from the role of RN to the role of NP and pursue National Certification with one of the current certifying bodies.

Once certified, NPs are then eligible to apply for licensure as Advanced Practice Registered Nurses (APRNs) in the state provider status is desired. Currently for FNPs and AGPCNPs, The American Association of Nurse Practitioners and the American Nurses Credentialing center both support the outcome of the APRN Consensus Model to ensure licensure after completion of an accredited program(s) of study and certification, which is recognized on a national level. The consensus model supports the goals of the nationally recognized APRN certification process with the ultimate goal of aligning credentials in regards to education, accreditation, licensure, and certification to establish a more uniform practice across the country.

This week you will review the importance of certification and licensure and recognize the differences in the application process at the state level. Additionally, students will examine the importance of Scope of Practice in regard to certification, licensure, and practice.

Learning Objectives

By the end of this week, students will:

  • Analyze NP certification, licensure, and relocation processes
  • Compare Scope of Practice among acute care, family practice, and adult gerontology primary care nurse practitioners
  • Evaluate certification exam options
  • Create plans for passing National Certification Exams
  • Analyze state restrictions or limitations for practice

NURS 6565: Synthesis in Advanced Practice Care of Complex Patients

The National Council of State Boards of Nursing (NCSBN) is a non-profit organization comprised of members from each state board of nursing in the U.S., the District of Columbia, and the four U.S. territories. Their role is to provide a platform for all state boards of nursing to convene, discuss, and ensure all state boards work together to provide the appropriate regulation to ensure that public health, safety, and welfare is the primary focus. A key element of NP licensure is understanding the components of Scope of Practice and subsequent practice within the parameters of the educational program completed and appropriate national certification.

To prepare:

  • Consider the differences in certification exams options for your specialty
  • Consider whether primary care NP graduates are qualified to seek employment in acute care settings such as ER, OR, or hospitalist/intensivist
  • Review and select one of the following case studies to research in depth:
    • Case Study One: Selecting the Certification Exam for your specialty.
      Mary is in the last two months of her program of study. She is trying to decide whether to take the American Association of Nurse Practitioner Credentialing Exam or the American Nurses Credentialing Exam.
    • Case Study Two: Obtaining initial licensure post matriculation.
      Amy, FNP-BC has recently graduated from an accredited Family Nurse Practitioner Program. She decides to relocate from her home state of Tennessee to Missouri and practice in a rural area. She is very excited about her new role and new position.

By Day 3

Post the National Certification Exam you plan to take, a brief explanation for why you chose this exam, and an outline of your plan for passing the National Certification Exam you selected. Then, provide an explanation of the professional and/or clinical practice issues the new Nurse Practitioner will need to consider and address with the certification, licensure, credentialing, or relocation process. Compare Scope of Practice between the Acute Care, Family Practice, and Adult Gerontology Primary Care Nurse Practitioner and how practice may differ from state to state. Then, identify and explain at least two types of settings that are appropriate for FNP and AGPCNP graduates to practice.

Read a selection of your colleagues’ responses.

By Day 7

Respond to at least two of your colleagues on three different days in one or more of the ways listed below. Respond to colleagues who selected a different Case Study than you did.

  • Reflect on the differences between certifying bodies that offer credentialing exams for registered nurses.
  • Provide key components a Nurse Practitioner should consider when relocating from one state to another.

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NURS 6565 Week 7: Prescriptive Authority and Drug Enforcement Administration Registration

Prescriptive authority is granted under state law by the appropriate board. The board granting prescriptive authority may be the Medical Board, State Board of Pharmacy, or Nursing Board for the appropriate state licensure is being pursued. The authority to write for a controlled substance is granted at a federal level and is verified through the Drug Enforcement Administration (DEA) by the appropriate state board. Drug Enforcement Agency registration is granted at the federal level and has additional requirements/fees for the registration process.

Each state has different laws regarding the role of the Nurse Practitioner that may significantly impact the NPs’ practice. Legislative changes may occur annually, bi-annually, or during an emergency legislative meeting at the state or federal level. These legislative sessions and any subsequent changes will significantly impact your scope of practice as a Nurse Practitioner.

Remaining current regarding state law is essential. In the Week 4 Discussion, as you may recall, we introduced the recent change regarding the classification of hydrocodone-containing drugs at the federal level from a Schedule III drug to a Schedule II drug. For states that allow for Nurse Practitioners to write Schedule III-V drugs, these NPs are now unable to write for hydrocodone-containing medications, which significantly impacts their ability to provide care for their patients. However, there are states that do not grant NPs prescriptive authority and/or do not allow NPs to write for controlled substances. Over the last 55 years, Nurse Practitioners have made great strides in obtaining prescriptive authority to prescribe both non-controlled and controlled drugs.

This week students will explore the prescriptive authority application process for their state. Additionally, the DEA Registration Application process will be reviewed.

Learning Objectives

By the end of this week, students will:

  • Analyze appropriate prescriptive authority and DEA registration processes
  • Analyze safe prescribing practices
  • Evaluate professional strengths and weaknesses
  • Evaluate mastery of NP clinical skills

In 1915, the Drug Enforcement Administration was formed, known then as the Bureau of Internal Revenue. Recognizing the variance in state laws and the process for completing applications for prescriptive authority and DEA registration is essential to the role of the NP as a prescriber. Within the last decade, safe prescribing of opioids has also become a national concern. For this Discussion, you will focus on the process for obtaining prescriptive authority after successfully completing your program of study and passing a National Certification Exam. You also will explore safe prescribing.

To prepare:

  • Review your state’s process for obtaining prescriptive authority and associated fees
  • Review the DEA website and review the process for obtaining a DEA number and associated fees.
  • Review and select one of the following case studies and analyze the provider information:
    • Case Study One: Lori, FNP-BC, is a new graduate and has recently passed her certification exam. She has just been hired to work for a Primary Care Clinic in a small town. She will be working with one physician at one site.
    • Case study Two: James, FNP-BC, works with a physician who specializes in pain control. He works in several clinics in the large urban city where he practices.

By Day 3

Post a brief summary of your case study and an explanation of the appropriate prescriptive authority and DEA registration process needed for the case study you selected. Then, explain the safe prescribing practices that these providers should use for these settings.

Read a selection of your colleagues’ responses.

By Day 7

Respond to at least two of your colleagues on three different days in one or more of the ways listed below. Respond to colleagues who selected a different Case Study than you did.

  • Suggest additional actions to take to ensure delivery of safe care.
  • Provide key components of a Malpractice Policy.
  • Validate an idea with your own clinical experiences with the support of an additional literature search.

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NURS 6565 Week 8: Coding and Billing Issues

As you are now approaching graduation, your clinical exposure has allowed you to better understand the coding and billing process. An essential element in clinical practice will be reimbursement. All NPs must give due diligence and ensure all services provided are accurately coded and billed appropriately. Avoiding fraudulent billing is a key element to your success as an NP. As providers, we are ultimately responsible for billing that occurs with our assigned Medicare, Medicaid, and other third party reimbursement entities’ assigned numbers.

This week you will focus on understanding the differences in levels of billing and the importance of coding accurately. Additionally, billing barriers, which inhibit independent practice, and how this impacts your decision on relocating to an alternate state to have independent practice will be reviewed.

Learning Objectives

By the end of this week, students will:

  • Analyze reimbursement issues
  • Compare the impact of reimbursement issues between collaborative practice and independent practice
  • Analyze ethical and legal implications of reimbursement issues

NURS 6565: Synthesis in Advanced Practice Care of Complex Patients

Understanding the complex process of accurate coding and billing is essential to a sustainable practice. As NPs, we are ultimately responsible for ensuring all coding and billing is accurate for each patient seen. For this Discussion, you will search the health care literature and summarize a peer-reviewed journal article published within the last five years.

To prepare:

  • Select one of the following topics:
    • Applying for Medicare and Medicaid Provider Numbers
    • Application process for National Provider Identifier Number
    • Incident to billing
    • Coding-Evaluation & Management
    • Fraudulent billing
    • Billing Self-Pay patients
    • Managed Care Organizations
  • Conduct a search and select a peer-reviewed journal article published within the last five years related to the topic you selected.

Note: For this Discussion, all students are to avoid all written work, which reviews or outlines coding and billing at previous or current worksites as well as previous or current practicum sites.

By Day 3

Post a brief summary of the article you selected. Include the key reimbursement issue addressed and how they would impact the NP in a collaborative practice versus and independent practice. Discuss an ethical or legal implication(s) associated with your article.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days by providing a comparison between the article you selected and the article that your colleague selected

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NURS 6565 Week 9: Professional and Business Practice

NPs may establish Independent Practice in multiple states and districts. States are currently categorized as either allowing full practice, reduced practice, or restricted practice. Full practice states allow NPs to evaluate, order diagnostics, diagnose, and treat patients and are licensed under the exclusive authority of the State Board of Nursing for the appropriate state. Many states may require prescriptive authority protocols in addition to collaborative agreement. Change is constant in this arena as NPs’ status as providers improves on a national level.

This week students will review the current status of NP Practice throughout the United States. Additionally, students will explore independent practice as NPs and the associated responsibilities of being business owners, as well as health care providers.

Learning Objectives

By the end of this week, students will:

  • Evaluate business structures
  • Create a business plan
  • Analyze costs associated with establishing independent practice

Elizabeth Jones, FNP-BC, has been an NP for 8 years. She has worked in the primary care setting, as well as the urgent care setting. She is considering relocating to a state that allows for unrestricted independent practice and opening her own primary care clinic. There are multiple benefits to owning an independent practice. However, owning a practice requires extensive knowledge and support. For an NP to establish independent practice, an appropriate plan must be developed. For this Assignment, you will create a Business Plan for your potential future business.

Write a 2-3 page paper Business Plan that addresses the following:

  • Identify and explain your chosen business structure
  • Estimate monthly cost for establishing your own independent practice in your home state, including:
    • Clinical site expenses
    • Employee structure and expenses
    • Supplies
    • Utilities and other overhead expenses
    • Malpractice insurance
    • Continuing education expenses
    • Accounting fees
    • Services identified that you will provide (e.g., primary care services, drug screens, DOT exams)
    • Projected monthly income necessary to support your independent practice

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NURS 6565 Week 10: Leadership Implications

“The greatest leader is not necessarily the one who does the greatest things. He is the one that gets the people to do the greatest things.”

— Ronald Reagan
U.S. President (1981-1989)

Leadership is a critical role for advanced practice nurses. In order to be an effective leader, one must examine his or her role as an advanced practice nurse, and use his or her knowledge, and leadership skills to address issues related to his or her specialty area. There is a saying that one must know when to follow and when to lead. In order to be a good leader, you must also learn how to follow. As you transition from student to practicing NP, seek opportunities for mentorship to develop your leadership skills. Recognizing when to lead and when to follow is an interchangeable process that requires experience and preparation. The future for Americans in health care is unpredictable. This week it is important to focus on the complex and advanced leadership role that is needed to make effective change in a dynamic and demanding health care system.

This week you will focus on the importance of leadership in advanced practice nursing. You will have an opportunity to examine how you can execute positive social change in your state for salient advanced practice nursing issues.

Learning Objectives

By the end of this week, students will:

  • Analyze state NP practice agreements
  • Analyze state physician collaboration issues
  • Analyze barriers to NP independent practice
  • Create plan for addressing state NP practice issues
  • Create professional cover letters, resumes, and portfolios
  • Evaluate professional strengths and weaknesses
  • Evaluate mastery of NP clinical skills

NURS 6565: Synthesis in Advanced Practice Care of Complex Patients exam help

This week you will have an opportunity to evaluate state practice agreements in your state and examine issues related to NP practice.

To prepare:

  • Review practice agreements in your state
  • Identify at least two physician collaboration issues in your state

By Day 3

Post a brief description of the practice agreements for NPs in your state and the two physician collaboration issues that you identified. Explain what you think are the barriers to NPs practicing independently in your state. Finally, outline a plan for how you might address NP practice issues in your state.

Read a selection of your colleagues’ responses.

By Day 7

Respond to at least two of your colleagues on three different days in one or more of the ways listed below.

  • Suggest additional actions to take
  • Validate an idea with your own clinical experiences with the support of an additional literature search.

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NURS 6565 Week 11: Social Change Agents

“We’ve been called disruptive innovators,” Ford said. “And I think ‘disruptive innovators’ is great – we just need more of them.”

— Heidesch, T. (2008)

As NPs, we are obligated to promote our profession. A component of promoting the profession is proactively being engaged with our communities and identifying areas where change is needed. An example of this would be identifying a community issue, such as an increase in the rate of obesity in a middle-school population and discovering that soda machines are present in the schools. Identifying a problem and being a positive change agent is an essential component of the NP role. Understanding the lawmaking process and how to initiate a local or state change empowers the NP to impart Social Change.

This week you will focus on the importance of leadership in advanced practice nursing. You will have an opportunity to examine how you can execute positive social change in your state for salient advanced practice nursing issues.

Learning Objectives

By the end of this week, students will:

  • Evaluate changes needed at the national, state, or community level
  • Analyze nursing legacies and enacting social change
  • Synthesize information from your course and practicum experiences to suggest social change needed in your community

NURS 6565: Synthesis in Advanced Practice Care of Complex Patients

Consider the following:

During NP clinical practicum experiences, we identify, as nurses, many health care issues that need to be addressed at the local, state, or national level. Addressing the need for change in health care policy is now an intricate part of your role as a social change agent.

For this Discussion, you will identify a change needed in your community and what your nursing legacy for positive social change will be.

To prepare:
  • Consider the health care issues and deficits you have recognized in your professional practice.
  • Identify a change needed in your community in health care policy and discuss how you could impart change during your career as an NP.
  • Consider your future as a NP and what your nursing legacy will be. How will you impart Social Change?

By Day 3

Post a change needed in your community and an explanation for how you will begin to implement that change. Then, share with your colleagues a brief explanation of what your nursing legacy will be and how will you impart Social Change.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who have identified a change needed different from your own. Provide them at least one suggestion for how they could implement the change and for their nursing legacy.

The Fitzgerald Health Education Associates (FHEA) FNP or AGPCNP 150 University Exit Comprehensive Exam is a learning activity used to guide your preparation for your national certification exams and serves as your Final Exam for this course. The results of the exam will help you understand how well prepared you are for your national certification exams and the areas in which you need to further prepare.

You should have received an email from Fitzgerald Health Education Associates (FHEA) explaining how to access the Fitzgerald Health Education Associates (FHEA) FNP or AGPCNP 150 University Exit Comprehensive Exam. Please follow the directions FHEA provided and complete the exam.

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