...Nursing Concepts of Professional Nursing Practice BSN 306, Section 05 Anne Johnston-Silverberg, MS, FNPc September 14, 2012 The Affordable Care Act: The Role of the Nurse Practitioner The recent implementation of the Affordable Care Act (ACA) has had a significant impact on the American health care delivery systems. The passage of this bill mandates that all Americans must have health care coverage and that insurance companies cannot disqualify applicants due to preexisting conditions (National Council of State Boards of Nursing, 2014). These changes will undoubtedly lead to an increase in the number of people seeking medical care, particularly those with chronic diseases. It is estimated that this influx in the number of patients will result in a primary care provider shortage of 20% by the year 2025 (Poghosyan, Boyd & Knutson, 2014). With many new physicians choosing to pursue specialties due to the promise of a larger salary, hospitals and clinics will need to start looking to other health care providers, such as nurse practitioners, to fill this role. The purpose of this paper is to discuss the role nurse practitioners play with regards to the Affordable Care Act by examining the history and qualifications of nurse practitioners, the current practice of nurse practitioners, the basics of the Affordable Care Act legislation, and potential nursing challenges. History of Nurse Practitioners The role of the modern day nurse practitioner emerged in the late 1960’s out of...
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...with an Advanced Practice Nurse Introduction Interview with APN/CNP, Diane John Diane John, APN/CNP is a nurse practitioner at Health land, a Hawaii center for the public. She has devoted 30 years to her nursing career. She has worked as a nurse in a medical intensive care unit and as a research nurse in the study in the intensive care unit. She has been a Female Nurse Practitioner for the past 20 years where she started out as a midwife at wife care center, where she provided midwife services to women. Rationale for an engaged interview process The reason for this interview is to find out Competencies necessary for APN role development and also to get some background information of a nurse leader on a one on one basis. This information will be important because it will help us to develop leadership skills in the field of nursing. About the Diane John APN leader Diane John, APN/CNP is an attendant specialist at Health land, a Hawaii community for the general population. She has dedicated 30 years to her nursing profession. She has filled in as an attendant in a restorative emergency unit as a examination nurture in the study in the emergency unit. Interview What is the CNS nurse? The CNS is a practice for preparing advance practice nurses to be part of the clinical practice team where you work together with doctors to provide service to patients.Bringing knowledge into practice to improve health outcomes of patients as well as improvement of education of nurses. What is your...
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...workforce as a whole. This report advocated for many changes in the practice of nursing. Such changes include enhancing nursing education to provide better quality patient care. The report also stresses the benefits of nurses actively partaking in leadership roles when treating patients. Moreover, the report suggests ways for nurses to be better practitioners at the community and national levels. Through these propositions, the IOM report has made a positive impact on the profession of nursing. The IOM report emphasizes the importance of education for nurses. The report recommends elevating the current standard of nursing education so that the basic requirement for licensure is a baccalaureate degree. The report cites that there is a positive correlation between the number of nurses with a BSN degree and improved patient outcomes. (Cronenwett, 2011), This suggests that the baccalaureate nurses are better equipped to provide quality patient care. Furthermore, IOM advises changing the existing nursing curriculum to implement focus on interpersonal collaboration and communication. This is crucial because the health care team involves many different disciplines including; physicians, pharmacists, therapists, and social workers etc. The communication and collaboration between all of these professionals contributes to a better quality outcome. The IOM report implores that nurses should be life long learners. Thus, nurses must be up to date with the...
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...Critical Analysis of a Quantitative Study Introduction Research analyzing is a process in which a research undergoes a careful examination for its strength and weakness. Analyzing a research gives the nurse a chance to know the credibility of the study, its findings to see the evidence base for practice or utilization or application of the findings into the care practice. This paper is about analysis of a research conducted in relation to wound care in primary health care. This research took place in Stockholm, Sweden. The study shows a descriptive quantitative approach in investigating district nurse wound care management. Protection of Human Participants For this study district nurses (DNs) working at primary health care centers (PHCs) were randomly selected, to make sure that differences between sample and population are a function of chance. The nurses got information in writing and verbally the reason for the study and that the information used will be confidential. Participants remained anonymous in the results presentation. Ethics Research Committee at Karolinska Institute gave an approval for the research proposed. In addition, the researchers got permission from director in each health care to obtain samples. Twenty-three primary healthcare centers met the research criteria but only five randomly were selected from Stockholm, Sweden and two sub-urbs for the study. No force for participation found. Data Collection The study involved a survey based on the...
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...ADVANCED NURSING ROLES BROWN_K_W5A2_SU_NSG5000 Kerry Ann Brown South University Due to the changing health care environment, the nursing profession is currently in a process of evolution. Scopes of practice and role expansions are being prepared. Some of these roles are traditional, such as nurse practitioners who have been fighting for equality and recognition since the early 19th century. With the advent of technological advancements in health care new roles such as nurse informaticists, recognized as a specialty in the later part of the 20th century, are being put into practice and defined. More responsibilities are being given to the nursing profession due to its knowledge base within the constructs of organization, implementation, and evaluation skills with a human approach. During the context of this class much knowledge was gained in respect to the nurse practitioner (NP), nurse administrator, nurse educator, and nurse informaticist (nurse informatics specialist). Because health care is changing, the aforementioned roles are also evolving, this paper will explore the commonalities with each advance practice role and analyze the roles and contributions of the nurse informatics specialist. The nurse practitioner is a postgraduate prepared registered nurse, who has either a master’s degree or doctorate. Upon graduation, NPs possess a wealth of knowledge allowing them to independently manage direct clinical aspects of patient-centered holistic care (Hamric, Hanson...
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...to be resolved. The public policy question that warrants further inquiry and needs to be addressed is section 3502 of PL111-148 does not include nurse practitioners. The public policy question is: Should the federal government mandate inclusion of nurse practitioners. The resolution to the public policy problem is to amend section 2703 of PL 111-148 to say: Section 3503 would include nurse practitioners provided they are practicing with and/or under a licensed health care professional. “Coupled with an estimated shortage of over 60,000 primary care physicians, the country's public health care system will be at a challenging crossroads, as there will be more patients waiting to see fewer doctors. Nurse practitioners (NPs) can help to ease this crisis” (Hansen-Turton et. al, 2013). Nurse practitioners are health care professionals who are more than capable of providing and critical access to primary care, particularly for vulnerable populations. Nurse practitioners are vital resources to help rural hospitals, create more financial sustainability by reducing costs to per patient, and maximizing patient outcomes. It would be extremely advantageous to expand the roles of NPs to include preventive services (Marsh, Diers, & Jenkins, 2012). It is vital for the sake of the nation's healthcare to break the barriers preventing nurse practitioner to provide care for the patient-centered medical home (Auerbach et. al, 2013). Measurable Goals for the Proposed Amendment 1. As a result...
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...patients to be seen in a timely manner. The effective utilization of advanced practice registered nurses (APRN) is vital to successfully evaluating and treating this influx of patients that is flooding the medical market. As healthcare expenses continue to rise, it is imperative that we look for ways to reduce medical costs. Research shows that the use of APRN’s definitely helps with provider coverage and reducing costs. When looking at the cost efficiency between an APRN and a physician, it is essential to look at a couple of aspects. It is significantly cheaper to educate the APRN....
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...Bachelors in science in nursing is that a BSN nurses are better prepared in medical setting vs. an ADN nurse especially in the acute care settings. Hospitals want nursing to be better prepared especially with all the advancements in the medical field. “The complexity of medical and surgical interventions undertaken in hospitals requires an even bigger and more sophisticated clinical workforce” (Altamann 2011). A lot of ADNs do not have the complexity or the critical thinking as do BSNs do. ADN nurses only have 2 years to complete their program, therefore their programs are usually shortened in order to meet the 2 years, and also this program main purpose is hands on skills. The ADN program provided clinical skills so that a nurse could work in a clinical set up and do required tasks, it was all about looking after the patients, routine care and doing what the physician or practitioner told them to do. The most obvious reason nursing student chose to get their ADN is for the financial advantage and that it less time to complete their program. Many community colleges for nursing cost less money each semester to attend full time. Attending community college gives nursing students the chance to prepare for the financial demands of a 4-year university if they plan on transferring. If transferring were something the student would like to do. Some students are able to get scholarships and are able to transfer to a university. BSN nurses it different not only it is a 4-year degree...
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...nonprofit institution that provides independent, objective analysis and advice to the nation” and “the IOM’s aim is to help those in government and the private sector make informed health decisions by providing evidence” (The National Academies of Science, Engineering, Medicine) that are reliable and straightforward, all aimed at improving health. The IOM has been developing and publishing reports on health care issues for many years, and one of which is The Future of Nursing: Leading Change, Advancing Health, published in 2010. This report had impact, and will continuously do so, on the nursing profession, especially related to nursing education, nursing practice, and nurse’s role as a leader. Related to nursing education, IOM’s 2010 report recommends that all nurses should “achieve higher levels of education and training through an improved education system that promotes seamless academic progression” (Future of Nursing, 2010). The report also mentions that due to the changes in the nation’s demographics as well as health care needs, the ways of education during the 20th century are not appropriate anymore in dealing with health care in the 21st century. The report of IOM 2010 also recommends that “80% of nurses should be baccalaureate prepared and the number of doctorally prepared nurses should double by 2020” (Chard, R., 2013). In order to comply with the IOM recommendations and increasing patient demanding and complexity in providing care, nurses should advance knowledge and skill...
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...Systematic Review Analysis: “A systematic review of nurses’ inter-shift handoff reports in acute care hospitals” 2013 Outline: A) Introduction. B) Article Analysis. C) Conclusion. Thesis: The present paper provides the analysis of the systematic review “A systematic review of nurses’ inter-shift handoff reports in acute care hospitals” by Poletick & Holly (2010). The influence of this review on clinical practice is discussed. The article “A systematic review of nurses’ inter-shift handoff reports in acute care hospitals” by Poletick & Holly (2010) provides the systematic review of the handoff reports between and among the nurses which ensure the quality exchange of information for the improved health care service. The continuity of care is the major concern for nurses, and the procedure of patient care transfer should take that into account. The objective of the review was stated clearly and mentioned the appraisal and synthesis of the qualitative evidence related to the nursing handoff report. Moreover, the authors aimed at recommending the improvements which would facilitate and enhance the information transfer. by reviewing the qualitative studies which dealt with the real experience of nurses with their inter-shift handoff reports. As the authors admit, this is likely to contribute to the improvement of the patient care. The conclusion on the potential...
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...work as a community nurse and I have recently become intrigued about one of my patients requiring treatment for a leg ulcer. For the purpose of this assignment I shall call her MA, because as a nurse and a professional I have professional and ethical duty to protect patient identities (Quacker Nursing Council [QNC]2010). My rationale for selection of topic is that Leg ulcers (LU) cost this country’s health service an estimated 200million quars per year in hospitalisation fees for those individuals who do not have health insurance (Quacker Health Board [QHB] 2012, Wilson 2010). An outline of LU is provided in Appendix One, while Appendix two provides a synopsis of MA and her LU. Community nurses are increasingly seeing patients with LU as insurers only pay for three episodes of treatment for one condition (Medins 2011). This disadvantages those patients like MA, as if they have a long term or chronic condition they may not receive treatment or care and this in turn will raise the country’s morbidity and mortality rates. In the UK the Government provides all healthcare free at the point of delivery and prevention of ill- Health and patient’s taking responsibility for managing their own illness or disease is viewed as an important Public Health Strategy ( DH 2010). In this assignment I will discuss strengths and limitations of evidence based practice (EBP),sourcing different forms of evidence which will enable me to provide the best evidence-based practice I can for my patients...
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...Incidence of Counseling in Obese Adult Patients by Nurse Practitioners in the Primary Care Setting NaliniAnumula, Andrew Lebson, Katherine Wiggins Instructor: Dr. Colleen Carmody NURP 507 Simmons School of Nursing and Health Sciences Incidence of Counseling Obese Adult Patients by Nurse Practitioners in the Primary Care Setting Background Obesity is an increasing epidemic. In the United States, more than 60 million or one in every three adults are obese as defined by Body Mass Index (BMI). Obesity is defined as a BMI greater than or equal to 30 (CDC, 2015). Successful treatment methods have been identified for reducing weight which include increasing physical activity and decreasing caloric intake. Exercise and physical activity have been shown to not only lose weight, but also improve cardiovascular functioning, lower blood pressure, and lower serum cholesterol levels (Porth, 2011, p. 232). Exercise also lowers blood sugar levels, improves insulin response in the body, and can decrease stress and anxiety; the opposite of each has been associated with obesity. A diet low in saturated fat and simple carbohydrates can improve the body’s insulin response, decrease adipose tissue, increase the body’s metabolic functioning ability (Porth, 2011, p. 232) and thereby reduce one’s BMI. Though obesity may be preventable and treatable through diet changes and exercise, reducing the rates is proving to be very difficult (Briscoe & Berry, 2009, p. 164).Professional medical...
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...PORTFOLIO INTRODUCTION As part of our acceptance onto the NMC register for nurses and midwives we agree to ‘facilitate students and others to develop their confidence.’ (NMC 2008) In 2006 new guidelines were developed for registered nurses to ensure we are able to provide a supportive learning environment for students and to carry out meaningful assessments so we can guarantee our future nurses are safe, skilled and competent practitioners and pose no threat to the public. (NMC 2006) These guidelines identified and formalised the qualities required of a successful mentor and allowed mentors to apply standards consistently to any learner. The development of the portfolio is a result of a working group consisting of representatives from different areas of health education departments and N.H.S. boards. The outcome was ‘The Core Curriculum Framework’ which is the structure in place to help mentors support students in a consistent and recognisable way. (NHS Education for Scotland 2006) In a study by Watson and Harris (1999) 46% of mentors agreed that students were sometimes allowed to pass practice placements despite an unsatisfactory performance. A variety of reasons where identified i.e. inexperienced mentors lacking confidence to fail a student, unwilling to fail students early in their course hoping they improve with experience and marginal students given the benefit of the doubt because mentors don’t want to be responsible for having a student terminated from their course...
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...- Services, Inc. | I recommend Our Company make a charitable contribution to Services, Inc. based on an examination of their Form 990. Services has program services expenses totaling $2,892,058 with a program efficiency ratio of nearly 81% while management and general expenses represent only 17% of $3,545,504 in revenue. Services, Inc. has an annual growth rate of 2.32% based on total revenues reported on their form 990 between 2011 and 2013. Services also follows good governance practice and has shown that its programs and activities align with their mission. “Empowering youth to overcome barriers and strive towards healthy and self-sufficient lives” is the mission statement of Services, Inc. Services accomplishes their mission by providing integrated mental health, medical and family planning, and case management services in a manner sensitive to adolescents. They also offer a special prenatal program that offers services by a prenatal specialist, nurse midwife, and nurse practitioner. The program also offers nutritional counseling and an outreach program offers classes, support, and education. Mental health services provide individual, group, and family counseling either through their organization or at St. Paul schools that are designed to treat adolescent issues and problems such as depression, school issues, relationship problems, abuse, family problems, and stress. Services also offer a variety of support groups. In addition, they provide services specifically...
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...underestimated. Much of the research undertaken to date in relation to adverse medication events has neglected the impact that nurses have or could have in improving patient safety. In examining literature regarding adverse medication events one can see the urgent need for significant improvement in medication practices and processes. In addition that this health care issue will only improve with the participation of all disciplines working towards a common goal of improving the safety of those in our care. Introduction Medications play a key role in healthcare but can also be a significant key cause of medical error and of adverse patient outcomes. Nurses by the nature of their roles in medication administration can be the last line of defense in eliminating or reducing adverse medication events. The administration of medication is a common and almost routine activity in a nurse’s daily work, yet it is fraught with complexity and risk for both the patient and nurse. As a student nurse working in partnership with a registered nurse I have observed a variety of practices in medication administration that have varied from what I have been taught in class. On reflecting on these practices and questioning nurses why such practice has been adopted has illustrated to me both the flawed processes and environment that nurses provide care in. Nurses will need to develop an understanding of how the environment they work in and within the systems that are currently in place can...
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