NUR601 - Test 1 Study Guide 2023/2024

Define APN and explain how it is currently expanding and evolving answers - As clinicians that blend clinical expertise in diagnosing and treating health conditions with an added emphasis on disease prevention and health management, NPs bring a comprehensive perspective to health care. Education-MSN or higher degree, 3 Ps, advanced practice nursing focus in a clinical concentration (6 population foci) Clinical knowledge Assessment skills Nursing care now reflects a patient-centered approach based on nursing theory and shaped by a nursing process of reasoning Nurses are now accountable to a definition of practice that recognizes and codifies practice in accordance with current nursing knowledge and clinical practice standards Dunphy says changes in nurse practice precede educational and regulations Articulate the history, similarities, and differences of each of the traditional roles categorized as APN. answers - Similar: 1. They are "new permutations of longstanding nursing commitments." 2. They currently all need graduate degrees, certification, licensing, and credentialing 3. They are all professional positions see individual slides Distinguish the role of NP from other care providers (What makes NPs unique)? answers - Unique theoretical knowledge base: expanded by ongoing research Unique legal boundaries Unique profession with a political and social organizational structure Describe the American Association of the Colleges of Nursing (AACN) position statement on the practice doctorate in nursing answers - The doctorate should be the entry level educational credential for advanced practice (2004) by 2015 Identify issues surrounding MSN, DNP and PhD preparation of APNs answers - Educational disparities between APN roles Some believe that allowing the NP dgree will make the PhD less desireable thereby lessening the amount of research available for nurses Discuss the pros and cons of requiring a doctoral education for APN. Consider personal, professional, health care and societal perspectives. answers - Pros and Cons of DNP for entry level pros Parity with other professionals (ie Pharmacy, Psycologists, etc) Putting in enough hours for a Doctorate with masters We are the largest group in the health profession. It makes sense that we should have a doctorate cons Additional education with no increase in pay or scope of practice Large number of nurses who will go to DNP will leave PhD void - need for research Analyze factors in our current health care system that is driving the need for nurses prepared as expert clinicians answers - lack of primary care providers more complex health issues AHCA -Movement into higher education and now to the doctoral level -Emphasis on critical thinking, evidence-based practice, and systems evaluation -Changing patterns of practice Identification of core and specialty competencies -Changing patient needs and populations -Reimbursement and managed care -Movement from institutional to community practice -Growing need for patient advocacy -Pressure to decrease medical resident hours -Changing attitudes about the role of the nurse Review and know the glossary of terms from the NONPF (2012) answers - see individual slides Describe the primary purpose of the American Academy of Nurse Practitioners (AANP), the American Association of NPs (AANP- careful), and the Florida Nurse Practitioner Network (FNPN) answers - see individual slides Discuss the 3 primary reasons for having professional standards when practicing as an APN answers - 1. be accountable and accept responsibility for their actions 2. benefit the public 3. provide access to social mobility Who establishes professional standards for advanced practice nursing? answers - Professional Nurse organizations establish standards of practice 1. State practice act - (created and approved by state legislature) 2. Board of nursing - group of appointed persons who usually represent all levels of nursing practice 3. Nursing Administrative Rules and Regulations - comprise the details of how Nurse Practice Act will be enforced Nurse Midwifery Tradition answers - Helped women who did not have access to care where Nurse anesthetists mostly practice answers - in rural areas Define CNS answers - Roots deep in mainstream nursing Experts in specialty practice focus on secondary and tertiary care settings Working through others CNSs who work in hospitals, can't... answers - bill directly When asked in a survey, only 6% of CNSs could identify ways they answers - generated income When did NA start in US? answers - Sister Mary Bernard, 1887 PhD in nursing difficulties (4) answers - 1 Delayed completion of the degree 2 Proliferation of programs but no significant increase in admissions or graduates 3 Socialization and mentoring into the nurse scientist role difficult to obtain 4 Impact of the faculty shortage Rationale for DNP as entry level educational requirement (4) answers - Current master's too heavy with content and credits Predictions of more knowledge demands in the future Requirement for more supervised practice Many health-care disciplines have already evolved toward a required doctorate Arguments against DNP (4) answers - No data-based evidence Credits could be used more selectively Absence of a cost/benefit analysis To follow the evolution of other professions is a mindless excuse What is the nurse practice act answers - The Nurse Practice Act is a statute created and approved by the state legislature to provide broad guidelines for the practice of nursing. What is the board of nursing answers - Group of appointed persons who usually represent all levels of nursing practice, other health care professionals, and lay citizens. Boards of Nursing are usually responsible for disciplining nurses and creating nursing rules and regulations. What is the Nursing Administrative Rules and Regulations answers - These rules and regulations comprise the details of how the Nurse Practice Act will be enforced. For example, the Nurse Practice Act may require that a nurse graduate from an approved College of Nursing. The administrative rule will describe in detail what is required for a College of Nursing to be approved. The rules are usually proposed by the Board of Nursing, and then they are publicly posted for comment AANC answers - American Academy of Nurse Practitioners promotes credentialing Has info on healthcare and research on health policy ANCC* - what is it and what does it do answers - American Nurses' Credentialing Center (Dr. Stevens likes this one) Works with ANA to promote quality healthcare through CREDENTIALING programs for individuals (certifications for NPs) Accredits healthcare organizations that provide and approve continuing education AANP answers - American Association of NPs Primarily on health policy: to improve pt safety and access to care Defend NPs scope of practice They have a journal FNPN answers - Florida Nurse Practitioner Network 1. networking 2. career and educational opportunities for NPs and Student NPs 3. event and conferences state practice act answers - (created and approved by state legislature) board of nursing answers - group of appointed persons who usually represent all levels of nursing practice Nursing Administrative Rules and Regulations comprise the details of how what will be enforced answers - comprise the details of how Nurse Practice Act will be enforced care process answers - Actions or changes that occur during the delivery of health care. Clinical Investigative Skills answers - Those skills needed to conduct inquiry of practice questions/therapies, evaluate discovered evidence, and then translate it into practice. Cultural Diversity answers - Common beliefs, values, practices and behaviors shared by multiple subgroups or individuals. Culture of excellence answers - The environment developed through the internalization of core values and a shared commitment in which the highest standards of personal integrity, professionalism, and clinical expertise are upheld. Evidence-based practice answers - The "conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. Individual clinical expertise is integrated with the best available external evidence from systematic research." (modified from Sackett, 1996). Globilization answers - The interrelated influence of actions, resources, cultures, and economies across nations. what is Health Policy and what does it influence answers - The set of decisions pertaining to health whether made at local, state, national, and global levels that influences health resource allocation. Independent Practice answers - Recognizes independent licensure of nurse practitioners who provide autonomous care and promote implementation of the full scope of practice. Information literacy answers - The use of digital technology, communications tools, and/or networks to access, manage, integrate, evaluate, create, and effectively communicate information Interprofessional Practice answers - Occurs when multiple health workers from different professional backgrounds work together with patients, families, and communities to deliver the highest quality of care. Interprofessional education answers - When two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes. Knowledge management answers - Strategies that identify, create, represent, distribute, and enable the efficient use of all types of information. Licensed independent practitioner answers - An individual with a recognized scientific knowledge base that is permitted by law to provide care and services without direction or supervision. Quality care answers - The degree to which health services to individuals and populations increase the desired health outcomes consistent with professional knowledge and standards. Quality care also means avoiding underuse, overuse, and misuse of health care services. Patient centered care answers - Care based on a partnership between the patient and health care provider that is focused on the patient's values, preferences, and needs. Peer review answers - Evaluation of the processes and/or outcomes of care by professionals with similar knowledge, skills and abilities. History of Midwifery answers - up until 1910 50% of births in US done by midwifery - determined to be not in the public interest - medical OBs felt they should be in control - moved from homes to hospitals Breckenridge saw autonomy as possible, saw the British model - care of mothers and babies - 1920's - legislation to provide funds for midwives due to poor mortality rate among birthing moms and children before 1 year old *certifies non nurses as midwives - they conceptualize themselves as a mix between nurses and midwives History of NAs answers - Bernard 1877 nurses were first anaesthetists as no one with medical training wanted to do it Alice Magaw - provided anaesthesia to over 3000 patients by 1899 - comfort for patients primary were not able to join ANA b/c ANA thought the anaesthetists were practicing medicine. History of CNS answers - More traditional nurse role - more trained in specific patient Francis Reiter 1943 believed the final stage of the CNS should be collaborating with the doctor and have mutual responsibility for the pt Hildegard Peplau - 1953 trained psych nurses to provide direct care Also rejected by ANA role expansion in the 1960s - medical tech, complex health issues, nurses coming back from Vietnam. Nurse training act 1964 - funding for nurses training Hx of NPs answers - Dr. Stead - tried - decided to go with PAs 1960s - nurses better educated Ford and Silva - collaboration between doctor and nurse - geared for poor rural children Collaboration between NP and doctor has been debated Mostly served in areas with great need consensus model still battling for autonomy Why did the role of NP initiate (5, kind of 6) answers - less medical students choosing primary care (only 7%?) reluctance of doctors to practice in underserved or rural areas healthy people 2020 - access for all Americans to quality health care Need good leaders and managers given the flux of our current nurses ever since they started limiting hours for residents in hospitals something about labor and delivery For the state of Florida describe the certification process, licensure, and certification maintenance for the ARNP answers - Cert = degree, exam, (need online application, RN license) Licensure = RN license upgrade fee, pass test, malpractice ins or proof of exemption, fingerprints Maintenance = see other slide Describe the purpose of the Consensus Model. answers - A model of regulation for future of advanced practice nursing designed to align the interrelationships among licensure, accreditation, certification, and education. - should enhance nurse practice and patient care What is the consensus model? (LACE) answers - Licensure - see above (need cert first) Accreditation - Formal review by accredited agency (State and institution? - the education institution must be accredited? or the nurse?) Certification - see above Education - Masters or higher - 3 Ps, clinical experience and knowledge Describe the benefits of the consensus model (3) answers - 1. The uniformity will enable APRNs to practice to the full extent of their education and licensure 2. Provide new opportunities for nurses through the possibility of ease of mobility across the state lines 3. Increase job satisfaction through opportunities to practice more independently Distinguish different methods of professional credentialing answers - Federal, State, institutional, probably more Discuss regulation of APNs answers - Boards of Nursing are state gov't agencies that regulate nursing practice. They: 1. oversee the safe practice of nursing. 2. They outline standards of safe nursing care 3. issue licenses 4. monitor licensee's compliance to law Discuss scope of practice for APN roles and responsibilities. answers - 4 APRN roles - population foci - the APRN will be licensed for one of the 4 roles within at least one of the 6 population foci Who regulates the APN answers - Boards of nursing What factors have contributed to the development of APN roles? (6) answers - Changing patient needs and populations Reimbursement and managed care Movement from institutional to community practice Growing need for patient advocacy Pressure to decrease medical resident hours Changing attitudes about the role of the nurse SN - What the population needs drives what we practice Identify essential professional organizations answers - ... What is the purpose of the AANP answers - ... What is the purpose of the American Association of NPs answers - ... What is the purpose of the FNPN answers - provide networking opportunities, professional and educational development for all NPs in FL, serve as resource by promoting research, educational opportunities, and excellence in practice Describe essential characteristics of the APRN - schooling, licensing, skills, etc answers - 1. completion of graduate level program in one of the 4 areas 2. national cert exam 3. Clinical knowledge, skills, education, and practice for direct patient care 4. Practice builds on RN competencies - knowledge, data synthesis, complex skills, intervention, role autonomy 5. License to practice What are examples of core competencies? (4) answers - Bioethical integrity act as advocate and guide patients strive to be expe