Week1 Discussion: Scope of Practice

Week1 Discussion: Scope of Practice

Week1 Discussion: Scope of Practice

Week1 Discussion: Scope of Practice

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Week 1 discussion Discussion Part I: Scope of Practice, Credentialing, and Negotiation Note: In this course, some Discussions will have two parts: Part I will consist of a specific topic related to the week’s content. Part II will consist of a pharmacology review of approximately 250 words. Please submit each posting separately but within the same Discussion thread. You will be assessed on your posting and responses to both parts. As medical care evolves, so does the role and scope of practice of the advanced practice nurse in acute care settings. When providing patient care, however, you, as an advanced practice nurse, must always ensure that you are working within the scope of practice outlined by your state’s laws and institution’s regulations.

Week1 Discussion: Scope of Practice

For this Discussion, you examine these laws and regulations and consider how they might affect your future clinical practice, consider the credentialing process for your area, and discuss negotiation techniques you may use in a job search. To prepare: Locate a collaborative practice agreement. Based on this agreement, consider the scope of practice of an advanced practice nurse in your state. Locate and select at least two hospitals where you would be interested in working at once you obtain your licensure. Locate the hospitals’ credentialing documents and investigate the scope of practice at each hospital. Note: All hospitals do not have the same scope of practice even if they are located within the same city and state. Consider how the laws and regulations of the state and hospitals might affect your practice with medical and surgical patients in acute care settings. Think about how you would negotiate your first Advanced Practice role. Consider issues such as salary range, Continueing Medical Education (CME), license and DEA costs, insurance, hours, on call requirements, etc. Post on or before Day 3 an explanation of the scope of practice of advanced practice nurses, as outlined in the collaborative practice agreement.

Week1 Discussion: Scope of Practice

Then, identify the two hospitals of interest that you selected. Based on the credentialing documents, explain the scope of practice for acute care advanced practice nurses at each hospital. Explain how this might affect your practice in terms of caring for medical and surgical patients in acute care settings (i.e., medical treatments, procedures you can perform, interpreting diagnostics, etc.). Finally, describe job negotiation considerations. Note: To support your Discussion post, you must include references (with URL links) from the state and the hospitals you selected. Read a selection of your colleagues’ responses. Respond on or before Day 6 to at least two of your colleagues on 2 different days who selected a different state or hospital from yours. Share additional insights or alternative perspectives. Discussion Part II: Pharmacology Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus. To prepare: Read the following articles to enhance your knowledge of commonly prescribed medications: Chalikonda, S. A. (2009). Alpha2-adrenergic agonists and their role in the prevention of perioperative adverse cardiac events. AANA Journal, 77(2), 103–108. Retrieved from the Walden Library databases. Frankenstein, L., Katus, H. A., Grundtvig, M., Hole, T., de Blois, J., Schellberg, D., … Agewall, S. (2013). Association between spironolactone added to beta-blockers and ACE inhibition and survival in heart failure patients with reduced ejection fraction: A propensity score-matched cohort study. European Journal of Clinical Pharmacology, 69(10), 1747–1755. Retrieved from the Walden Library databases. Hao, G., Wang, Z., Guo, R., Chen, Z., Wang, X., Zhang, L., & Li, W. (2014).

Week1 Discussion: Scope of Practice

Effects of ACEI/ARB in hypertensive patients with type 2 diabetes mellitus: A meta-analysis of randomized controlled studies. BMC Cardiovascular Disorders, 14, 148. Retrieved from the Walden Library databases. Levy, P. D., Laribi, S., & Mebazaa, A. (2014). Vasodilators in acute heart failure: Review of the latest studies. Current Emergency and Hospital Medicine Reports, 2(2), 126–132. Shi, C. (2013). Blood pressure lowering efficacy of alpha blockers for primary hypertension. International Journal of Evidence-Based Healthcare, 11(3), 204–205. Retrieved from the Walden Library databases. Tocci, G., Battistoni, A., Passerini, J., Musumeci, M. B., Francia, P., Ferrucci, A., & Volpe, M. (2015). Calcium channel blockers and hypertension. Journal of Cardiovascular Pharmacology and Therapeutics, 20(2), 121–130. Retrieved from the Walden Library databases. Toppen, W., Sareh, S., Satou, N., Shemin, R., Hunter, C., Buch, E., & Benharash, P. (2014). Do preoperative ?-blockers improve postoperative outcomes in patients undergoing cardiac surgery? Challenging societal guidelines. American Surgeon, 80(10), 1018–1021. Retrieved from the Walden Library databases. Wang, A. (2012). Efficacy of class III antiarrhythmics and magnesium combination therapy for atrial fibrillation. Pharmacy Practice, 10(2), 65–71. Retrieved from the Walden Library databases. All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage. Alpha agonists Alpha blockers Beta blockers Antiarrhythmics Calcium channel Vasodilators ACE versus BBlocker with spironolactone in CHF ACE versus ARB Note: When sharing your initial post, select a topic that has not yet been discussed. If all topics have been discussed, then you may select that topic again, but select a different drug within the medication group. For this Discussion, address 1 of the following options. Post by Day 3: Option 1: Post a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose. Option 2: Conduct an evidence-based drug search on the drug you selected and post an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication? Option 3: Post an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Describe a patient to whom you would prescribe this medication. Week 2 discussion Discussion Part I: Limitations and Challenges From providing ongoing assessments to monitoring for complications and facilitating recovery, advanced practice nurses who care for patients in perioperative environments experience a unique set of limitations and challenges.

Week1 Discussion: Scope of Practice

Reflecting on your experiences in this complex and critical environment will help you develop your professional competency and prepare you for your future role as an advanced practice nurse. In this week’s Discussion, you consider limitations and challenges of clinical practice in perioperative care settings. To prepare: Reflect on this week’s clinical experiences. Consider one limitation or challenge you encountered. Think about how you overcame this limitation or challenge and how this might affect your future practice in pre- and post-operative care settings. Post on or before Day 3 a description of at least one limitation or challenge you encountered during your clinical experience this week. Explain how you overcame this limitation or challenge and how this might affect your future practice. Note: If you refer to a patient in your Discussions or Assignments, be sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient. Read a selection of your colleagues’ responses. Respond on or before Day 6 to two colleagues by sharing additional insights or alternative perspectives. Discussion Part II: Pharmacology Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus. To prepare: Read the following articles to enhance your knowledge of commonly prescribed medications: Ando, S., Yasugi, D., Matsumoto, T., Kanata, S., & Kasai, K. (2014). Serious outcomes associated with overdose of medicines containing barbiturates for treatment of insomnia. Psychiatry Clinical Neuroscience, 68(9), 721. Dassanayake, T. L., Jones, A. L., Michie, P. T., Carter, G. L., McElduff, P., Stokes, B. J., & Whyte, I. M. (2012). Risk of road traffic accidents in patients discharged following treatment for psychotropic drug overdose: A self-controlled case series study in Australia. CNS Drugs 26(3), 269–276. Retrieved from the Walden Library databases. Kulick, D., & Deen, D. (2011).

Week1 Discussion: Scope of Practice

Specialized nutrition support. American Family Physician, 83(2), 173–183. Retrieved from http://www.aafp.org/afp/2011/0115/p173.html Martini, D. I., Nacca, N., Haswell, D., Cobb, T., & Hodgman, M. (2015). Serotonin syndrome following metaxalone overdose and therapeutic use of a selective serotonin reuptake inhibitor. Clinical Toxicology 53(3), 185–187. Robinson, A., & Wermeling, D. P. (2014). Intranasal naloxone administration for treatment of opioid overdose. American Journal of Health-System…

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