Download MSN 612 Final EXAM LATEST 2024/2025 COMPLETE QUESTION AND ANSWER (100% GUARANTEED PASS) and more Exams Nursing in PDF only on Docsity!
MSN 612 Final EXAM LATEST 2024/
COMPLETE QUESTION AND ANSWER (100%
GUARANTEED PASS)
Define System-based practice Domain 7: Ability to function as a change agent within a broader healthcare system, coordination of resources. Define Informatics and Healthcare technologies Domain 8: data generation and evaluation, use of EHR, seeking out new technology to improve patient care Define Professionalism Domain 9: APN is accountable, ethical, complies with laws and regulations Define Personal, Professional, and Leadership Development Domain 10: flexible leader working to gain knowledge and better themselves, participation in activities and self-reflection that fosters personal health, resilience, well-being.
YEST ANOTHER "DISRUPTIVE INNOVATION"
THE DOCTOR OF NURSING PRACTICE - The new doctorate is a "practice" doctorate in contrast to the Doctor of Philosophy (PhD)- the traditional research degree- and is not intended to "replace" the PhD. POSITION STATEMENT ONTHE PRACTICE OF DOCTORATE IN NURSING AACN endorsed October 2004, which called the movement of educational preparation for advanced practice nursing roles from the master's degree to the doctoral level by
Duke University 1957 conceived of advanced role for nurses somewhere between the role of the nurse and the doctor. Colorado University first NP's emergerd in the 1960s LACE L - licensure A - Accreditation C - Certification
An individualized, collaborative formulary established by the APN with a collaborating physician Unlimited authority with no formulary or collaborative requirements APNs have no limitations regarding what they can prescribe. Credentialing process by which healthcare organizations or insurers determine an APNs qualifications to provide and/or be reimbursed for healthcare services. Six purposes frame the concept of credentialing
- Public protection
- Quality assurance and risk management
- Consumer information and choice
- Competitive advantage
- Economic advantage
- Employment of health professionals in declared emergencies Licensure
The granting of authority to practice Accreditation Formal review and approval by recognized agency of educational degree or certification. Certification The formal recognition of knowledge, skills, and experience demonstrated by the achievement of standards identified by the profession Education The formal preparation of APNs in graduate or postgraduate programs Teamwork is critical, translate a shared vision into an ever-evolving practice. 5 Qualities in Learning Organization
- Personal Mastery
- Use of Mental models
System thinking foundational in teamwork, forces a focus on the whole pattern of the collaborative practice rather than any isolated role. LEVELS OF ADVOCACY
- Individual & Family Advocacy
- System-level Advocacy (involves changing policies) Patient-Advocacy Skills
- Empathetic listening
- Self-confidence
- Assertiveness
- Negotiation
- Collaboration
- Communication
- Physical Assessment
- Mental Status Assessment
- Teaching Evidence base Practice (EBP)
approach in which practitioners make practice decisions based on the integration of the research evidence with clinical expertise and the patient's unique values and circumstances. Key skill of ANPs translating evidence into practice PICOT Format P - Population or problem of Interest I - Intervention of practice interest C - Comparison Intervention or practice, usually SOC or no comparison O - Outcome of the intervention or practice T - Timeframe in which outcome is expected Removing Barrier to APN Research Activities APN involvement in clinical research is critical to the profession. At the this end, it is necessary to remove all the barriers to APN Research Activities It is important to consider having Professional Liability insurance. whether:
Define Person-centered care Domain 2: Focus on individual within multiple complicated contexts. Holistic, individualized, just, compassionate, evidence based. Define Population Health Domain 3: spans healthcare delivery continuum from public health prevention to disease management of populations. Define Scholarship for nursing discipline Domain 4: Evaluation, conduction, and utilization of ethical evidence-based research. Define Quality and Safety Domain 5: focus on patient safety through evaluation of data, implementation of risk reduction strategies, advocation of change. Define Interprofessional Partnership Domain 6: Intentional collaboration across professions; APN is a team leader who facilitates respect, positivity, and promotion of diversity.
Fein v. Permanente NP standard of practice, not MD for tort case Sermchief v. Gonzales APRN and MDs did not violate scope of practice laws because nurses' scope of practice had expanded as an APRNs Berdyck v. HR Magruder Hospital All professions owe the same duty of care, within their respective professional practice boundaries, e.g. APRN and MD both have a duty of care defined by their professional roles Ali v. Community Health The trial court stated that the standard was what a reasonable nurse midwife would have done in the situation. HMO prevailed, plaintiffs appealed stating that the standard of care was too low. The appellate court affirmed, because it defined the standard of care within the context of the nurse-midwife's practice. Spine Diagnostics Center V. Louisiana Board of Nursing Interventional pain management was outside CRNA's scope and exclusively under the MDs scope of practice. The decision was ruled because the BON rule change was enacted without proper notice and comment period.
Colorado had first NPs LACE-Consensus Model Licensure Accreditation Certification Education Future Directions for APRNs
- Most important is being a nurse
- Core mastery and competency are required in all aspects of the nursing process
- Development of leadership skills is Imperative
- seeing other h/c team as adversaries is not productive As a result of the Pandemic, the National Academy of Medicine (NAM) will consider
- RNs addressing social determinants of health
- Access to care and barriers to care
- Deployment of all level of nurses across the continuum
- RN workforce diverse in gender, race, ethnicity, all levels 5.RNs as Change agents-eliminating disparities and gaps
- RN well-being ensuring high quality h/c in COVID/disasters
Models of Collaboration Trust, Knowledge, Shared Responsibilities Mutual Respect, Communication, Cooperation, Optimism 3 Primary Practice Models Parallel-APN stable pts, MD complex pts Sequential-APN intake, MD dx & manage. Shared Model- Alternate schedules-full care for APN Collaborative-APN manages all complexity, MD comanage during unstable periods, collaboratives w APN in plan of care. Interdisciplinary teaming/ interprofessional collaboration Requires members of h/c team integrate their disciplines' work together, centering this plan on the patient's needs
Economic advantage Employment of hlth prof in emergencies Licensure Accreditation Credentialing Education L-granting of authority to practice A-formal review and approval by a recognized agency of educational degree or certification programs in nursing or nursing-related programs. C-formal recognition of knowledge, skills, and experience demonstrated by the achievement of statndards identified by the profession. E- schooling to be competent in your practice. Masters programs. Collegial Team 5 Qualities PUSTS Personal Mastery-tru to a personal vision while staying committed to the truth
of the current reality Use of Mental Models- using c/o delivery scenarios keeps us from rigid practice Shared Vision-working together Team Learning- thinking together- operational trust Systems Thinking- focuses on whole pattern of collaborative practice vs single role Levels of Advocacy for APNs Individual & Family Public policy Advocacy Models at Individual & Family Level
evidence summaries-Cochrane, ACP Google scholar Appraising Evidence Valid. clearly defined? randomized, list concealed?, all particpants accounted for, intention to treat analysis exist, blinded? were groups treated equally throughout did randomization create comparable groups at the start are the results important How lg is the txment effect how precise is the finding from the trial- if humans, was there a review board Removing Barriers to APN Research Activities Clinical access and clinician buy-in Administrative support Time Money Respondeat Superior "Let the master answer" an employer is vicariously liable for the behavior of an employee working within his or her scope of employment
if APN practicing as an independent contractor but is required to operate in a controlled manner proscribed by the other party the APN is considered an employee If APN asked to practice as an independent contractor, what do you make sure is in your contract That the agency you are contracting with will assist you financially in the credentialling, and recredentialing process If contract says report disciplinary action to the agency Do not hesitate, witholding is reason to terminate Chalmers-Franci v. Nelson (1936) nurse's administration of anesthesia over the objection of a physician and one of his associates. went to CA supreme court court ruled anesthesia by nurses did not constitute diagnosing or prescribing within the state medical practice act Fein v. Permanente Medical Group is important as the case defined the standard of care for the advanced practice nurse. How was that standard of care defined? examining and diagnosing
