NURS 6560:Week 1: Scope of Practice of the Acute Care Advanced Practice Nurse in Perioperative Environments Essay Assignment Paper

This week, you examine the scope of practice for acute care advanced practice nurses in perioperative environments. You also explore the impact of scope of practice laws and regulations on clinical care.

Learning Objectives

By the end of this week, students will:

• Analyze the scope of practice for acute care advanced practice nurses
• Evaluate the impact of scope of practice on clinical care

Learning Resources

Note: The information presented in this course is vital. As a result, numerous resources are provided in various formats to facilitate your competence in caring for patients in acute care settings. The Doherty textbook, Current Diagnosis and Treatment,will serve as your primary text. When multiple resources are available on the same topic, select the primary text first, followed by those that best meet your personal learning needs.

Required Readings

Doherty, G. M. (2015). Current diagnosis and treatment: Surgery (14th ed.). New York, NY: McGraw Hill.

• Chapter 1, “Approach to the Surgical Patient”
• Chapter 2, “Training, Communication, Professionalism, and Systems-based Approach”
• Chapter 3, “Preoperative Care”
• Chapter 4, “Postoperative Care”
• Chapter 5, “Postoperative Complications”
• Chapter 7, “Power Sources in Surgery”
• Chapter 11, “Anesthesia”

Weber, E. C., Vilensky, J. A., & Fog, A. M. (2013). Practical radiology: A symptom-based approach. Philadelphia, PA: F. A. Davis Company.

• Chapter 1, “Modalities of Medical Imaging”

Bielaszka-DuVernay, C. (2011). Improving quality and safety. Retrieved from http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=45

De Bord, J. (2014). Informed consent. University of Washington School of Medicine. Retrieved from https://depts.washington.edu/bioethx/topics/consent.html

Nurse Practitioner (NP) Student Clinical Orientation

Document: Introduction to Clinical Experiences (PPT)

Document: Practicum Manual (PDF)

Discussion Part I: Scope of Practice, Credentialing, and Negotiation

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. 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.

By Day 3

Post an explanation of the scope of practice of advanced practice nurses, as outlined in the collaborative practice agreement. 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.

By Day 6

Respond 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.

Note: 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.

Hao, G., Wang, Z., Guo, R., Chen, Z., Wang, X., Zhang, L., & Li, W. (2014). Effects of ACEI/ARB in hypertensive patients with type 2 diabetes mellitus: A meta-analysis of randomized controlled studies. BMC Cardiovascular Disorders, 14, 148.

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.

Vasodilators in acute heart failure: Review of the latest studies by Levy, P. D., Laribi, S., & Mebazaa, A. in Current Emergency and Hospital Medicine Reports, 2(2). Copyright 2014 by Current Science, Inc. Reprinted by permission of Current Science, Inc., via the Copyright Clearance Center.

Shi, C. (2013). Blood pressure lowering efficacy of alpha blockers for primary hypertension. International Journal of Evidence-Based Healthcare, 11(3), 204–205.

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.

Toppen, W., Sareh, S., Satou, N., Shemin, R., Hunter, C., Buch, E., & Benharash, P. (2014). Do preoperative β-blockers improve postoperative outcomes in patients undergoing cardiac surgery? Challenging societal guidelines. American Surgeon, 80(10), 1018–1021.

Wang, A. (2012). Efficacy of class III antiarrhythmics and magnesium combination therapy for atrial fibrillation. Pharmacy Practice, 10(2), 65–71.

 

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.

1. Alpha agonists
2. Alpha blockers
3. Beta blockers
4. Antiarrhythmics
5. Calcium channel
6. Vasodilators
7. ACE versus BBlocker with spironolactone in CHF
8. 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.

By Day 3

For this Discussion, address 1 of the following options:

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 3Post 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.

Note: To be considered as one of your required responses, your pharmacology rationale must include a supporting reference.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!