NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion
Chamberlain University NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion– Step-By-Step Guide
This guide will demonstrate how to complete the Chamberlain University NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion
Whether one passes or fails an academic assignment such as the Chamberlain University NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion
The introduction for the Chamberlain University NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
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How to Write the Body for NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion
After the introduction, move into the main part of the NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion
I appreciate your honesty. I also feel that most NPs are not fully aware of the regulations governing practice in their respective states, nor are NPs fully aware of the liabilities associated with the various APN roles. Even if current and future NPs feel they are knowledgeable about both topics, regulations governing practice and liabilities, they should constantly educate themselves on these matters. In nursing, laws and acceptable practices change all the time. NPs must know the current laws guiding practice at all times. We already know that most physicians view NPs as a threat and that most insurance companies and state/federal policies regarding NPs scope of practice are slow to change; therefore, we must protect ourselves and our profession. The Oregon Nurses Association (2018) has re-posted an article by the Journal for Nurse Practitioners that discusses/gives an overview of APN/NP liability claims. The article contends since the NPs role in healthcare has broadened, it is important that NPs review liability claims to develop “useful risk-management strategies” (Oregon Nurses Association, 2018).
References
Oregon Nurses Association. (2018). The journal for nurse practitioners’ article: “NP professional liability: A synopsis of the CNA heal. Retrieved from http://www.oregonrn.org/?389
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Sample Answer for NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion
As their scope of practice and autonomy increases, NPs are being held legally accountable for their actions (Iglehart, 2013). Nurse practitioners must pass classes and certification requirements regarding understanding the legal obligations of prescribing medications (Iglehart, 2013). Regardless of an NPs scope of prescriptive authority, the standard of practice and care is to ensure that any medication prescribed is compatible with other medications a patient is taking and that the correct medication is prescribed. The $525,000 settlement awarded to Sherry Huelskamp (Huelskamp v.Patients First Health Care, LLC) in 2014 against nurse practitioner Barbara King for prescribing the wrong medication emphasizes these standards.
The four APN roles currently defined in practice are Nurse Practitioners (NP), Clinical Nurse Specialists (CNS), Certified Nurse-midwives (CNM), Certified Nurse Anesthetists (CNA). A CNS typically works in a specialized area of nursing practice defined by parameters, such as disease, setting, population (Judge-Ellis & Wilson, 2017). The CNA is restricted to administering pre- and post-anesthesia care to patients for surgery and other procedures. The CNM provides healthcare services to women, such as gynecological services, pregnancy and childbirth care, postpartum services, etc. Jessica will do well in the NP role because of her nursing background and the ability of the NP to serve the same patient populations as the other APN roles. Furthermore, the CNM, CNS, and CNA roles are too restrictive in that nurses who work in these specialized areas of the nursing practice provide distinct services. According to the U.S. Department of Health and Human Services, the most common type of APN is the nurse practitioner (Judge-Ellis & Wilson, 2017). NPs are trained to provide a wide range of primary and acute health care services. NPs diagnose and treat medical conditions, as the scope of practice has expanded to allow NPs to perform many of the same medical services as a physician to include writing prescriptions in approximately 20 states (Judge-Ellis & Wilson, 2017). The median annual salary for NPs is $103,000 (Judge-Ellis & Wilson, 2017). In the other APN roles, Jessica would have to obtain further training if she wanted to expand her scope of practice.
References:
Iglehart, J. K. (2013). Expanding the role of advanced nurse practitioners, risks and rewards. New England Journal of Medicine, 368(1935). Retrieved from DOI: 10.1056/NEJMhpr1301084
Judge-Ellis, T., & Wilson, T. R. (2017). Time and NP practice: Naming, claiming, and explaining the role of nurse practitioners. The Journal for Nurse Practitioners, 139(9), 583-589. Retrieved from DOI: https://doi.org/10.1016/j.nurpra.2017.06.024
Sample Answer 3 for NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion
Currently, certain rules must be followed to determine if the NP is reimbursed 100 percent. NP billing is done one of two ways: independent or “incident-to”. Independent billing is allowed when the patient is billed directly under the National Provider Identification (NPI) number of the NP providing the service. Incident-to billing occurs if the patient is treated by an NP, but the bill is submitted using the doctor’s NPI number. The first thing that needs to change are measures that require NPs to bill for their services under a physician-colleague’s name and provider number (Pickard, 2014). This makes it look like the NP cannot do his or her job without guidance like an intern; therefore, third party payers do not feel NPs should command top dollar for their services (Pickard, 2014). Furthermore, the difference in reimbursement has to do with multiple regulatory factors: billing guidelines at the state and federal level; credentialing, whether the patient is designated as outpatient or inpatient, and third-party payer policies (NAPNAP, 2018). Billing regulations must be strictly followed because they determine how much the NP can charge for his or her services, govern what services NPs can provide, who they provide services to, where these services can be rendered (NAPNAP, 2018). Each third-party payer (i.e. commercial or government insurer) has different rules on reimbursing NP services on these grounds. For example, reimbursement from private insurance agencies is distinct from the Medicare reimbursement process and may require a credentialing process. In order for reimbursement rates across the roles to be equal, third party payers, such as Medicaid and private insurers, would have to agree on service costs and reimbursement scales (Pickard, 2014). This is unlikely to happen for quite some time since the difference in reimbursement rates has to do with the bundling of services and who pays the bulk of the bill. While the billing process is meant to reflect the NPs productivity, I believe the current billing process is biased toward NPs and favors physicians when both parties provide the same service simply because of the title after the name. For example, if the Physicians Fee Schedule rate for a preventative care visit is $100, Medicare pays the physician $80; the patient then pays the $20 balance to the physician. If an NP performs the same service, Medicare pays the NP $68; the patient pays the NP $17. NPs should be reimbursed the same amount when performing the same service; the only way this will change is for NPs to document the clinical and financial outcomes related to the care they provide (Pickard, 2014). Consistent and thorough documentation from all NPs will support changes in coverage and reimbursement rules (Pickard, 2014).
References:
National Association of Pediatric Nurse Practitioners (NAPNAP). (2018). NP billing, coding, and reimbursement. Retrieved from https://www.napnapcareerguide.com/np-billing-coding-reimbursement/
Pickard, T. (2014). Calculating your worth: Understanding productivity and value. Journal of the Advanced Practitioner in Oncology, 5(2), 128–133. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093517/
Sample Answer 4 for NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion
The friend is correct when she tells Jessica she can write prescriptions and the doctor is over her (depending on the state she practices in), but as an APN, she is still responsible and accountable for her care and actions.
The CNP (Nurse Practitioner) has been popular due to the increased patient population with diverse needs and a decrease in primary care providers (Poghosyan, Liu, & Norful, 2017). Most NPs work in ambulatory or primary care settings but can work with many different specialties according to the facility (Poghosyan et al., 2017). NPs are more affordable because they make less than doctors, most taking their own patient load (Poghosyan et al., 2017). They practice under state scope of regulations, with some being allowed to prescribe medications and some under physician supervision (Poghosyan et al., 2017).
The CRNA (Nurse Anesthetist) can practice in every healthcare setting in the US to deliver anesthesia to patients (Tracy, 2017). CRNAs can be the sole anesthesia provider in some rural settings (Tracy, 2017). CRNAs have different training in school, and their education is different from the other APN roles (Tracy, 2017). The AANA determines their scope of practice, but most work under an anesthesiologist, possibly limiting their full scope (Neft, Okechukwu, Grant, & Reede, 2013). They have great salaries compared to other APNs.
A CNS (Nurse Specialist) is mostly responsible for an entire healthcare system or a facility at a time (Romp & Cecil, 2017). They influence patients, nurses, and the healthcare organization as a whole (Romp & Cecil, 2017). They need to promote education, change, and advancement (Romp & Cecil, 2017). CNSs can have prescription rights in some states, so they should be prepared to diagnose and treat patients, although scope could be limited by the state lived in (Mohr & Coke, 2018). They can also specialize in a particular patient population (ex: diabetes). They can practice in clinics, ICUs, or specialty clinics, billing patients for services (Mohr & Coke, 2018).
Lastly, a CNM (midwife) is an independent provider of healthcare to women and newborns (). They provide treatment from adolescence through menopause, STD treatment, and care of the healthy newborn for the first 28 days (AWHONN, 2016). They can work in clinics, birthing centers, home, office, or hospital (AWHONN, 2016). They have prescription rights in all states and refer to specialist doctors if patient conditions are outside of the CNMs scope of practice (AWHONN, 2016). CNMs get Medicaid reimbursement the same as physicians (AWHONN, 2016).
Each of these APN specialties are unique. There are many pros and cons for Jessica to consider. She could make a more significant impact on patient care with all of these. With higher education comes greater responsibility. She has patient lives in her hand. A CRNA is responsible for putting people to sleep and waking them up. If she is not ready for the significant responsibility, she should not do that. Depending on the state she lives in, she could write prescriptions, diagnose, and treat. A CNM can provide independent gynecologic and obstetric care. If she would prefer working with or under a doctor, she should consider eliminating that option. CNS job description seems closest to administration, while still impacting patients for the better. She could still specialize in the people she treats or a higher management style position. If she wants more one on one patient care, a CNP is a good option. I think a CNS degree is what Jessica should pursue.
AWHONN (2016). AWHONN position statement: Midwifery. Nursing for Women’s Health, 20(3), 320-323. doi:10.1016/S1751-4851(16)30144-1
Poghosyan, L., Liu, J., & Norful, A. A. (2017). Nurse practitioners as primary care providers with their own patient panels and organizational structures: A cross-sectional study. International Journal of Nursing Studies, 74, 1-7. doi:10.1016/j.ijnurstu.2017.05.004
Tracy, A. (2017). Perceptions of certified registered nurse anesthetists on factors affecting their transition from student. AANA Journal, 85(6), 438-444.
Neft, M., Okechukwu, K., Grant, P., & Reede, L. (2013). The revised scope of nurse anesthesia practice embodies the broad continuum of nurse anesthesia services. AANA Journal, 81(5), 347-350.
Romp, C. R., & Cecil, M. J. (2017). Issues in advanced practice. Remote clinical nurse specialist: Making a difference from a distance. AACN Advanced Critical Care, 28(4), 314-318. doi:10.4037/aacnacc2017501 Mohr, L. D., & Coke, L. A. (2018). Distinguishing the clinical nurse specialist from other graduate nursing roles. Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 32(3), 139-151. doi:10.1097/NUR.0000000000000373
Sample Answer 5 for NR 510 Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion
Although Jessica’s colleague’s statement may have sounded great, there is more truth to it than that. Even though as an NP you are working under a physician, you are still held accountable for all the ways you are treating your patients and everything you are prescribing.
The four roles of the APN are: Certified registered nurse anesthetist (CRNA), certified nurse midwife (CNM), clinical nurse specialist (CNS), and certified nurse practitioner (CNP). CRNAs provide anesthetics to patients in every practice setting, and for every type of surgery or procedure. They solely take care of patients who receive anesthesia (Cahill, 2014). Some cons for a CRNA is that the role requires a great amount of education and the job can require irregular and long hours, and you’ll need to be available for some emergency and off-hour situations. The CNM can provide prenatal care as well as care during labor and delivery care, and gynecological care. CNMs also provide family-centered primary healthcare to women throughout their reproductive part of life (Cahill, 2014). The pros of being a CNM is having the opportunity of being the primary care provider throughout your patient’s prenatal care, labor, birth, and postpartum care, developing closer relationship with the patient’s family. You will have the opportunity to make a difference and support choices in labor and birth. The con of being a CNM is the hours. You will have to be on call. CNS are APNs who hold a master’s or doctoral degree in a specialized area of nursing practice. The CNS can provide acute and chronic care management and as well as education and advocacy. A con for a CNS can be time consuming and costly, but the pro is there is a wide variety of career options to choose from. Certified Nurse practitioners (also referred to as advanced practice nurses, or APNs) have a master’s degree in nursing and board certification in their specialty. Nurse Practitioner can work in any field of nursing, whether its pediatrics, clinics, hospitals and so forth. (Lampe, 2013). Being a CNP can be stressful due to the amount of autonomy, but this is also a pro since making decisions on patient care is the reason a lot of nurses become a CNP (Parahoo, 2014).
Cahill, M., Alexander, M. (2014). The 2014 NCSBN Consensus Report on APRN Regulation. Journal of Nursing Regulation. 4(4), 5-12.
Lampe, J. S., Geddie, P. I., Aguirre, L., & Sole, M. L. (2013). Finding the Right Fit: Implementation of a Structured Interviewing Process For Clinical Nurse Specialists . AACN Advanced Critical Care, 24(2),194-202. doi: 10.1097/NCI.0b013e31828a0b1f
Parahoo, K. (2014). Nursing Research: Principles, Process and Issues. Retrieved from http://www.scirp.org/(S(czeh2tfqyw2orz553k1w0r45))/reference/Links to an external site.ReferencesPapers.aspx?ReferenceID=1982958