Peer 1 

Advanced practice nurses play a major role in transforming the healthcare system enhancing increased healthcare accessibility, provision of value-driven healthcare environment as well as promote the delivery of high quality of care to patients. The advanced practice nurses develop and implement numerous initiatives and health programs aimed at promoting effective disease management thereby enhancing continuous improvement in value, access, and quality of healthcare services (Pickard, 2014). 

          There are various tactics utilized by advanced practice nurses to put them in a better strategic position regarding pay equality. Such tactics include designing and implementing cost-efficient and effective healthcare models to facilitate maximum utilization of advanced practice nurses’ contributions. Furthermore, the diversity associated with a nursing practice including a wide range of roles and numerous varieties of practice settings calls for application of care and cost-effectiveness standards thereby influencing nurses to acquire a better position on pay equality (Pickard, 2014). Another tactic employed to enhance advanced practice nurses attains pay equality is enhancing the appropriate presentation of nursing practice in both the decision-making panels of the government and private organizations. The presentation facilitates the implementation of effective metrics under which payment, pricing, cost, and value are based on. 

          Advanced practice nurses should not view themselves as lower-cost providers given that their knowledge, skills, and capabilities of healthcare practice continue to expand and advance over a given period. This means that their delivery of care services improves with time calling for an increase in payment to enhance maximum utilization of their dynamic evolving skills to impact the positive transformation of the healthcare system (Woo, 2017). As APNs continuously contribute to the establishment of innovative healthcare models to enhance the satisfaction of the patient’s needs, the payment schemes must include appropriate measures of the value contributed by the APN 

Peer 2 

Although advanced practice nurses, commonly referred to as APN, provides somewhat similar services, their pay often tends to match owing to a variety of distinct reasons. A persistent salary gap exists in the nursing profession (Bhagyalekshmi, Sha, & Rajendran, 2019). As a result, this has been perceived, by many, as both discriminatory and harmful. The salary gap often exists on gender basis. Based on a study conducted by Nurse.com, fields where female nursing practitioners are considered to be dominant bear significant disparities in terms of pay (Yi, 2016). In such scenarios, male APNs tend to earn more money in the profession as compared to their female counterparts. As such, the need prevails to come up with relevant strategies that would facilitate relevant means of bridging the said gap. 

One of how pay inequity could be rectified is by ensuring that female nurse representatives can negotiate salaries for female nurses before them accepting the employment opportunity (Yi, 2016). Las such, one should not be willing to accept a job before issuing a counteroffer regardless of how much one requires or is need of the job. By doing so, this should enable employers to create favorable offers for all their employees based on their specified qualifications.  

Another way in which equality may be promoted in the nursing profession is by ensuring that there is proper representation for all nurses (Yi, 2016). Similar to how workers from different profession obtain proper representation such as their involvement in trade unions, nurses should also have a relevant body which is intended to guarantee proper working conditions for them. In addition to this, the employees, in this case, may be able to obtain better pays that are bot no-discriminatory and equal among all nurses. 

APNs’ Position 

Owing to APNs’ contribution to the healthcare system, they must be treated similarly when it comes to matters regarding their pay (Yi, 2016). The main reason for this is because people in the profession often undergo proper training that makes them uniquely skilled for their various position, and hence their services may and cannot be provided by individuals from other career fields.  

Although nurses are involved in the provision of low-cost services to patients, this should not necessitate lower pay in comparison to other occupations (Hakim & Bahri, 2016). The main reason behind this mostly lies behind the fact that they provide services that are crucial and life-saving from a literal point of view. As such, this should necessitate them to push for a pay that is comparable with others. This should be extended to them being issued with similar services as well. By doing so, this would enable the nurses to feel highly motivated hence allowing them to provide better services to their customers (Yi, 2016). As a result, the facility or institution in which they provide may be able to experience increased growth more so since more people would be willing to obtain healthcare services from the hospital in question.  

With the inclusion of equal pay among APNs, this would create room for proper working conditions in the profession. In addition to this, this would ensure that proper legal requirements are instilled concerning the protection of the welfare of employees (Hakim & Bahri, 2016). Similarly, this would allow for the creation of opportunities where nurses experience economic boost hence ensuring that they work in a manner that best guarantees innovation and competitiveness in the profession. 

Response post with a minimum of 150 words each response. Word document, double space. APA (6th) 

Below is the original activity if you needed:

Reflect on the current roles of advanced practice nurses in healthcare as the care providers at the front line of disease management and health promotion in primary care and many other specialty settings. What do you think are some effective tactics for APN strategic positioning regarding pay equality? Should APNs position themselves as lower-cost providers who provide better care or push for comparable worth, same service and same pay?
 

Below is an article that provides great practical information that highlights how provider productivity is calculated in the clinical setting, which is important to know as future nurse practitioners.

Calculating Your Worth: Understanding Productivity and Value- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093517/

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There are multiple differences between leaders and managers. According to Clarke, L. (n.d), the difference between leader and manager can be drawn on the following grounds:

1. A leader influences his subordinate to achieve a specified goal, whereas a manager is a person who manages the entire organization.
2. A leader possesses the quality of foresightedness while a manager has the intelligence
3. A leader sets directions, but a manager plans details.
4. A manager takes decision while a leader facilitates it.
5. A leader and the manager is that a leader has followers while the manager has the employees.
6. A manager avoids conflicts. On the contrary, a leader uses conflicts as an asset.
7. The manager uses transactional leadership style. As against this, transformational leadership style is used by the leader.
8. Leaders promote change, but Managers react to the change.
9. A leader aligns people, while a manager organizes people.
10. A leader strives for doing the right things. Conversely, the manager strives for doing the right things.
11. The leader focuses on people while a manager focuses on the Process and Procedure.
12. A leader aims at the growth and development of his teammates while a manager aims at accomplishing the end results.

However, (Gillikin, n.d.) states that managers are often considered to be the members of an organization that are more interested in executing goals and objectives rather than creating new visions and missions for their organizations. With this, Arruda (2016) writes that leaders are often the ones promoting full scale change within their organizations while managers are more interested in maintaining the status quo. So, the main difference between leadership and management largely lie in philosophy and the practical execution of one’s role. While the philosophical differences strongly contrast from one another, some of the practical aesthetics of management and leadership overlap. Many managers are called to create plans and objectives for their organization that can encourage long term growth and budgeting over time. While these long term changes are not designed to be visionary, a practical manager may end up optimizing or changing major operational practices that have been used for some time in a company.

In addition, by its very nature, the professional nurse role is one of leadership. Across the healthcare continuum, regardless of our role or practice setting, we are looked to as leaders. The call to leadership moves all of us to a higher plane of responsibility and accountability, with or without a management title; it is inherent in all nursing positions from staff nurse to CEO. We all have similar goals and responsibilities for patient care. With all the changes currently underway in our healthcare delivery system and the nursing profession, all nurses must strive to emulate the hallmarks of good management and leadership and never stop working on our professional growth. We all need to stay informed and be politically saavy; we need to know what our professional journals and nursing organizations are saying and advance our education. In the end, all nurses must be visionaries, critical thinkers, skilled communicators and teachers. And the good news is you do not need a formal manager or leader title required to do any of these things (Williamson, E. 2017).

Nurse leaders that want to encourage change in their organizations should do so by being proactive managers that want to increase the value of the services their facilities offer. Thew (2018) writes that nurse managers can take advantage of the industry’s shift to value based care by looking at how they can optimize the use of their fellow nurses in the field. Rejecting some of the financial reimbursements that come with solely focusing on fee based services means that nurse managers will create more optimal business strategies.

References:

Clarke, L. (n.d.). Key Differences Between Leader and Manager. Retrieved from https://inside.6q.io/whats-the-difference-between-manager-and-leader/

Gillikin, Jason. (n.d.). Management vs. leadership in a healthy organizational culture. Small Business – Chron. Retrieved from http://smallbusiness.chron.com/management-vs-leadership-healthy-organ

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1 postsRe: Topic 5 DQ 2

This catastrophic earthquake took place on January 12, 2010, in the country of Haiti. With a magnitude of 7.0. on the Richter scale, this earthquake took many lives. An international relief operation was initiated soon after the earthquake happened. The United States sent thousands of military troops to Haiti to provide resources, help with finding lost loved ones and friends and help sustain peace.

According to Green (2018), “Primary prevention in disaster management involves planning prior to the disaster.” Thinking of the situation that is taking place and planning how to overcome the obstacles to help treat and save people. For instance, access to surgical, medical and emergency equipment, plans set in place to handle burns, trauma or other issues that might occur. Access needs to also be available to medications like antibiotics and IV fluid. Additionally, Green (2018) adds that “Secondary prevention may occur when the onset of the disaster has occurred or within hours of its impact; this is when the response occurs during a disaster.” This could be priority immunizations, including mass vaccination campaigns for tetanus immunization as part of wound care. This happens in the second phase to insure that once people are not in danger, they do not get an infection from a secondary situation. Secondary situations to educate on would be wound care and proper dressing change Finally, Green (2018 ) describes the last stage as “Tertiary prevention occurs after the offending event has ceased and the focus is on recovery.” This stage is when the recovery process begins. The duration of the recovery phase varies and can focus on the mental health of persons involved in the tragedy. Spiritual guidance and prayer are highly recommended at this stage to help people cope with the disaster.

There are many organizations that manage a crisis to this magnitude. One organization that I would work with is FEMA. FEMA is trained to respond to crisis situations and has a protocol already in place to follow to ensure the safest and most effective rescue and treatment for the public. I would also work with the American Red Cross. This organization is also highly trained to deal with disaster situations and getting proper supplies to people in need. I would also work with community churches and faith-based organizations to help people spiritually and mentally.

References

Community and Public Health: The Future of Health Care. (2018). Retrieved from Grand Canyon University (Ed.): https://lc.

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I need a reply for this 2 peers. 

A minimum of 2 paragraphs is required for all posts  

Support all posts with at least 2 cited peer review references within 5 years of publication (references cannot be older than 5 years). 

All posts are to be written in APA 6th edition format  

Peer 1 

The Role of Advanced Practice Nursing in Safe Prescribing 

The s. 893.03 Florida Statutes mandate the APRNs to prescribe controlled substances in line with the supervisory standards. The professionals have to engage in three-hour training sessions on safe prescribing and the effective implementation of the related strategies (Florida Board of Nursing, 2016). The APRNs have to evaluate and define the patients’ health issues to offer the right prescriptions. They should also equip patients with relevant information about warnings as well as how one should take the prescribed drugs (Pigman et al., 2016). Additionally, the practitioners monitor the patients regularly to make sure they receive the intended benefits of the prescriptions at hand. According to the state requirements, the APRN practitioners have to meet the same prescription standards as physicians. 

Prescribing Barriers for APRNs 

Various barriers limit the APRN practitioners from undertaking their prescription roles effectively. First, state licensure restricts the APRNs from engaging in full practice in line with their educational qualifications. The practitioners can only engage in one of the NP roles based on collaborative agreements. Secondly, APRN training programs may fail to equip learners with advanced skills for delivering high-quality health care services. Negative perceptions of the existing working conditions and inadequate knowledge also limit the practitioners from performing their prescription roles effectively (Jun, Kovner, & Stimpfel, 2016). Additionally, certain payer policies deter the APRN from engaging in health care delivery activities to the full extent of their training as well as licensure. For instance, some scope-of-practice policies restrict practitioners to specific roles. Job satisfaction issues also hinder practitioners from undertaking their prescription roles in a way that impacts significantly on patient outcomes. Some practitioners experience unfavorable working conditions, which reduce their productivity. 

Peer 2 

ARNPs have in their hands a high level of responsibility when prescribing medications. The degree of responsibility depends on whether they can or not prescribe medicines that rely on the state’s laws related to the prescriptive authority given to APRNs. There are twenty-one states that are fully independent prescribing by nurse practitioners (Teri, & Marylou, 2015). The responsibility for the final decision on which drug to use and how to use it depends on the APRN prescriber. To be a safer prescriber, it is important that APRN assume the higher level of legal responsibility that is required. Also, the knowledge of medicine, pharmacology, determine the diagnose for which the drug will be ordered, prescribe the appropriate drug, monitor the outcome, and educate the patient about the medication and possible adverse effects. 

Despite many positive expansions to the APRN role that include caring for ethnically diverse, underserved populations within an aging society and across many healthcare settings, there are a lot of barriers requiring attention. Prescribing medications is one of the main components of the APRN role and essential to his/her practice. One of the barriers is the restrictions on prescriptive authority that limit the ability of NPs to provide comprehensive health care services. AANP recommends that NP prescribing authority be solely regulated by state boards of nursing and in accordance with the NP role, education and certification. This process of license and regulation exclusively by the nursing board promotes public safety and competent practice (Hain, D., & Fleck, L., 2014). 

The Florida Board of Nursing states that ARNP may only prescribe or dispense a controlled substance as defined in s. 893.03 Florida Statutes if the ARNP graduated from a program with a master’s or doctoral degree in a clinical nursing specialty area with training in specialized practitioner skills. However, all ARNPs and PAs are required to complete at least three hours of continuing education on the safe and effective prescribing of controlled substances. Also, Under the new law, an ARNP’s prescribing privileges for controlled substances listed in Schedule II are limited to a seven-day supply and do not include the prescribing of psychotropic medications for children under 18 years of age, unless prescribed by an ARNP who is a Psychiatric Nurse. The bill also clarifies that only allopathic physicians licensed under chapter 458, Florida Statutes, or osteopathic physicians licensed under chapter 459 Florida Statutes may dispense medications or prescribe controlled substances in a registered pain management clinic (Florida Board of Nursing, 2016).In addition, every person who prescribe controlled substances must register and obtain a registration number with the US Drug Enforcement Administration. Also, they have to maintain and keep on file for a minimum of 2 years accurate records of controlled drugs they purchase, distribute, administer, and dispense.  (Teri, & Marylou, 2015). 

This is the original assignment if you needed: 

Discuss the role of advanced practice nursing in safe prescribing and 3  prescribing barriers for APRNs. 

https://www.flsenate.gov/Committees/BillSummaries/2016/html/1424 

http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-19-2014/No2-May-2014/Barriers-to-NP-Practice.html 

https://floridasnursing.gov/new-legislation-impacting-your-profession/ 

https://www.aanp.org/advocacy/advocacy-resource/position-statements/nurse-practitioner-prescriptive-privilege 

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I need a response for each peer. Response posts must be minimum 100 words each. Word document , double space, APA 6th

Peer 1  

Antimicrobial resistance is an important issue the public health center is battling with presently. The resistance occurs after the mutation of microorganisms following the continuous exposure to antimicrobial drugs and antivirals. The resistance threatens the health of humans and animals with the resistant organisms increasing the infectious diseases. WHO’s suggestion is that the world may be heading to a post-antibiotic era in the 21st century where minor injuries and common infections can kill (“How to stop antibiotic resistance? Here’s a WHO prescription”, 2015). 

Nurses can help with practical contributions by seeing to a reduction of inappropriate prescription of antibiotics and professionally backing of antimicrobial stewardship. The latter is an approach for promoting and monitoring if antimicrobials are used judiciously for the preservation of their effectiveness in the future (Beović et al., 2017. Since nurses play significant roles in inpatient care aspects, they can hence be influential in the use and prescription rates during varying patient care stages. 

Both Global disease and domestic disease surveillance entails tracking, detection, assessment, and response to health events.  However, domestic disease surveillance involves systematic data collection, comprehensive analysis, and interpretation of data from households (Nsubuga et al., 2006).  Global disease surveillance, countries, and public health entities across the globe gang up efforts to ensure capacity building to ensure preparedness for global health emergencies (“Global Health Surveillance”, 2012) 

Early detection of diseases averts the occurrence and re-occurrence of such infectious diseases, thus minimizes global health threats. Family nurse practitioners have the capability of making long-lasting relationships with patients. These nurses, therefore, empower individuals to make positive health choices as well as influence them to adopt healthy lifestyle practices that help in the prevention of non-communicable diseases such as diabetes. They also ensure that the surveillance programs cover the most remote at-risk population. 

Peer 2

Nurses can improve Policies in the use of Antibiotics  

Nurses and nursing organizations can improve policies and encourage the judicious use of antibiotics in humans. Nurses implement most of the policies in the health care sector because they deal with patients directly. They also administer antibiotics to patients, and thus, they can get first-hand feedback from patients (Malani et al., 2012). Therefore, nurses should collect data about the effectiveness of different antibiotics and their side effects from patients. They can use their organizations to channel the information to policymakers, who can respond appropriately. Consequently, policymakers can stop the use of certain antibiotics or increase the dosage, among other changes. Nurses and nursing organizations should also conduct scientific studies about different antibiotics to identify their effectiveness and drawbacks (Malani et al., 2012). The findings of these studies can enable policymakers to make policies that can help humans to use antibiotics cautiously.  

Disease surveillance refers to the process of monitoring the spread of a disease to identify its progression and spread patterns. It involves collecting, analyzing, and interpreting data about a condition, especially during an outbreak (Lombardo & Buckeridge, 2012). The gathered information can help in identifying the risk factors of a disease, its impacts on members of the society, and the population that is at risk. Global disease surveillance refers to the process of monitoring the spread and progression patterns of disease worldwide. Conversely, domestic disease surveillance refers to the process of monitoring the spread and progression patterns of a disease locally. There is a correlation between the two because the information that is obtained in domestic disease surveillance can be used in global disease surveillance (Lombardo & Buckeridge, 2012). More importantly, Family Nurse Practitioners play a crucial role in both domestic and global disease surveillance. They interact with patients at a family level and collect useful data about the spread and progression patterns of certain diseases, locally and globally. 

Below is the original homework if you need it:

Examine how might nurses and nursing organizations improve policies to encourage the judicious use of antibiotics in humans? Identify the correlation between global disease surveillance and domestic disease surveillance, and the significant role the family nurse practitioner plays. 

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