NR506 NP Full Course Papers (week 1-4) Chamberlain University

NR506 NP Full Course Assignments Week 1 Discussion

Barriers to Practice

Purpose

Discuss barriers to practice as an APN in one’s state from both a state and national perspective.  Research methods to influence policy change from various forms of competition, state legislative and executive branches of government and interest groups.

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Activity Learning Outcomes

• Through this discussion, the student will demonstrate the ability to:
• Discuss the history of policy development and policy making in nursing (CO1)
• Examine different types of policy and their relationships to healthcare policy (CO1)
• Explain current barriers to practice for advanced practice nurses (CO2)
• Discuss health policy and methods of lifting barriers to practice (CO2)

NR506NP Full Course Assignments Requirements:

• Using the readings from this week as well as outside reliable resources to:
• Identify and describe practice barriers for APNs in your state and discuss these barriers on a state and national level.
• Identify forms of competition on the state and national level that interfere with APN’s ability to practice independently.
• Identify the lawmakers at the state level (i.e., key members of the state’s legislative branch and executive branch of government)
• Discuss interest groups that exist at the state and national levels that influence APN policy.
• Discuss methods used to influence change in policy in forms of competition, state legislative and executive branches of government and interest groups.

NR506NP Healthcare Policy and Leadership Week 2 Discussion

Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study

Purpose

The purpose of this discussion is to discuss organizational changes and ethical-legal influences in a clinical scenario at an out-patient family practice. Students will explore potential effects on patient outcomes and ethical and legal implications for members of the heath care team as a result of illegal behaviors.  Students will develop strategies that result in prevention of untoward outcomes that result in a positive practice culture  NR506NP Full Course Assignments.

Activity Learning Outcomes

• Through this discussion, the student will demonstrate the ability to:
• Demonstrate effective leadership styles in the management of organizational change (CO3)
• Interpret various forms of ethical theories and application into practice (CO4)
• Discuss practice guidelines and malpractice prevention (CO2)

NR506NP Full Course Assignments Requirements:

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

Case Study Questions:

What are the potential ethical and legal implications for each of the following practice members?

• Medical assistant
• Nurse Practitioner
• Medical Director
• Practice

What strategies would you implement to prevent further episodes of potentially illegal behavior?

What leadership qualities would you apply to effect a positive change in the practice?? Be thinking about the culture of the practice.

Week 3 Discussion

Review the Hedis Measures and select ONE (1) measure. Briefly discuss the measure.

Discuss how each intervention can result in improved patient outcomes and cost savings for the practice. Provide evidence to support your discussion.

Discuss how each intervention can result in improved patient ratings (an NP’s patient scorecard). Provide evidence to support your discussion.

Use the provided APA Paper Template to complete the assignment.

Review writing for grammar and mechanics. Consider using academic writing resources to support writing. Your paper should include a title page, introduction with a purpose statement, body with citations to support assertions, conclusion addressing the findings of the paper, and reference page.

Review APA formatting. Consider using APA resources to support citation and reference formation.

Enjoy the learning and reach out to me if you have questions.

NR506NP Healthcare Policy and Leadership Week 4 Discussion

This is a required, but not graded open forum. Your post should add further clarity to the assignment and content of the readings and lessons for the week. Please feel free to post questions related to content or assignments.

NR506NP Healthcare Policy and Leadership Week 5 Discussion

Ethical and Legal Implications

Purpose

Discuss potential complications in a clinical scenario at an out-patient family practice. Students will explore potential effects on patient outcomes and implications for members of the heath care team as a result of conflict among the healthcare team.  Students will develop strategies that result in prevention of untoward outcomes that result in a positive practice culture.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

• Recognize potential areas of conflict in NP clinical practice (CO1)
• Determine methods of data collection to assess the conflict (CO3)
• Examine corporate compliance and its effect on clinical practice (CO2)
• Understand risk management in clinical practice (CO4)

 

NR506NP Full Course Assignments Requirements:

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 NR506NP Full Course Assignments.

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.

Case Study Responses:

Analyze the case study for potential issues for members of the healthcare team from office conflict. Contrast the potential effects for each member of the healthcare team based upon the required readings from the week. Discuss the potential ethical and legal implications for each of the following practice members:

• Medical assistant
• Nurse Practitioner
• Medical Director
• Practice
• What strategies would you implement to prevent further episodes of potentially dangerous patient outcomes?
• What leadership qualities would you apply to effect positive change in the practice? Focus on the culture of the practice.

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NR 506: Conflict at the Office Discussion SAMPLE PAPER

Analysis of the Case Study

The case study presents an ideal scenario of conflicts at the office that emanate from workplace incivility. Although the outpatient primary care office has been in operation for over 15 years, the prevalence of uncivil behaviors, including conflicts among nursing staff affects team cohesion and employees’ ability to fulfill their responsibilities and roles. For example, an intense argument between a medical assistant and her colleague affects her ability to report the vital signs of a patient grappling with very low blood pressure. Equally, these conflicts compromise the competence of cooperating effectively and reduce time spent with patients, affecting clinical workflows and threatening patient safety. Amidst the adverse consequences of uncivil behaviors and acts, workplace leadership should implement evidence-based practices and strategies to improve behaviors, transform workplace culture, and promote interpersonal collaboration.

Potential Ethical and Legal Implications in the Case Study

Medical assistants, nurse practitioners, and medical directors encounter various legal and ethical implications of conflicts and other forms of uncivil behaviors that affect clinical practices. For example, a medical assistant’s failure to record and report the vital signs of a patient struggling with hypotension can jeopardize care continuity and lead to adverse consequences, including death and errors of omission. The reported conflicts between healthcare professionals and the potential effects on the patient’s safety attract various legal and ethical implications, including suspension, licensure revocation, and lawsuits. These legal and ethical issues affect medical assistants, nurse practitioners, and medical directors responsible for case management and the enactment of care plans. Equally, conflicts between healthcare professionals and other forms of workplace invincibility affect professional practice by perpetuating negative behavioral, psychological, and somatic effects (Asghari et al., 2017). These concerns increase healthcare professionals’ propensity to medication errors, burnout, heavy workloads, and intentions to quit.

Strategies to Prevent Further Episodes of Potentially Dangerous Patient Outcomes

As a nurse practitioner, I must demonstrate knowledge and awareness of various forms of workplace incivility in my office space and comprehend proven interventions for preventing workplace incivility. According to Armstrong (2018), the recommended interventions for addressing uncivil behaviors and acts in healthcare institutions include educating and training employees regarding responses to uncivil behaviors and improving self-efficacy in responding to uncivil behaviors. Equally, improving communication patterns and enhancing people’s knowledge and skills are essential to avert behaviors that affect team cohesion and collaboration (Asghari et al., 2017). These approaches require the incorporation of leadership competencies to transform workplace culture.

Leadership Qualities to Effect Positive Change in Nursing Practice

Transformative leadership qualities are necessary for promoting positive change in the context of uncivil behaviors and acts that affect team cohesion and nursing workflow. According to Bhardwaj (2022), leadership tools like the ability to articulate an organizational vision, active listening, leading by example, persuasion, and storytelling effectively promote positive change and transform workplace culture to eliminate uncivil norms, behaviors, and acts. Equally, it is essential to embrace the four principles of transformative leadership to improve workplace culture. These tenets are idealized influence, intellectual stimulation, inspirational motivation, and inspirational motivation.

References

Armstrong, N. (2018). Management of nursing workplace incivility in the health care settings: A systematic review. Workplace Health & Safety, 66(8), 403–410. https://doi.org/10.1177/2165079918771106

Asghari, E., Abdollahzadeh, F., Ebrahimi, H., Rahmani, A., & Vahidi, M. (2017). How to prevent workplace incivility? Nurses’ perspective. Iranian Journal of Nursing and Midwifery Research, 22(2), 157. https://doi.org/10.4103/1735-9066.205966

Bhardwaj, A. (2022). Organizational culture and effective leadership in academic medical institutions. Journal of Healthcare Leadership, 14, 25–30. https://doi.org/10.2147/jhl.s358414

NR506NP Healthcare Policy and Leadership Week 6 Discussion

Scope of Practice and Patient’s Healthcare Accessibility

Purpose

The purpose of this assignment is to identify the scope of practice in one’s state including level of independence of practice, prescribing authority, any limitations of practice, process for obtaining licensure in your state, certification and education requirements for licensure.  Next, students will discuss how the level of independence of practice in their state, i.e., reduced, restricted or full practice, affects patient’s access to care in their local community.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

• Understand NP practice as defined by law (CO2)
• Determine legislation as defined by legislation, statutes and regulations (CO2)
• Identify barriers to ensuring patient’s rights (CO3)

NR506NP Full Course Assignments Requirements

Discuss your state NP community in terms of scope of practice. Include the your state’s scope of practice for NPs including:

• Level of independence of practice
• Prescribing authority
• Any limitations of practice
• Process for obtaining licensure in your state
• Certification and education requirements for licensure.

If you live in a restricted or reduced practice state, how has patient care been impacted in your local community from these barriers?  For instance, is the ED used for primary care?  Are the EDs overcrowded with long wait times?  Are there urgent care clinics readily available? Is there adequate access to primary care?  If you live in a full practice, how has independent practice of the APN resulted in improved patient access to healthcare?

How does access to NPs impacts any healthcare disparities?

NR 506 Discussion SAMPLE APPROACH

California is among the states that implement restrictive regulations for nurse practitioners (NPs). According to the American Association of Nursing Practitioners [AANP] (2022), restricted practice laws restrict the ability of NPs to engage in at least one element of NP practice. Equally, these regulations require nurse practitioners to establish career-long supervision, delegation, or team management with other healthcare providers, especially certified physicians. In full practice states, nurses can engage in all elements of nursing practice, including evaluating patients, diagnosing illnesses, ordering and interpreting diagnostic tests, and prescribing medications. Conversely, nurse practitioners in restricted states like California face practice limitations that affect their full practice and ability to engage in these elements of nursing practice.

Prescribing authority is one of the highly-regulated elements of nursing practice in California. According to California Nursing Practice Act (n.d.), a registered nurse may dispense drugs or devices upon an order by a licensed physician and surgeon. Equally, this regulation requires nurses to complete training and competency assessment before dispensing self-administered hormonal contraceptives (California Nursing Practice Act, n.d.). Training and competency assessment entails various aspects, including medical standards for ongoing women’s preventive health, contraception options education and counseling, mechanisms for documenting and assessing patient and family history, and utilizing the United States Medical Eligibility Criteria for Contraceptive Use.

Process for obtaining licensure in California

Aspiring nurse practitioners can obtain a nursing license in California by examination or endorsement. Licensure by examination requires applicants to complete a mandatory National Council Licensure Examination (NCLEX-RN®). Equally, all applicants must have completed an educational program that meets all California requirements. On the other hand, licensure by endorsement requires nurses to have a current, valid, and active RN license in other states in the United States or Canada. In the same vein, they must have completed an educational program that meets California requirements and have passed the National Council Licensure Examination or the State Board Test Pool Examination (SBTPE).

Certification and education Requirements for licensure

New nurse practitioner applicants should justify their successful completion of an NP education program that meets all standards set by the California Board of Registered Nursing (BRN). In this sense, they must possess a graduate degree in a clinical field related to nursing, including family practice, women’s health, pediatrics, psychiatry, acute care, and community/public health.

How restricted practice laws impact patient care

Restricted practice laws can result in negative impacts on patient care, considering the role of nurse practitioners as primary care providers. According to Spetz (2018), full practice states that grant a greater scope of practice authority exhibit an increase in the number and growth of nurse practitioners through educational enrollment and migration. Also, these states have a greater provision of primary care and expanded healthcare utilization since nurses can engage in all elements of nursing practice. Conversely, restrictive laws result in care delays, limit the scope of primary care, exacerbate overcrowding due to unfavorable nurse-to-patient ratios, and affect emergency care.

How does access to NPs impact any healthcare disparities?

Geographical disparities and barriers are common among people in underserved rural areas. These disparities affect people’s access to care services and overall healthcare utilization. States with restricted practice laws encounter various challenges that exacerbate these disparities. According to the American Association of Nurse Practitioners [AANP] (n.d.), nurses in full-practice states are more likely to operate in rural and underserved areas, improving NP workforce recruitment and reducing geographical inequalities. Further, full-practice laws can reduce the burden of chronic diseases, address primary care shortages, and curtail care costs.

References

American Association of Nurse Practitioners. (n.d.). Issues at a glance: Full practice authority. Retrieved November 29, 2022, from https://www.aanp.org/advocacy/advocacy-resource/policy-briefs/issues-full-practice-brief#

American Association of Nurse Practitioners. (2022). State practice environment. American Association of Nurse Practitioners. https://www.aanp.org/advocacy/state/state-practice-environment

California Nursing Practice Act. (n.d.). Excerpt from Business and Professions Code Division 2, Chapter 6. Article 2 Scope of Regulation. 1–6. https://www.educationandstaffdevelopment.com/wp-content/uploads/2019/07/CA-Nurse-Practice-Act-2.6.2..pdf

Spetz, J. (2018). California’s nurse practitioners: How the scope of practice laws impact care (pp. 1–21). https://www.chcf.org/wp-content/uploads/2018/09/NursePractitionerScopePracticeLaws.pdf

 

NR506NP Healthcare Policy and Leadership Week 7 Discussion

APNs as Healthcare Policy Leaders

Purpose

The purpose of this assignment is to discuss healthcare policy of the APN profession and how Transformational Leadership can help to influence policy changes. This week’s assignment focuses on the APN as a Health Policy Leader, one of the nine NONPF NP competencies.  Students will analyze how health policy may affect NP practice and how Transformational Leadership can help to influence policy changes.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

• Critically analyze how healthcare systems and APRN practice are organized and influenced by ethical, legal, economic and political factors (CO2)
• Demonstrate professional and personal growth concerning the advocacy role of the advanced practice nursing in fostering policy within diverse healthcare settings (CO3)
• Advocate for institutional, local, national and international policies that fosters person-centered healthcare and nursing practice (CO4)

NR 506 Discussion SAMPLE APPROACH

Q1. Explanation of how healthcare policy can impact the advanced practice nurse profession

Advanced practice nurse professionals play a forefront role in safeguarding patient safety and improving well-being by engaging in various elements of nursing practice, including the management of chronic diseases, conducting disease diagnostics, implementing new technologies, and educating the public about health issues. Examples of specialties for advanced practice registered nurses (APRNs) include nurse practitioners (NPs), certified nurse-midwives, and nurse anesthetists (American Nurses Association, 2017). They demonstrate an understanding of the theoretical, methodological, and practical underpinnings of nursing practice, enabling them to provide evidence-based care, participate in decision-making, and utilize research as a problem-solving tool.

Although APRNs play a significant role in promoting people’s health and wellness, organizational, state, and national policies impact their professional practice and standards. According to Hajizadeh et al. (2021), health policies encompass decisions, actions, and plans for achieving specific healthcare objectives and goals. In this sense, policies primarily focus on priority areas of the current healthcare systems, including patient safety, care accessibility, social determinants of health (SDOH), care costs, and the incorporation of advanced technologies in clinical practices. For example, state policies and regulations, such as the scope of practice (SOP) laws determine APRNs’ autonomy to engage in all elements of nursing practice.

Advanced practice registered nurses (APRNs) understand the intricacies and demands of the current healthcare systems due to their reputable experience and academic qualifications. As a result, they can effectively participate in political actions for improving care quality, accessibility, affordability, and utilization. Equally, they can assume managerial and leadership roles to initiate, plan, implement, and sustain organizational change in the ever-dynamic health sector.

Q2. Explanation of why advocacy is an essential component of advanced practice nurse’s role

Populations grapple with poor social determinants of health (SDOH) that result in preventable health inequalities and disparities. Examples of unfavorable conditions that constitute social determinants of health are poverty, poor housing and neighborhood, deficient infrastructure, socioeconomic status, level of educational attainment, and social contexts (Murray, 2018). Healthcare professionals operate as the bridge between vulnerable populations and quality care services. As a result, advocacy emerges as an essential component of the advanced practice nurse’s role since it entails addressing the causes of health disparities and operating on behalf of susceptible populations. Abbasinia et al. (2020) contend that patient advocacy entails multiple attributes, including patient empowerment, care continuity, follow-up, counseling, whistle-blowing, and valuing diversities. At a policy level, APRNs can fulfill their advocacy role by influencing policies, assuming leadership and management positions, and using their experience and knowledge to ensure adherence to bioethical principles; autonomy, beneficence, non-maleficence, and justice. Therefore, advocacy is a profound dimension of addressing health disparities and bridging chasms in care quality, accessibility, affordability, and utilization.

Q3. Discuss the four pillars of transformational leadership and the effect they may have on influencing policy change

Transformational leadership remains the best approach for promoting and influencing change, considering its emphasis on inspiring followers, promoting collective organizational visions, and motivation. This leadership style has four core pillars: individualized consideration, inspirational motivation, intellectual stimulation, and idealized influence (Khan et al., 2020). Individualized consideration denotes the leader’s ability to attend to followers’ needs and provide support, including mentorship. Secondly, inspirational motivation is the competency for articulating an appealing vision to inspire and motivate followers to perform beyond expectations (Bradley, 2020). Thirdly, idealized influence entails role modeling and the promotion of high standards of ethical behavior that contribute to teamwork and cohesive interpersonal collaboration. Finally, intellectual stimulation involves challenging uninformed assumptions, supporting creativity and innovation, and encouraging critical thinking (Bradley, 2020, p. 59). Transformational leaders can influence change by developing a systems approach and using collaborative, interdisciplinary interventions for challenging restraining factors for change and enhancing individual and team motivation.

References

Abbasinia, M., Ahmadi, F., & Kazemnejad, A. (2019). Patient advocacy in nursing: A concept analysis. Nursing Ethics, 27(1), 141–151. https://doi.org/10.1177/0969733019832950

American Nurses Association. (2017, October 19). Advanced Practice Registered Nurses (APRN). https://www.nursingworld.org/practice-policy/workforce/what-is-nursing/aprn/#

Bradley, R. (2020). Reviewing transformational leadership and change management in the United States of America. Journal of Human Resource & Leadership, 4(6), 56–65. https://stratfordjournals.org/journals/index.php/journal-of-human-resource/article/view/689/800

Hajizadeh, A., Zamanzadeh, V., Kakemam, E., Bahreini, R., & Khodayari-Zarnaq, R. (2021). Factors influencing nurses’ participation in the health policy-making process: A systematic review. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00648-6

Khan, H., Rehmat, M., Butt, T. H., Farooqi, S., & Asim, J. (2020). Impact of transformational leadership on work performance, burnout and social loafing: A mediation model. Future Business Journal, 6(1), 1–13. https://doi.org/10.1186/s43093-020-00043-8

Murray, T. (2018). Overview and summary: Addressing social determinants of health: Progress and opportunities. OJIN: The Online Journal of Issues in Nursing, 23(3). https://doi.org/10.3912/ojin.vol23no03manos

 

NR506NP Full Course Assignments Requirements

• Criteria for Content
• Explanation of how healthcare policy can impact the advanced practice nurse profession
• Explanation of why advocacy is considered an essential component of the advance practice nurse’s role
• Discuss the four pillars of Transformational leadership and the effect it may have on influencing policy change

NR506NP Healthcare Policy and Leadership Week 8 Discussion – Reflection on Achievement of Outcomes

NR 506 Week 8 Discussion SAMPLE APPROACH

Q1. How to make informed decisions on nursing practice and patient outcomes on a global basis. In addition, state how you will apply what you have learned in this course to your upcoming practicum experience.

The current global healthcare systems face multiple issues that prompt healthcare professionals to make informed decisions and adopt information-driven practices. Examples of issues in current healthcare systems are a high prevalence of chronic and non-communicable diseases, high care costs, and health inequalities. According to Berwick et al. (2018), preventable mistakes, harm, high rates of incorrect and ineffective treatment, and disrespect to people when interacting with the healthcare system are among the issues that contribute to the worsening quality of healthcare in every country. Equally, Berwick et al. (2018) contend that poverty, low-income status, lack of standard metrics, and insufficient research on quality interventions are major causes of the prevailing chasms in healthcare. Healthcare professionals are responsible for tackling these factors for disproportionate care access, affordability, and utilization by implementing appropriate strategies for decision-making and problem-solving. A profound role of nurse practitioners in addressing chasms in healthcare is active involvement in policy development, enactment, and evaluation.

This course has been a revelation and insightful regarding the concept of nurses’ involvement in policy development and the rationale for patient advocacy. I have learned that nurse practitioners have an overarching role in improving health policy through lobbying, using their experience and scholarly knowledge to improve policies, advocating for patients and communities, and assuming leadership positions in policymaking contexts. Equally, they can improve care quality by making informed decisions. According to Nibbelink & Brewer (2018), informed decision-making in nursing requires nurses to incorporate research and the best evidence amidst time pressure and ever-demanding healthcare scenarios. In my practicum experience, I endeavor to apply the learned concepts in coping with new organizational demands and translating theoretical knowledge to practice. I am at using my advocacy role to provide patient-centered care and embrace evidence-based practice to make informed decisions.

Q2. Describe how one will apply content from NR506NP to the upcoming courses

As I advance my academic knowledge, I expect complex concepts in the upcoming courses, including involvement in care planning and case management. Amidst these contexts, I should play a forefront role in promoting care quality and aligning my competencies with the demands of the current healthcare systems. Turale & Kunaviktikul (2019) argue that organizations around the world emphasize the need for nurses to play a significant role in leadership, advocacy, and policymaking because they understand the intricacies and demands of quality care delivery. It is essential to note that nurse practitioners should move from recipients and implementers of health policies to developers and leaders by rightfully engaging in policy development, health reforms, and advocacy (Turale & Kunaviktikul, 2019). Nurses’ active role in policies and reforms enhances opportunities for patients and at-risk populations to access and benefit from well-thought-out and evidence-based policies that emphasize care quality, patient safety, and improved health outcomes.

The NR506NP course captures aspects of nursing leadership, health policies, and nurses’ advocacy roles. As I anticipate the upcoming courses, the knowledge acquired from this course is consistent with the need to align my competencies and academic knowledge to the dynamics of healthcare. As a result, I will actively participate in leadership, join professional nurse associations, involve patients in collaborative care plans, and impact healthcare policies through research and specializing in graduate programs focused on aspects of health policy and leadership.

References

Berwick, D., Snair, M., & Nishtar, S. (2018). Crossing the global healthcare quality chasm. Journal of American Medical Association, 320(13), 1317–1318. https://doi.org/10.1001/jama.2018.13696

Nibbelink, C. W., & Brewer, B. B. (2018). Decision-making in nursing practice: An integrative literature review. Journal of Clinical Nursing, 27(5-6), 917–928. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5867219/

Turale, S., & Kunaviktikul, W. (2019). The contribution of nurses to health policy and advocacy requires leaders to provide training and mentorship. International Nursing Review, 66(3), 302–304. https://doi.org/10.1111/inr.12550

 

Purpose

The final week will focus on Global Policy Reform and the impact on patient care.  Students read the Berwick article and respond to the required discussions.  In addition, students reflect on what they have learned in NR506NPNP and how it is applicable to their upcoming clinical courses.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

• Understand the role of advanced practice nursing in the International Context (CO2)
• Research global aspects of healthcare and the effect on the US healthcare system (CO5)
• Discuss the implications of global health on your clinical practice (CO5)
• Berwick, D., Snair, M., & Nishtar, S. (2018). Crossing the global health care quality chasm: A key component of universal health coverage. Journal of American Medical Association, 320(13), 1317-1318.

Read the Berwick article and reflect on the concepts and practices you have learned in NR506NP on healthcare systems, politics, and health policy. Reflections should include:

• How to make informed decisions on nursing practice and patient outcomes on a global basis.? In addition, state how you will apply what you have learned in this course to your upcoming practicum experience.?
• Describe how one will apply content from NR506NPNP to the upcoming clinical courses.

NR506NP Week 3 Assignment

Quality Healthcare: Measuring NP Performance

Purpose

The purpose of this assignment is to have students research the measurement tools of NP performance.  Through the use of quality patient outcomes, student will l ist and discuss three different patient interventions and how  they would specifically measure the outcomes and h o w these primary care interventions result in improved patient outcomes and cost savings for the practice .  In addition,  students will discuss how these interventions result in improved patient ratings .

Activity Learning Outcomes

Through this assignment, the student will demonstrate the ability to:

• Employ strategies to impact the development, implementation, and consequences of holistic healthcare policies using evidence-based practice principles (CO1)
• Critically analyze how healthcare systems and APRN practice are organized and influenced by ethical, legal, economic and political factors (CO2)
• Demonstrate professional and personal growth concerning the advocacy role of the advanced practice nursing in fostering policy within diverse healthcare settings (CO3)
• Analyze social, historical, ethical and political contexts of healthcare policies and advanced practice leadership (CO4) NR506NP Full Course Assignments
• Advocate for institutional, local, national and international policies that fosters person-centered healthcare and nursing practice (CO5)

NR 506 Week 3 Quality Healthcare: Measuring Nurse Practitioner Performance SAMPLE APPROACH

Healthcare professionals play a significant role in improving patient and community health and well-being. However, healthcare professionals face multiple challenges, including increased demands for quality care, nursing staff shortages, a high prevalence of chronic conditions, and the need to integrate technology into clinical practice. These issues can affect care providers’ performance, prompting the need to measure nurse practitioners’ performance consistently. According to Kahya & Oral (2018), assessing the performance of healthcare professionals is a profound strategy for guaranteeing high-quality care and achieving the desired medical outcomes. The National Committee for Quality Assurance (NCQA) provides a set of standards for improving care quality and measuring patient outcomes consistent with nursing interventions. Consequently, this paper discusses BMI (Body Mass Index) assessment as a performance measure and identifies strategies for improving patient outcomes, cost saving, and enhancing patient ratings.

Patient Interventions

Adult body mass index (BMI) assessment is a profound approach for enabling people to maintain healthy body weights and preventing multiple overweight-associated conditions. According to the National Committee for Quality Assurance [NCQA) (n.d), BMI remains the most useful population-level measure of obesity and overweight. When justifying the rationale for frequent adult BMI assessment, it is vital to consider obesity as a significant population health problem that results in detrimental consequences, including a high prevalence of chronic conditions like diabetes, cardiovascular diseases (CVDs), and premature deaths. The National Committee for Quality Assurance (n.d) contends that obesity contributes to approximately one in five deaths in the United States. Other consequences associated with obesity and overweight include social stigma, psychological stress, compromised quality of life, and increased care costs (Gutin, 2017). As a result, weight-for-height screening (BMI assessment) enables healthcare professionals to estimate and identify the amount of body fat.

Equally, careful BMI monitoring helps healthcare professionals to identify at-risk populations and develop individualized interventions for preventing and treating obesity, including involving adults in regulated physical exercises, practicing diet control mechanisms, and educating them on self-care interventions. Arguably, it is possible to ensure appropriate BMI assessment and improvement of patient outcomes by obtaining, documenting, and frequently updating records regarding weight, height, and BMI for all outpatient adults, educating at-risk populations on interventions for managing healthy body weights, and developing follow-up plans to ensure long-term effects of the enacted strategies for preventing obesity and overweight.

Obtaining, Documenting, and Updating Records for Adults BMI

Healthcare professionals can adopt various ways of assessing adults’ BMIs and identifying at-risk individuals. According to Khanna et al. (2022), strategies for measuring and evaluating the body mass index include establishing the percentage of the body or visceral fat, measuring the waist circumference, and computing the waist-to-hip ratio. These criteria are fundamental in defining obesity and overweight. The World Health Organization [WHO] (2021) defines obesity as a body mass index (BMI) greater or equal to 30kg/m², while overweight represents a BMI greater or equal to 25kg/m². Based on the World Health Organization’s definitions of obesity and overweight, it is possible to detect the levels of risk and proximity to the risk factors for obesity and overweight.

After assessing adult BMI based on waist-to-hip ratios, waist circumference and computing the percentage of the body or visceral fat, healthcare professionals are responsible for keeping accurate documentation and frequently updating records to establish the effectiveness of interventions in preventing and treating overweight and obesity. Healthcare professionals should ensure accurate documentation of BMI by using electronic medical record systems (EMRS). Verberne et al. (2018) contend that electronic health records (EHRs) contain complete and structured patient health status information documentation. Also, these technology-mediated modalities allow clinicians to accurately compute adult BMI by automating the process and leveraging data regarding patients’ heights and weights. Therefore, they enhance procedure accuracy and convenience. After applying these strategies to compute and assess adult BMI, it is possible to track and measure patient outcomes by creating spreadsheets and updating the team consistent with results from subsequent BMI assessments.

Educating At-risk People on Effective Strategy for Managing Weight

The second population-level intervention for improving BMI assessment and preventing obesity is educating at-risk people on appropriate strategies for managing weight and addressing risk factors for obesity and overweight. Hartmann-Boyce et al. (2018) contend that individual-level efforts for preventing and treating obesity are transferable to the broader population, providing opportunities for reducing the burden of obesity-related diseases, including cardiovascular conditions, some types of cancer, and diabetes. In the same vein, the World Health Organization [WHO] (2021) presents obesity as a multifactorial public health problem that prevails due to various risk factors, including an increased intake of unhealthy foods (high in fat and sugars), physical inactivity, and sedentary lifestyles. A lack of knowledge and awareness of self-management practices can increase an individual’s susceptibility to obesity and other associated problems.

Amidst the need to improve individual and population health literacy and awareness of preventive behaviors and activities, it is essential to tailor an educational program to enlighten people about self-management interventions. According to Hodgkinson et al. (2019), obesity awareness campaigns and educational programs focus on socio-behavioral factors that cause obesity. For instance, educating individuals and the community improves people’s knowledge of healthy diets and physical activity levels. It would be essential to assess the outcomes of this intervention by using Kirkpatrick’s evaluation model that evaluates educational programs based on participants’ training experience, learners’ learning outcomes, change in behavior and improvement, and the overall impacts of the educational program (Heydari et al., 2019). This approach can evaluate the program’s impact on staff satisfaction, behavior, and learning.    

Developing Follow-up Plans

Although accurately recording BMI measurements and educating people about obesity and preventative measures can enhance interventions for preventing and treating obesity, these efforts are unsustainable if a proper follow-up plan is lacking. Welzel et al. (2018) argue that healthcare professionals should assist patients in continuous weight management. A comprehensive and well-timed follow-up can improve patient outcomes by fostering meaningful relationships with healthcare organizations, improving adherence to preventative and treatment options, and enhancing effective communication to support care coordination.

Improved Patient Outcomes

Implementing the identified population-level interventions aims to improve patient outcomes by reducing their susceptibility to obesity and overweight-associated conditions, such as cardiovascular diseases (CVDs) and diabetes. Also, early BMI assessment, community-based educational programs, and follow promote preventive behaviors by providing opportunities for early obesity detection, emphasizing preventative measures, and adherence to treatment interventions. According to Hodgkinson et al. (2019), educational interventions targeting at-risk populations can improve their health literacy, influence and promote preventive behaviors and activities, and enable people to sustain preventive and treatment strategies, including healthy diets and physical exercise. As a result, it is valid to associate the identified patient interventions with improved patient outcomes.

Cost Savings

Obesity and overweight inflict a massive cost burden on individuals, families, and healthcare systems. According to the Centers for Disease Control and Prevention [CDC] (2022), obesity costs the United States government approximately $173 billion annually. More essentially, a high prevalence of obesity-related diseases, including cardiovascular conditions, some types of cancer, and diabetes, exacerbate and increase care costs. As a result, implementing the identified measures can reduce care costs by promoting preventive behaviors and acts, providing early obesity screening and detection opportunities, and improving people’s health literacy.

Patient Ratings

Patient ratings are products of consumer experiences and satisfaction levels. Positive experiences and highly satisfactory healthcare services can improve care acceptability, appropriateness, and utilization. The proposed patient interventions for preventing and treating obesity are engaging and evidence-based. Hong et al. (2019) argue that obesity is a stigmatized condition that leads to weight-based discrimination. As a result, engaging patients and at-risk people in early BMI assessment, education programs, and follow-up plans can enhance their health, reduce susceptibility to obesity-related conditions, and curtail care costs. Participative and practical approaches can improve patient safety and contribute to care acceptance.

Conclusion

Healthcare professionals encounter various tools for measuring their performance amidst dynamics in healthcare. Consistent measuring nurse practitioner performance is a profound approach to improving health quality and patient outcomes. The National Committee for Quality Assurance (NCQA) provides a set of standards for improving care quality and measuring patient outcomes consistent with nursing interventions. For example, adult BMI assessment is the primary measure of obesity and overweight. This performance measure enables healthcare professionals to identify at-risk adults and develop/implement evidence-based, population-oriented services. This paper discusses BMI (Body Mass Index) assessment as a performance measure and identifies strategies for improving patient outcomes, cost-saving, and enhancing patient ratings

References

Centers for Disease Control and Prevention. (2022, July 14). Why it matters. https://www.cdc.gov/obesity/about-obesity/why-it-matters.html#

Gutin, I. (2017). In BMI we trust: Reframing the body mass index as a measure of health. Social Theory & Health, 16(3), 256–271. https://doi.org/10.1057/s41285-017-0055-0

Hartmann-Boyce, J., Aveyard, P., Piernas, C., Koshiaris, C., Velardo, C., Salvi, D., & Jebb, S. A. (2018). Cognitive and behavioral strategies for weight management in overweight adults: Results from the Oxford food and activity behaviors (OxFAB) cohort study. PLOS ONE, 13(8), e0202072. https://doi.org/10.1371/journal.pone.0202072

Heydari, M. R., Taghva, F., Amini, M., & Delavari, S. (2019). Using Kirkpatrick’s model to measure the effect of new teaching and learning methods workshop for health care staff. BMC Research Notes, 12(1). https://doi.org/10.1186/s13104-019-4421-y

Hodgkinson, A., Abbott, J., Hurley, M. A., Lowe, N., & Qualter, P. (2019). An educational intervention to prevent overweight in pre-school years: A cluster randomized trial with a focus on disadvantaged families. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-7595-2

Hong, Y.-R., Pavela, G., Lee, A. M., Williamson, V. G., & Cardel, M. I. (2019). Satisfaction with health care among individuals with overweight and obesity: A nationally representative cross-sectional study. Journal of General Internal Medicine, 34(8), 1397–1399. https://doi.org/10.1007/s11606-019-04939-2

Kahya, E., & Oral, N. (2018). Measurement of clinical nurse performance: Developing a tool including contextual items. Journal of Nursing Education and Practice, 8(6), 112. https://doi.org/10.5430/jnep.v8n6p112

Khanna, D., Peltzer, C., Kahar, P., & Parmar, M. S. (2022). Body mass index (BMI): A screening tool analysis. Cureus, 14(2). https://doi.org/10.7759/cureus.22119

National Committee for Quality Assurance. (n.d.). Adult BMI assessment. Retrieved November 11, 2022, from https://www.ncqa.org/hedis/measures/adult-bmi-assessment/

Verberne, L. D. M., Nielen, M. M. J., Leemrijse, C. J., Verheij, R. A., & Friele, R. D. (2018). Recording of weight in electronic health records: An observational study in general practice. BMC Family Practice, 19(1). https://doi.org/10.1186/s12875-018-0863-x

Welzel, F. D., Stein, J., Pabst, A., Luppa, M., Kersting, A., Blüher, M., Luck-Sikorski, C., König, H.-H., & Riedel-Heller, S. G. (2018). Five A’s counseling in weight management of obese patients in primary care: A cluster-randomized controlled trial (INTERACT). BMC Family Practice, 19(1). https://doi.org/10.1186/s12875-018-0785-7

World Health Organization. (2021, June 9). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

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NR506NP Full Course Assignments Requirements

The National Committee for Quality Assurance (NCQA) was formed to ensure quality of patient care and measurement of patient outcomes with set standards.

Healthcare Effectiveness Data and Information Set (HEDIS) is a performance measurement tool used by millions of health insurance plans. There are 6 domains of care:

• Effectiveness of Care.
• Access/Availability of Care.
• Experience of Care.
• Utilization and Risk Adjusted Utilization.
• Health Plan Descriptive Information.
• Measures Collected Using Electronic Clinical Data Systems

You may access the 6 domains of care by clicking this link:

(NCQA, n.d. https://www.ncqa.org/hedis/ (Links to an external site.))

As an APN, productivity will be an important measurement for the practice to determine reimbursement and salary. Fee-for-service practices will require a set number of patients per day to maintain productivity NR506NP Full Course Assignments.

A capitated practice will require the APN to have a large panel of patients but also will focus on controlling costs. This can be accomplished through effective primary care that is accessible, convenient for the patients and has a method of measuring quality of care.

Write a formal paper in APA format with title page, introduction, the three required elements below, conclusion and reference page NR506NP Full Course Assignments.

You are now employed as an NP in primary care. Choose one performance measure from one of the six domains of care, i.e. Adult BMI Assessment, Prenatal and Postpartum care, etc.

Develop three different patient interventions for that one performance measure and how you would specifically implement the intervention and measure the outcomes for that particular performance measure in clinical practice.

How would these primary care interventions result in improved patient outcomes and cost savings for the practice?

How can these interventions result in improved NP patient ratings?

NR506NP Week 4 Assignment  – Kaltura Health Policy Analysis

Purpose

This assignment will focus on developing a health policy analysis presentation that includes a problem statement, background, landscape, options and recommendations from the week’s readings.  The health policy analysis presentation is based upon an identified healthcare issue in one’s local community NR506NP Full Course Assignments.

Activity Learning Outcomes

Through this assignment, the student will demonstrate the ability to:

• Employ strategies to impact the development, implementation, and consequences of holistic healthcare policies using evidence-based practice principles (CO1) NR506NP Full Course Assignments
• Critically analyze how healthcare systems and APRN practice are organized and influenced by ethical, legal, economic and political factors (CO2)
• Analyze social, historical, ethical and political contexts of healthcare policies and advanced practice leadership (CO4)
• Advocate for institutional, local, national and international policies that fosters person-centered healthcare and nursing practice (CO5)

Requirements for NR506NP Full Course Assignments

Research healthcare issues that have been identified in your local community. Develop a power point presentation offline. Structure a health policy analysis presentation that addresses the following topics particular to your health problem.

• Problem Statement
• Background
• Landscape
• Options
• Recommendations
• Next, record your Kaltura presentation and upload it into the week 4 assignment. How to use Kaltura resources are in Home/Resources/Technology Resources
• Posting your recording:
• Go to the week four assignment tab and hit Submit Assignment
• Use the Text Entry Tab. You will have the option of selecting the Kaltura icon
• It will take you to your My Media Gallery and upload it from there, example below.