Ch 12 Professional Practice Issues
A truth concerning the DNP program is that the program focuses on practice more than on research.
The following six populations are the foci for the APRN established by the consensus model for the APRN regulation:
Adult-Gerontology
Family/Individual Across the Lifespan
Neonatal
Pediatric
Women's Health/Gender-Related
Psychiatric-Mental Health.
The consensus model describes 4 essential components for the regulation of APRNs (commonly referred to as LACE):
Licensure
Accreditation
Certification
Education
A small, straightforward set of evidence-based practices that, when performed collectively and reliably, have been proven to improve patient outcomes, is called a safety bundle. The Council on Patient Safety in Women’s Health Care is a multidisciplinary partnership that, along with the AIM, has designed safety bundles to reduce severe maternal morbidity and mortality.
Under the consensus model for the APRN, the entity that is responsible for licensing APRNs is the individual State Boards of Nursing.
Battery is the actual, intentional, and unlawful touching or striking of another person against the will of that person. One example is placing an intrauterine contraceptive device in the uterus of an intellectually disabled patient who is not able to give informed consent may constitute battery.
A covered entity under HIPAA is the governmental agencies that license healthcare providers. HIPAA-covered entities (those to whom the privacy rules apply) include health plans, healthcare clearinghouses, and any healthcare provider who transmits health information in electronic form in connection with transactions.
Safe medication practices include always using a leading zero for doses less than 1 unit (e.g., use 0.1 mg, not .1 mg). To reduce medication errors, do not use a trailing zero after a decimal point (use 1 mg, not 1.0 mg).
Correlational research study designs are used for systematic investigation of relationships between two or more variables to explain the type ( positive and negative) relationships, but not to examine cause and effect.
States must provide Medicaid coverage to the following groups if they meet specified income-eligibility requirements:
pregnant women and children younger than 6
children younger than age 19
adults younger than age 65 without dependent children
adults with short-term disability.
The best place for the APRN to find comprehensive standards of practice related to her or his particular role and population focus is a professional organization representing the role and the population focus.
Standards of practice are overarching statements that the nursing profession uses to describe the responsibilities of its members to provide safe and competent care. APRNs are held to standards of practice promulgated by the nursing profession and standards determined by professional organizations representing their role and population focus.
AMCB certification must be renewed every 5 years with the completion of three maintenance modules plus 20 contact hours of continuing education or retaking the AMCB certification examination (no sooner than the 4th year of the cycle) plus 20 contact hours of continuing education.
Qualitative research is defined as a systematic, interactive, subjective approach used to describe life experiences and give them meaning.
The type of research that would receive the strongest rating for strength of evidence is Meta-analysis. Meta-analysis level I (meta-analysis or multiple controlled studies) is the strongest rating.
An elderly woman signs DNR orders and a statement that she does not want extraordinary care. This individual is exercising their right to refuse treatment. Refusal of treatment is the inherent right of a conscious and mentally capable individual to refuse any form of treatment, either personally or through the person’s legal representative.
A culture of safety promotes a learning organization by using root-cause analysis when an adverse event occurs. This process is used to answer four basic questions:
What happened in this case?
What usually happens?
Why did this event occur?
What, if anything, can be done to prevent it from happening again?
The A-D category applied to the strength of evidence in research is based on the quality of the study’s design, which affects the believability of the findings.
The nongovernmental validation of a nurse practitioner’s or nurse-midwife’s knowledge and acquired skills in a particular population focus is certification. Certification is the formal process by which a private agency or organization certifies (usually by examination) that an individual has met standards as specified by that profession.
The APRN obtains an NPI number from the CMS.
The goal of the privacy rule of HIPAA is to provide federal protections for privacy and preserve quality care, and the rules apply to all PHI.
Fidelity is the ethical principle of the healthcare professional keeping any promises or commitments made in a therapeutic relationship.
Authority for prescriptive authority is contained in state nurse or midwifery practice acts or in other statutes that vary from state to state.
With a claims-made policy, the incident must happen and be reported while the policy is in force to be covered.
“Incident to” means that it requires that the physician demonstrate ongoing involvement in the patient’s care. “Incident to” billing is implemented for Medicare services provided by the APRN under the supervision of a physician and does not include initial visits or subsequent visits with a new problem.
Predetermined payment based on a contractual per-member, per-month rate. Captiated systems of payment/prospective pricing are set as a cost per member, per month, determined in advance by contract.
MCO characteristics include:
A capitated system of payment
Opportunities for service billing
Some financial risks are assumed by the provider
One of the principal differences between Medicare Parts A and B is the monthly premium requirement for Part B, which is a supplementary medical insurance available to individuals for a monthly premium if they are eligible for Medicare Part A. It covers provider services, outpatient care, diagnostics, and durable medical equipment.