NR510 Wk 1 – 5 Discussions latest 2016 september

NR510 Wk 1 – 5 Discussions latest 2016 september

NR510 Wk 1
Dq 1, Dq 2 & Dq 3 latest 2016 september
dq 1
Discussion Part One (graded)
Mary, a baccalaureate prepared registered nurse, has been
practicing for fifteen years. Throughout her nursing career, she worked in
pediatric, surgical, and emergency departments. She worked as a floor nurse,
charge nurse, and was recently offered a position as a nursing supervisor. A
stipulation for becoming a nursing supervisor is that Mary must attain a Master
of Health Administration degree within 2 years of accepting the position. The
offer prompted Mary to contemplate her career. She is interested in returning
to college, but she realized that she does not want to pursue working in
administration and away from patients. Mary decided to become an Advanced
Practice Nurse (APN). Mary knows that working as an APN will allow her the
opportunity to make a larger contribution to individuals, environment, health,
and nursing. She researched graduate nursing programs and discovered that there
are four roles of the APN. Mary must choose one role and apply to a program,
but she is unsure about the different roles and their individual scopes of
practice.
Discussion question:
How would you decide? Develop apros and cons list to assist
Mary in making her decision. Include each role of the APN on the list and be
certain to provide appropriate rationales and citations.

dq 2
Discussion Part Two (graded)
A clear definition for the various roles of CNM, CNP, CNS,
and CRNA has been convoluted by various state definitions that confuse the
roles and often obscure their intended meaning. Such state definitions reveal
further confusion with regard to role separation, competency, emphasis,
approach, and variation. This misunderstanding extends to nurse educators,
providers, reimbursement, and even the public. The lack of clarity regarding
initial role preparation versus current certification serves to further frustrate
accreditors, consumers, and employers alike.

Discussion question:
How does your state define the role and scope of the CNP?
Provide a correctly formatted citation for your reference resource.

dq 3
Discussion Part Three (graded)
Mary expressed that she wants to work directly with
patients. She is familiar with working in a large hospital system, and prefers
to remain in her current town when she graduates. She has considerable clinical
experience in pediatric, surgical, and emergency nursing.
Discussion question:
Based on Mary’s experience and interests, which role would
you choose for her, and why?

NR510 Wk 2
Dq 1, Dq 2 & Dq 3 latest 2016 september
dq 1
Discussion Part One (graded)
Mary, a registered nurse, decided that she wants to become a
CNP. She applied and was accepted to the Family Nurse Practitioner program at
Chamberlain College of Nursing. She received a course curriculum which outlined
the courses necessary to complete her degree. One of the early courses in the
program curriculum is NR-501 Theoretical Basis for Advanced Nursing Practice.
You are a student colleague of Mary’s enrolled in the same
class. On the class Q&A discussion board, Mary posted, “I took nursing
theory classes fifteen years ago in my bachelor’s program. I don’t understand
why I need to take theory classes again.”

Discussion Question:
How would you respond? Develop a logical response to Mary’s
post. Provide evidence to support your arguments.Topic responses

dq 2
Discussion Part Two (graded)
Mary wrote, “All nursing theories are the same and certainly
there is no connection to APN practice.”
Discussion Question:
How would you respond? Develop a logical response to Mary’s
post. Provide evidence to support your arguments.
dq 3
Discussion Part Three (graded)
The following response on the discussion board was posted by
the course instructor:
“The advanced practice roles of CNM, CNP, CNS, and CRNA
require an intensive set of clinical skills, understandings, and integrative
abilities that synthesize advanced practice nursing knowledge.”
Discussion Question:
What does the course instructor mean by “integrative
abilities”? Provide evidence to support your response.

NR510 Wk 3
Dq 1, Dq 2 & Dq 3 latest 2016 september
dq 1
Discussion Part One (graded)
You are a Family Nurse Practitioner (FNP) employed as a
contact employee in a busy primary care practice for 2 years. The providers in
the group include one physician, who is also the owner of the practice, and two
other nurse practitioners. The owner of the practice recently made comments
about the need to produce more revenue. You relate with his concerns and feel
that you have several strategies that could be helpful. Your contract is up for
renewal in 3 months. You are highly satisfied with your job and want to stay in
the group. You see 20 patients per day on average, and take call every third
weekend.

Discussion Question:
What negotiation strategies should you use to propose a
contract renewal? Use logical reasoning and provide evidence based rationales
for your decisions. Keep in mind that your negotiation terms and conditions
must be within the legal scope of practice for an ANP.

dq 2
Discussion Part Two (graded)
As revenue generators, NPs must be aware of how their work
contributes to the overall revenue of the clinical practice. You see 20
patients per day on average, and take call every third weekend. According to
Buppert (2011), an NP who sees 15 patients per day at $56 per patient visit, on
average, brings in $840 per day. Allowing 1 week off for continuing education,
1 week off for illness, and 4 weeks off for vacation, this NP will bring in
$193,200 a year, potentially. However, not all bills are paid. With a 90%
collection rate—a reasonable collection rate for an efficient practice—this NP
actually will bring in $173,800 per year. An NP who sees 24 patients per day
will bring in $1344 per day, or $309,120 per year in accounts receivable. With
a 90% collection rate, this NP will bring $278,208 to the practice (Buppert,
2011).
Discussion Question:
In this scenario, what are you “worth” to the practice? Use
logical reasoning and provide evidence based rationales for your decisions.
Keep in mind that your negotiation terms and conditions must be within the legal
scope of practice for an ANP.

dq 3
Discussion Part Three (graded)
Establishing a salary can be a challenge for NPs. Deducting
40% of the NP’s gross generated income for overhead expenses (rent, benefits,
continuing education, supplies, malpractice, lab expenses, and depreciation of
equipment) leaves $104,280 for the 15-patient-per-day NP and $166,925 for the
24-patient-per-day NP. Further deducting 15% of that figure to pay a physician
for consultation services leaves $88,638 in salary for the 15-patient-per-day
NP and $141,887 in salary for the 24-patient-per-day NP. Deducting 10% for
employer profit leaves $79,775 in salary for the 15-patient-per-day NP and
$127,699 for the 24-patient-per-day NP (Buppert, 2011).

Discussion Question:
What salary would you propose for the contract renewal? Use
logical reasoning and provide evidence based rationales for your decisions.
Keep in mind that your negotiation terms and conditions must be within the
legal scope of practice for an ANP.

NR510 Wk 4 Dq
1, Dq 2 & Dq 3 latest 2016 september
dq 1
Discussion Part One (graded)
You are a Family Nurse Practitioneremployed 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 one week ago. You also noted your name printed on the label
as the prescriber. The patient admitted that she called last week concerned
about her cough and spoke to Stephanie. You do not recall having discussed this
patient with Stephanie, nor do the other providers in the practice.

Discussion Question:
What is your next logically sound course of action? Provide
evidence to support your response.

dq 2
Discussion Part Two (graded)
Upon further investigation, you learn that Stephanie spoke
with the patient and called the medication into the patient’s pharmacy without
consulting with a provider. Stephanie claimed that the patient was insistent
about needing a prescription. Since Mrs. Smith was coming into the office the
following week for an appointment, she didn’t think you would mind if the
patient received the prescription early.
Discussion Question:

What are the ethical-legal concerns associated with this
situation? Provide evidence to support your response.

dq 3
Discussion Part Three (graded)
Due to the incident, you are concerned with office policies
and procedure. Upon investigation, you find there isn’t a policy in place to
address non-urgent patient requests for prescriptions.

Discussion Question:
What quality improvement strategies might you implement as
an APN in this practice to safeguard your role and assure patient safety?
Provide evidence to support your response.

NR510 Wk 5 Dq
1, Dq 2 & Dq 3 latest 2016 september
dq 1
Discussion Part One (graded)
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 witnesses several of the clinical staff
have heated arguments with each other, sometimes in patient areas. Today, one
of the back office assistants didn’t come to work. Unfortunately, this pattern
of behavior is not unusual in this practice. Your clinical schedule is
especially busy. Working without appropriate office staff will negatively
influence your ability to spend time with patients, impede the flow of patients
through the office, and could impact patient safety.
Discussion Question:
How should you logically respond in this situation? Provide
rationales and evidence to support your decisions.
dq 2
Discussion Part Two (graded)
Leadership is not random. It is multifaceted and must be
communicated as a stated plan to effect a change. Organizational leaders
provide a vision and move others toward a common goal.
Discussion Question:
In this scenario, what evidence-based organizational
strategies and management skills might you employ to resolve co-worker
conflict? Provide evidence and rationales to support your decisions.
dq 3
Discussion Part Three (graded)
According to Buppert (2011), quality improvement and patient
safety are inextricably intertwined. A work environ­ment that sup­ports
teamwork and respect for other people is essential to promote patient safety
and quality of care. Unprofessional behavior is disruptive and adversely
impacts patient and staff satisfaction, the recruitment and retention of
healthcare professionals, communication, teamwork and undermines a culture of
safety. Unprofessional behavior is therefore unacceptable.
Discussion Question:
How does teamwork increase patient safety? Provide evidence
and rationales to support your decisions.


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