Advance Primary Care Iii 19453425

  

In this assignment I need a peer response for the main discussion, that show below.

The peer’s responses

Discussion Grading Criteria: Agreeing and disagreeing do not mean just voicing one’s opinion. The focus of the discussions should remain on the ideas posed in the readings. Agreeing and disagreeing mean making scholarly arguments from the literature that may support your own ideas. Faculty expects you to support your ideas from the readings or similar scholarly writing about the topic in nursing literature. Always cite your source(s) and reference in APA format.

Remember the post and responses should include scholarly writing about the topic in nursing literature.

Note por the professor:

Hello class,

Please refer to your APA format in your postings. The journal name and volume is italicized font. Ex.

The American Nursing Journal,7(9),,,,

Please update your APA to reflect doi 

Amely Perez Cicili

Advanced Family Practicum III

The application of national health reform with millions of people receiving health insurance service is increasing the current challenges facing primary care. A major issue focuses on how to rise capacity while improving superiority and cost efficacy. Policy makers and researchers are suggesting innovative approaches to guarantee the system is ready as more people are gaining access (Barnes & Novosel, 2018). While some strategies seek to increase the number of primary care providers (PCPs), others seek to encourage efficient use of existing providers. As providers, Nurse Practitioners have faced some challenges in their scope of practice. Three of these challenges are the autonomy in practice, the teamwork with physicians, and limited prescriptive authority.

State and organizational policies generate misunderstanding around NP roles. In some states, regulations require NPs to collaborate or be supervised by physicians, whereas in other states, these regulatory requirements have been removed by policy makers. Similarly, some organizations restrict NP practice or fail to provide necessary support so NPs can maximally contribute their advanced skills to teams. On the other hand, teamwork between NPs and physicians in primary care has received care due to their overlapping scopes of practice and the fact that lack of agreement exists between them about their respective roles. On the contrary, when patient care suffers, fragmented teamwork and poor collaboration and communication between team members are often found to be contributing factors (Poghosyan, Shang, Liu, et al.,2015).

Limited right for prescription and referral challenged the development of APN scope of practice. Some people believe that only a physician should be allowed to diagnose, refer, or treat any medical condition. Independent prescribing by a NP does not require collaboration with a physician and is a key element of scope of practice for NPs, as well as being part of the APRN Consensus Model, which seeks to achieve uniformity of state regulation of APRN practice. However, regardless of the existence of the consensus model, there are extensive disparities among the states with respect to prescriptive authority. In some states, prescriptive authority is granted at the time of APRN licensure; in others, the APRN must apply separately for these privileges. (Gardner, Chang, & Duffield, 2012).

References:

Barnes, H., Novosel, L. M. (2018). A scoping review of nurse practitioner workforce data: Part Two of a four-part series on critical topics identified by the 2015 Research Agenda Roundtable. Journal of the American Association of Nurse Practitioners. Advance online publication. doi:10.1097/JXX.0000000000000069.

Gardner, A., Chang, C., & Duffield, A. D. (2012). Delineating the practice profile of advanced practice nursing: a cross-sectional survey using the modified strong model of advanced practice. J Adv Nurs, 69 (9), pp. 1931-1942. Google Scholar

Poghosyan, L., Shang, J., Liu, J., Liu, N., et al. (2015). Nurse practitioners as primary care providers: creating favorable practice environments in New York State and Massachusetts. Health Care Manag Rev;40(1):46–55. doi: 10.1097/HMR.0000000000000010. [PubMed] [CrossRef] [Google Scholar]

 
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Advance Primary Care Iii 19463455

  

In this assignment I need a peer response for the main discussion, that show below.

The peer’s responses

Discussion Grading Criteria: Agreeing and disagreeing do not mean just voicing one’s opinion. The focus of the discussions should remain on the ideas posed in the readings. Agreeing and disagreeing mean making scholarly arguments from the literature that may support your own ideas. Faculty expects you to support your ideas from the readings or similar scholarly writing about the topic in nursing literature. Always cite your source(s) and reference in APA format.

Remember the post and responses should include scholarly writing about the topic in nursing literature.

Note por the professor:

Hello class,

Please refer to your APA format in your postings. The journal name and volume is italicized font. Ex.

The American Nursing Journal,7(9),,,,

Please update your APA to reflect doi 

Thalia T. Ayra

Advanced Nursing Practice

From above identify three challenges the Advanced Nurse Practitioner  encounter in their Scope of practice (SOP), include them on this week first peer response due.

Scope of practice (SOP) is a cornerstone for professional regulation used by nurse practitioner (NP) licensing boards across the country, usually a state’s Board of Nursing (BON). This concept defines the procedures, actions, and processes that NPs can perform as part of their professional licensure. Regulations are handled by each state and can vary from state to state.

By definition, the SOP for family NPs (FNPs) is broad, with FNPs caring for a wide spectrum of patients (from pediatrics to geriatrics) and domains (private practices to hospital clinics and other outpatient settings, both urban and rural). In some rural or remote settings, FNPs may be the only health care provider available to patients.

The SOP for FNPs could include providing mental health care services, and FNPs in primary care settings often are the first to see patients with common mental illnesses, such as depression and anxiety. In fact, FNPs are increasingly providing mental health care as demand from patients has increased. According to the National Institute of Mental Health, nearly 1 in 5 adults in the United States suffers from a mental illness (44.7 million in 2016). Among adolescents, an estimated 49.5% of young people aged 13 to 18 have had a mental disorder.

Among mental illnesses, major depression is common, with approximately 16.2 million adults (6.7% of all US adults) having had at least 1 major depressive episode. Anxiety disorders also greatly affect US adults, with more than 31% having had an anxiety disorder sometime in their lives. Furthermore, this increase in patient demand has been exacerbated in recent years by a growing shortage of mental health care practitioners, including psychiatrists, whose numbers declined by 10% from 2003 to 2013.7

Although a legal or regulatory concept, the importance of SOP cannot be overstated. FNPs need to be familiar with their state’s SOP to ensure patient safety as well as to protect their professional license, because acting outside of their recognized SOP in any patient care setting could expose them to civil liability and disciplinary actions brought by their BON, with the potential of having their professional licenses revoked.8 This is especially true when treating patients with mental illness or working with behavioral health issues, where an FNP may be trained and have the skills to diagnosis and initially treat mental illness but may be restricted by his or her SOP on the breadth and depth of care permitted.

With that in mind, this article will outline several important SOP issues for FNPs working with patients with mental health issues and provide recommendations to help them ensure best practices and patient safety. The recommendations also will help them avoid blurring the boundaries delineated by their SOPs and protect their professional licenses.

References

American Association of Nurse Practitioners. Scope of Practice. https://www.aanp.org/images/documents/publications/scopeofpractice.pdf. Updated 2015. Accessed August 15, 2018.

Nurse Journal. Role & Scope of Practice of a Family Nurse Practitioner. https://nursejournal.org/family-practice/role-scope-of-practice-of-a-family-nurse-practitioner/

Date accessed: August 15, 2018

 
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Advance Primary Care Iii 19467637

  

In this week will review  Educational Advancement:  The DNP (Doctor of Nursing Practice)/PhD . This topic will guide you and encourage you to take a next step to advance on your professional life.

Topics to review: Joel chapter 4

Suggested readings and Video:  Why should you get a Doctorate in nursing?  https://www.youtube.com/watch?v=q8oR_hVSLyg

Assignment:

Search in scholarly sources the similarities and difference between PhD and DNP.  Post three similarities and three differences found on your research.  Do not forget to include your reference. 

 
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Advance Primary Care Iii

  

Discussion 1
Hi class,

Topics to review during our first week of the course:

· How Healthcare reform is impacting primary care https://www.ajmc.com/contributor/sophiabernazzani/2016/03/howhealthcarereformisimpactingprimarycare 

• Healthcare reform 101: What the health is going on in 2018? https://www.youtube.com/watch?v=cwTWhwWLzHQ  

• Healthcare Transformation and Changing Roles for Nursing https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5266427/pdf/ornur3612.pdf 

Frequently when the shortage of primary care providers is mentioned with regard to healthcare reform, insurance companies and other institutions forget to factor in the impact nurse practitioners can have on increasing access. 

How do you think we can improve this understanding of the nurse practitioner role?

Please submit your initial response 09/07/19 by 11:59 PM.

Thank you

 
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Advance Role Of Nursing Practice Week 1 19399379

 

Based on your selected MSN program (Family Nurse Practitioner FNP) , write your first section of your ROLE paper using the following criteria:

For this assignment, you will research an advanced nursing practice role and summarize your findings in a 3- to 5-page paper (excluding the title page and references):

  • Focusing on the specialty for which you were admitted to South University, select an advanced nursing role to research. (It must be one offered by South University.)
  • Distinguish the role as clinical or non-clinical and how it promotes patient outcomes, ie safety, access to health care or health information relative to the ANP level
  • Apply an Advance Nursing Practice Concept to your chosen role
  •  Develop a minimum of ten questions that you would like to ask the advance practice clinician or non-clinician that you have chosen to interview.  Identify in the paper the individual by name, credentials, position and your planned date for the interview (Interview is due Week 3)
  • Support your findings with at least two research articles (study, design, sample and results must be discussed). Other peer reviewed articles that are non-research and nursing organization websites may be used. All articles must be current (not more than five years old, unless it is a hallmark reference; ieAmerican Association of College of Nursing. (2010)).
  • Format your paper, citations, and references using correct APA Style.
 
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Advance Role Of Nursing Practice Week 1

Instructions

Based on your selected MSN program, (Family nurse practitioner) write your first section of your ROLE paper using the following criteria:

For this assignment, you will research an advanced nursing practice role and summarize your findings in a 3- to 5-page paper (excluding the title page and references):

  • Focusing on the specialty for which you were admitted to South University, select an advanced nursing role to research. (It must be one offered by South University.)
  • Distinguish the role as clinical or non-clinical and how it promotes patient outcomes, ie safety, access to health care or health information relative to the ANP level
  • Apply an Advance Nursing Practice Concept to your chosen role
  •  Develop a minimum of ten questions that you would like to ask the advance practice clinician or non-clinician that you have chosen to interview.  Identify in the paper the individual by name, credentials, position and your planned date for the interview (Interview is due Week 3)
  • Support your findings with at least two research articles (study, design, sample and results must be discussed). Other peer reviewed articles that are non-research and nursing organization websites may be used. All articles must be current (not more than five years old, unless it is a hallmark reference; ieAmerican Association of College of Nursing. (2010)).
  • Format your paper, citations, and references using correct APA Style.

 
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Advance Roles Of Nursing Practice Week 1

 

Based on your selected MSN program (FAMILY NURSE PRACTITIONER) , write your first section of your ROLE paper using the following criteria:

For this assignment, you will research an advanced nursing practice role and summarize your findings in a 3- to 5-page paper (excluding the title page and references):

  • Focusing on the specialty for which you were admitted to South University, select an advanced nursing role to research. (It must be one offered by South University.)
  • Distinguish the role as clinical or non-clinical and how it promotes patient outcomes, ie safety, access to health care or health information relative to the ANP level
  • Apply an Advance Nursing Practice Concept to your chosen role
  •  Develop a minimum of ten questions that you would like to ask the advance practice clinician or non-clinician that you have chosen to interview.  Identify in the paper the individual by name, credentials, position and your planned date for the interview (Interview is due Week 3)
  • Support your findings with at least two research articles (study, design, sample and results must be discussed). Other peer reviewed articles that are non-research and nursing organization websites may be used. All articles must be current (not more than five years old, unless it is a hallmark reference; ieAmerican Association of College of Nursing. (2010)).
  • Format your paper, citations, and references using correct APA Style.

 
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Advance Week 8 Dis 1

 Portal Hypertension and effects of Portal Hypertension. 

 
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Advanced Clinical Inquiry And Systematic Reviews

 

Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

  • Identify and briefly describe your chosen clinical issue of interest.
  • Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
  • Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
  • Provide APA citations of the four peer-reviewed articles you selected.
  • Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples. 
 
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Advanced Coding Em Medicine And Anesthesia

 

1.   Anesthesia administered to a normal, healthy patient undergoing an esophageal procedure is coded as

   A. 00500-P1.   B. 00502-P1.   C. 00500-P2.   D. 00506-P1. 

 

2.   A new patient comes into the doctor’s office for her annual gynecological exam. During the course of the exam, she undergoes a screening cervical cytopathology smear, which is performed by an automated system under the supervision of a physician. What HCPCS code is assigned?

   A. G0185   B. G7869   C. G7452   D. G0147 

 

3.   A new patient is seen for a home visit that involves a comprehensive history, examination, and medical decision making of high complexity. What code should be assigned?

   A. 99349   B. 99345   C. 99342   D. 99350 

 

4.   A prolonged evaluation and management service before and/or after direct patient care for one hour is coded as

   A. 99359.   B. 99358.   C. 99361.   D. 99360. 

 

5.   A 57-year-old patient is admitted to the hospital for a hip arthroscopy procedure. The patient is a normal healthy patient with no systemic disease. What anesthesia CPT code should be assigned?

   A. 01242-P2   B. 01202-P1   C. 01202-P3   D. 01202-P5 

 

6.   Anesthesia for procedures performed on the larynx and trachea in an 11-month-old child would be assigned to code

   A. 00620.   B. 00625.   C. 00326.   D. 00532. 

 

7.   A patient returns for a follow-up office visit regarding the repair of her fractured knee. The office visit consists of a detailed history, detailed examination, and medical decision making of moderate complexity. What CPT code is assigned?

   A. 99213   B. 99212   C. 99211   D. 99214 

 

8.   Intramuscular nonhormonal antineoplastic chemotherapy administration would be assigned to code

   A. 96402.   B. 96405.   C. 96406.   D. 96401. 

 

9.   Home infusion with specialty drug administration during a 6-hour visit would be assigned what codes?

   A. 99606, 99607 ×3   B. 99601, 99602 ×4   C. 99604, 99605 ×2   D. 99603, 99604 ×2 

 

10.   A patient is seen for a psychiatric diagnostic evaluation. The physician obtains a complete history of the patient’s mental status and does a complete biological and psychosocial assessment along with a complete physical examination. The physician’s final diagnosis is recurrent episode of severe major depressive disorder, without any psychotic behavior involved. The patient also has a history of psychological trauma. What codes are assigned?

   A. F33.2, Z91.49   B. F33.1, Z91.47   C. F34.2, Z91.49   D. F36.2, Z91.46 

 

11.   A 17-year-old patient is diagnosed with a severe form of nutritional anemia. What ICD-10-CM code should be assigned?

   A. D45.9   B. D53.9   C. D74.9   D. D65.9 

 

12.   A 32-year-old patient receives anesthesia for spinal surgery. The anesthesia is complicated by utilization of controlled hypotension. What add-on anesthesia code would be assigned?

   A. 99174   B. 92117   C. 99100   D. 99135 

 

13.   Nursing facility discharge day management of 19.5 minutes would be assigned to code

   A. 99317.   B. 99319.   C. 99316.   D. 99315. 

 

14.   A patient is admitted to the hospital for leukemia. She has a comprehensive history, comprehensive examination, and medical decision making of high complexity. What CPT code should be assigned?

   A. 99202   B. 99223   C. 99213   D. 99251 

 

15.   A service that is rarely provided, unusual, variable, or new may require a

   A. physician’s authorization.   B. patient’s authorization.   C. staged or related procedure.   D. special report. 

 

16.   A new patient is seen for a prescription refill. During the visit, the physician obtains a problem focused history, problem focused examination, and medical decision making is straightforward. What CPT code should be assigned for this service?

   A. 99214   B. 99215   C. 99213   D. 99201 

 

17.   A 7-year-old child is brought to the clinic due to recurrent ear infections. The physician performs a bilateral tympanostomy under general anesthesia. What CPT code should be assigned?

   A. 69436-50   B. 69536-50   C. 69426-50   D. 69736-50 

 

18.   Code 00906 is assigned for

   A. an angioscopy.   B. anesthesia for surgery performed on the bony pelvis.   C. an osteotomy.   D. anesthesia provided for a vulvectomy. 

 

19.   A 25-year-old patient receives a Hepatitis A vaccination. The vaccine is administered intramuscularly in the clinic. What CPT codes should be assigned?

   A. 90632, 90471   B. 90541, 90489   C. 90637, 90472   D. 90672, 90451 

 

20.   A dark adaptation examination with interpretation and report is assigned to code

   A. 92326.   B. 92284.   C. 92287.   D. 92325. 

 
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