Select a patient (Patient has to be less than 18 years old) who you examined during the last 3 weeks. With this patient in mind, address the following in a SOAP Note:

• Subjective: What details did the patient or parent provide regarding the personal and medical history? Include any discrepancies between the details provided by the child and details provided by the parent, as well as possible reasons for these discrepancies.
• Objective: What observations did you make during the physical assessment? Include pertinent positive and negative physical exam findings. Describe whether the patient presented with any growth and development or psychosocial issues.
• Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?
• Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management? Include pharmacologic and non-pharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan.
• Reflection notes: What was your “aha” moment? What would you do differently in a similar patient evaluation?

***Use SOAP Format***

By Day 7 of Week 1

Write a 2- to 3-page paper that addresses the following:

The Assignment (case) for week one is listed below.

A friend calls and asks you to prescribe a medication for her. You have this autonomy, but you don’t have your friend’s medical history. You write the prescription anyway.

• Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
• Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state.
• Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation.
• Explain the process of writing prescriptions, including strategies to minimize medication errors.

To Prepare

• Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure.
• Review the scenario assigned by your Instructor for this Assignment.
• Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor.
• Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family.
• Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors

Review how one of the following theorists have influenced: quality improvement, decisions on quality care, patient health, and safety goals:

1. Dorothea Orem,

2. Betty Neuman,

3. Madeleine Leininger,

4. Jean Watson, and

5. Patricia Benner.

Primary reference must be from peer-reviewed NURSING journals less than 5 y/o. One other reference may be from National professional, or governmental, or educational organizations. Supplemental  references (.org, .gov, and .edu) and the course textbook may be used as supplemental references:

George, J. (2011). Nursing theories: The base for professional practice (6thed.). Boston: Pearson.

The initial posting must have a different reference than the response to peer posting. See grading criteria and rubric for discussion postings. APA format required.

Instructions

Overview/Description of Final Paper: The final written assignment will synthesize what you have discovered about the different advanced practice roles and scope of practice found in the master of nursing curriculum: APRNs, nurse educator, nurse informaticist, and nurse administrator/executive. You will review all roles and then examine the specialty for which you were admitted, focusing on the scope of practice, core competencies, certification requirements, and legal aspects of practice for that specific role. You will also identify the practice environment and population you will be working with, as well as peers and colleagues. In addition, you will discuss your future leadership role and participation in professional organizations.

Your paper is to be based on current literature, standards of practice, core competencies, and certification bodies for your chosen role. The paper should be 8-10 pages excluding the title and reference pages, and APA format is required.

Criteria:  

• Advanced Practice Roles in Nursing:
  • Briefly define advance nursing practice and the roles in advanced practice nursing pertaining to clinical practice, primary care, education, administration, and health information. Distinguish between ANP and the APN.
  • Describe the advance nursing practice role you aspire and briefly share the experiences and/or qualities you have that have influenced your decision. Include your personal philosophy.
• Selected Advanced Practice Role:
  • Identify the AP you interviewed and summarize the interview, which should/may include (if not in the interview, please address):
  • Examine regulatory and legal requirements for the state in which you plan to practice/work.
  • Describe the professional organizations available for membership based on your selected role.
  • Identify required competencies (domains), including certification requirements for your selected role.
  • Describe the organization and setting, population, and colleagues with whom you plan to work.
• Leadership Attributes of the Advanced Practice Role:
  • Determine your leadership style
  • Define Transformational Leadership and as it relates to your identified leadership attributes that you possess or need to develop
  • Apply the leadership style you will embrace in AP to one of the domains
• Health Policy and the Advanced Practice Role

Based on your program of study, review the literature and address the following:

• FNP/AGNP:Medicare reimbursement for NPs is 85%for the same health care that MDs receive at 100% reimbursement? Please address questions below and state your position on this mandate.
• FNP/AGNP:What states have NP Full Practice Authority and which states have limitations or restrictions? How does this apply to your state? Please address questions below and state your position on this regulation.

For the above category chosen, address the following:

• Describe the current policy or trends and determine if it needs to change; if opposed to change state why
• Provide the process required to make the change with key players and parties of interest; support opposition
• Explain how you could lead the effort to make or influence the change in policy or keep the policy the same and the impact in healthcare quality.
• Conclusion-Summarize your role paper by highlighting key points made in your paper.

Workflow analysis aims to determine workflow patterns that maximize the effective use of resources and minimize activities that do not add value. There are a variety of tools that can be used to analyze the workflow of processes and clarify potential avenues for eliminating waste. Flowcharts are a basic and commonly used workflow analysis method that can help highlight areas in need of streamlining.

In this Assignment, you select a common event that occurs regularly in your organization and create a flowchart representing the workflow. You analyze the process you have diagrammed and propose changes for improvement.

To prepare:

• Identify a common, simple event that frequently occurs in your organization that you would like to evaluate.
• Consider how you would design a flowchart to represent the current workflow.
• Consider what metrics you would use to determine the effectiveness of the current workflow and identify areas of waste.

To complete:

Write a 3- to 5-page paper which includes the following:

• Create a simple flowchart of the activity you selected. (Review the Sample Workflow of Answering a Telephone in an Office document found in this week’s Learning Resources for an example.)
• Next, in your paper:
  • Explain the process you have diagrammed.
  • For each step or decision point in the process, identify the following:
    • Who does this step? (It can be several people.)
    • What technology is used?
    • What policies and rules are involved in determining how, when, why, or where the step is executed?
    • What information is needed for the execution of this step?
  • Describe the metric that is currently used to measure the soundness of the workflow. Is it effective?
  • Describe any areas where improvements could occur and propose changes that could bring about these improvements in the workflow.
  • Summarize why it is important to be aware of the flow of an activity.
• Remember to include a cover page, introduction, and summary for your paper.