Need ONE Response Per Each Discussion Total 8 Responses. Attached Are The Discussions And Rubric Please Follow Them. Posts Will Be A Minimum Of 100 Words, APA Format.One Reference Per Each Discussion
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Discussion2.docxDiscussion 2
Mercedes Yumar
Advanced Primary Care of Family Practice I
I am pursuing a graduate degree because I want to grow professionally and acquire more knowledge that will help me make better decisions in patient care. In 5 years, I would like to be working as a Family Nurse Practitioner in a community-based health center.
Because of the additional training required to become an APN, these healthcare providers often have the opportunity to work in a clinical patient care setting with a high degree of independence and responsibility for patient care within the healthcare system. APNs may be certified to see patients without a doctor, to order diagnostic tests, to make a clinical diagnosis, and to make important medical decisions.
Evidence suggests that APNs can work in a variety of clinical settings, including medical offices, hospitals, and nursing homes. There are special certifications and roles that APNs, can hold, including nurse practitioner (NP), certified nurse midwife, nurse anesthetist, and clinical nurse specialist.
Evidence-based practice is the answer because it is a clinical decision-making process in which clinicians use theory-derived, research-based knowledge to inform their decisions about care delivery. Consideration of individual needs, preferences and resources are also included. EBP replaces policies and procedures based on other sources of evidence such as tradition or authority. It takes into account three things nursing students should consider at all times: best practice evidence, patient preferences and clinical expertise.
References
McAllister, B., & Smith, T. (2015). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing, 51-55.
Thomas, D. (2015). Nurse practitioners in contemporary nursing practice. OJIN: The Online Journal of Issues in Nursing, 23(2),4. doi: 10.3912/OJIN.Vol18No02Man04
Discussion 2
Muller Sanon
Advanced Primary Care of Family Practicum I
My name is Muller Sanon and I have been working for Northshore Medical Center for the past three years in various units; namely, Telemetry, Med-surg, dialysis, and now in Critical Care. I want to purse the FNP to broaden my career options. I plan to continue with a DNP program and eventually teach.
Since the inception of advanced nursing practice in primary care, its role has extended to other healthcare settings such as the acute care. Acute care provides short-term restorative stabilization to patients in unstable chronic conditions and with complex acute and critical illnesses. Acute care encompasses emergency and critical care.
Emergency and primary care advanced nursing practice do share similarities in that they serve as first-contact access to healthcare, but the acuity of the patient manifestations delineates the two. Unlike in primary care NP/APNs, emergency NP/APNs are trained to manage patients with acute life- or limb-threatening conditions
I strongly believe the EBP is the answer. For example In the mid-1980’s, research indicated that the NP role was most valuable in providing access to underserved, uninsured, rural, and minority populations.
One of the key principles in medicine today is evidence-based practice in nursing (EBP). This is the practice of medicine based on solid research, and it adheres to standards for high quality and safety, all while focusing on patients’ needs. Some examples of EBP are infection control and oxygen use in patients with COPD (Price, 2016).
For example, infection control is an example of EBP. The last thing a patient wants when going to a hospital for treatment is a hospital-acquired infection. Nurses play a key role in helping to prevent illness before it happens by adhering to evidence-based infection-control policies. This includes keeping the healthcare environment clean, wearing personal protective clothing, using barrier precautions and practicing correct handwashing. Although nurses are busy with many responsibilities, the time it takes to control infection is well worth the effort (Andrew, 2015).
Another well established example of EBP is the use of Oxygen in patients with COPD. For patient health and safety, it is essential that nurses follow evidence-based practice in nursing when it comes to giving oxygen to patients with COPD. Despite the belief by some that providing oxygen to these patients can create serious issues such as hypercarbia, acidosis or even death, the evidence-based protocol is to provide oxygen to COPD patients. This practice can help prevent hypoxia and organ failure. Giving oxygen, which is the correct treatment based on the evidence, can enhance COPD patients’ quality of life and help them live longer (Andrew, 2015).
References
Andrew, R. (2015). Evidence-based practice in advanced nursing care. Journal of Advanced Nursing Practice; 7(15).
Price, D. (2016). The role of nurse practitioners. Journal of Advanced Nursing Practice; 12(25), 28-42.
Discussion 2
Yindra Isaac
Advanced Primary Care of Family Practicum I
1. Please introduce yourself and tell me why you decided to pursue and Advanced Practice major?
My name is Yindra and I chose to pursue an advanced nursing degree because I thought I could do more to help the population and my patients with more education and more training. After becoming a registered nurse (RN), I decided that I wanted to broaden my career prospects and responsibilities, and also to increase my salary potential, and to have more autonomy and respect in a medical setting. I saw the opportunity of becoming a family nurse practitioner (FNP) as a path that will lead me to such goal. An Advanced Practice Registered Nurse is generally able to offer more in-depth and comprehensive care compared to RNs, and also assume more of a health care management role. RNs provide important support to physicians and nurse practitioners by examining patients, monitoring patient health, and maintaining medical records. However, FNPs can fulfill these duties while also making medical diagnoses, developing comprehensive treatment plans for patients, managing patients’ chronic health conditions, and supervising a larger health care team.
In addition to having greater autonomy and responsibility in a clinical setting, an Advanced Practice Major also have increased leadership opportunities in patient education, research, academia, and policy advocacy. As a future FNP, I can advance within my field by conducting medical research and helping to develop patient education programs.
2. What is the role of the advanced practice nurse?
A nurse practitioner is an advanced practice nurse that is trained to provide care throughout the lifespan. The NP will generally focus on health promotion, health education, and the foundations of health care (Joel, 2017, pp. 33-40).
The nurse practitioner was introduced with the hopes of closing the gaps found in health care services. Literature has pinpointed the mid 1960’s as the general time frame in which the first reported nurse practitioner role was introduced within the United States. Development in the 1960’s of the advanced practice nurse role was primarily to assess and treat patients in an ambulatory (Joel, 2017, pp. 33-40).
Some of the FNP Role Description includes: Primary care services , health promotion and disease prevention, diagnosing and treating injuries and illness.Managing chronic diseases, ordering diagnostic test and interpret results while performing procedures and prescribing medications and therapy if needed. (Joel, 2017, pp. 33-40).
The Role of Family Nurse Practitioners. According to the American Association of Colleges of Nursing (AACN), a family nurse practitioner is a clinician who combines clinical expertise in the diagnoses and treatment of health conditions with an emphasis on values-based health management and disease prevention (Joel, 2017, pp. 16-32).
3. What is the evidence suggesting regarding the role of FNPs in primary care?
In the mid-1980’s, research indicated that the NP role was most valuable in providing access to underserved, uninsured, rural, and minority populations. NPs are frontline health-care providers essential to developing and maintaining successful communication and collaboration among providers across health-care settings. In both primary and urgent care settings, NPs can ensure continuity of care, decrease health-care costs, and optimize health outcomes for patients (Joel, 2017, pp. 16-32).
Initially, patient populations cared for by NPs were often uninsured immigrants or low-income individuals who were Medicaid recipients. However, NPs since have sought to meet the needs of larger groups of patients and have expanded their practices to include clients from suburban and urban outpatient settings and clinics. This shift to highly populated, high-income areas where physicians are also readily available shows the increased acceptance of NPs (Joel, 2017, pp. 16-32).
In addition to this , the development of walk-in, retail, and urgent care clinics has changed the landscape for accessing primary care services. These clinics are major employers of NPs and thus provide an opportunity to showcase to the public some of the care that NPs can provide (Joel, 2017, pp. 16-32).
4. What do you think Family Nurse Practitioners could do differently to improve patient outcomes? Is EBP the answer? Give specific examples.
I strongly believe that what we as future nurse practitioner could do differently to improve patient outcomes is to take ownership and accountability for driving quality improvements and provide transformational leadership to encourage evidence-based practice changes. Creating an evidence-based practice moves beyond simply using results of a research study in an aspect of your nursing practice. It involves integrating the best available research evidence with the clinical expertise within our practice and also patient and family values to drive better clinical decision making. I think that what we can do differently is that not only get a better understanding of how to use evidence to guide practice but also how we can lead that change to occur and to measure those outcomes. We want to focus on prevention and behavior change. Let's eat healthier. Let's be more active. Let's decrease risky behaviors and take the focus away from simply writing a prescription , I think this is the cornerstone of the role of a Family Nurse Practitioner and what we can do differently in order to improve patient outcomes (Fagerström, 2012).
5. What do you think are the Skills & Personality Traits to be a Successful Nurse Practitioner?
I believe that the more prominent skills and personality traits needed to be an efficient nurse practitioner are : compassion , being an efficient communicator , being an ethical individual , having strong critical thinking skills , paying attention to details and having confidence, stamina and adaptability. Compassion is a fundamental personality trait needed for the nurse practitioner role because we are going to be responsible for caring for the sick and injured. This includes having empathy for the pain and suffering of patients, as well as a strong desire to make the clinical visit experience as positive as possible. In addition to this , a good communication skills are required to be an efficient NP.
References
Fagerström, L. (2012). the impact of advanced practice nursing in healthcare: recipe for developing countries. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117071/
Joel, L. A. (2017). Emerging Roles of the Advanced Practice Nurse. In Advanced Practice Nursing: Role Development: A Theoretical Perspective (4th ed., pp. 33-40). Philadelphia, PA: F.A. Davis.
Joel, L. A. (2017). Emerging Roles of the Advanced Practice Nurse. In Advanced Practice Nursing: Emerging Roles of the Advanced Practice Nurse (4th ed., pp. 16-32). Philadelphia, PA: F.A. Davis.
Titler, M. G. (2015). The Evidence for Evidence-Based Practice Implementation - Patient Safety and Quality - NCBI Bookshelf. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK2659/
Shiloh Webb 05/11/2020
Discussion #2
Good afternoon, my name is Shiloh Webb and I am currently a registered nurse working towards becoming an advanced nurse practitioner. I decided to pursue an advanced nursing role in order to promote health in others by encouraging self-care and advocacy. Healthcare is always evolving and I must also evolve my professional career in order to improve healthcare outcomes and serve diverse populations more effectively. My future as an advanced practice nurse will allow me to practice to the maximum capacity of my training and education.
Nurse practitioner’s advanced education and experience allows them to assume the role of managing their patient’s healthcare needs. Advanced education establishes the nurse practitioner as a leader, empowering the nurse practitioner with the expertise to clinical diagnose their patient and plan treatment for their patient. This is very important since nurse practitioners are able to provide vital care to meet the demand of the population. The demand for healthcare providers continues to rise due to workforce shortage in primary care, and advance practice nurses are transforming healthcare by being able to serve the growing demands of the population by taking an active role in healthcare management by efficiently providing healthcare as members of the interprofessional healthcare team (Hain, D., Fleck, L., May 31, 2014).
Continuing education (CE) is mandatory to maintain a nursing license however adding additional certificates or degrees will certainly improve patient outcomes. Advanced practice nurses can continue to grow professionally by taking the leap to Doctor of Nursing Practice (DNP) which I believe will improve patient outcomes. DNP’s are subjected to additional education which will offer more improvement in patient care. Another way nurses can enhance patient care is through using evidence based practice. For example, if a nurse lacks confidence in newly disseminated evidence-based practice in wound care then their patient may not be receiving the highest level of wound care available thus perpetuating the wound. Evidence-based practice means the patient will receive the best quality care that is linked directly to scientific evidence (Fencl, J. L., & Matthews, C. 2017). Of course, this means that providers must be committed to establishing evidence-based practice into clinical practice. Furthermore, by embrace new evidence-based guidelines when they are published providers demonstrate the highest level patient care.
In the contemporary healthcare system nurse practitioners must be ready to adapt to challenges to be successful. Patient satisfaction is important since healthcare is a business and nurse practitioners are providing a service. Empathy and the ability to communicate are tools that healthcare professionals may use to enhance patient satisfaction.
Reference:
Fencl, J. L., & Matthews, C. (2017). Translating evidence into practice: How advanced practice
RNs can guide nurses in challenging established practice to arrive at Best Practice: The official voice of perioperative
nursing the official voice of perioperative nursing. AORN Journal, 106(5), 378-392.
doi:http://dx.doi.org/10.1016/j.aorn.2017.09.002
Hain, D., Fleck, L., (May 31, 2014) "Barriers to Nurse Practitioner Practice that Impact
Healthcare Redesign" OJIN: The Online Journal of Issues in Nursing Vol. 19, No. 2, Manuscript doi: 10.3912/OJIN.Vol19No02Man02
May Lee Perez
Discussion 2
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Advanced Practice Nursing
I am a Registered Nurse since April 2019, working in Aesthetics procedures. Being an APN means taking responsibility of all avenues in patient care and not being limited to one. As such, with the increasing number of ailing patients, there is need for complex nursing and medical care. My aspiration towards pursuing this major is to learn how best to provide effective healthcare and increase patient safety by offering access to and continuity of care. Advanced Nurse practitioners are trained on additional medical courses such that they can offer advanced nursing care and prescribe medication. As such, they can treat and diagnose ailments, manage critical diseases, advise on public health issues and participate in health education to give information on the latest methodological and technical developments in the healthcare sector.,
All FNPs are nurse practitioners but not all nurse practitioners are FNPs. A FNP has undergone specialized clinical and academic training crucial in family-focused care. A FNP works with all age groups and is able to give a diagnosis, treat, and prescribe medication and quality care within the scope of their career. Depending on the state, FNPs have access to research and trials crucial in medical care. With such access, they are able to conduct evidence-based research on alternative options for medical care for chronic illnesses such as cancer and diabetes. Since they are trained to offer care to patients of all age groups, they can engage in public health programs that would give them access to information crucial to providing better medical care. Their exposure also grants access to previous forms of care that can be modified to improve patient health while maintaining their safety. For example, there has been continued research into the best form of care for patients with dementia in the elderly in nursing homes. Similarly, FNPs have researched on alternative methods for neonatal care and treatment to improve the recovery rates of critically ill neonates. To be a successful nurse practitioner, one must meet the academic requirement of at least a Master’s degree as well as other licensing needed in nursing education. Communication skills are also important, since nurses the first contact a patient has when they visit a healthcare facility. They need to encourage open communication such that they are able to help their patients based on the information shared with them. Additionally, one must be empathetic, a team player, diligent, compassionate, and a good listener such that they are able to offer the best form of medical care to their patients at all times.
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Discussion 2
Top of Form
My name is Euclides Munoz Perez, and I am a nurse by profession. Growing up, I had a passion for the role health practitioners play in the world. Therefore, I decided to study nursing as a career to serve the sick in society. I enrolled in Advanced Practice program, I sought to specialize in this field to provide the preventive care services to the public, to prevent them from exposure from disease-causing agents and this will boost to the development of a healthy community.
The advanced practice nurse has roles to play, which include, provision of primary and specialty health care across the lifespan(OERMANN& FLOYD, 2002). This is acquired by assessment and diagnosing illnesses and injuries. Qualified nurses administer the right dosage of anaesthesia and pain management services. The certified nurse-midwives aid in gynecological and reproduction procedures. These are part of the major roles advance practice nurses play.
Family Nurse Practitioners (FNPs) also play a vital role in primary care. They provide primary health care services to people of all ages. They provide services to an individual or families throughout an extended period. FNPs closely with other specialists to provide case management for illnesses for their patients.
Evidence-Based Practice is not the solution to improve the patient’s outcome. Reason being the patient’s immunity differs from each other. Procedures done and registered positive feedback on one patient may not be the same case for another. Therefore, EBP is not a recommendation. FNPs should give hope to their patients as it is essential for the recovery at first. They should also seek an alternative treatment once the current treatment method doesn’t provide positive feedback.
Skills and values are essential towards becoming a successful nurse practitioner. The nurse should have attention to detail, and this helps significantly to listening to comprehending patients. Physical endurance for maybe harsh working hours in health facilities(Morrisey& DeBourgh,2001). A nurse should have a love for the patients as this will help them adhere to their needs with attention, and also, they should have developed a quick response to their working environment as it is essential.
Reference
OERMANN, M. H., & FLOYD, J. A. (2002). Outcomes research: An essential component of the advanced practice nurse role. Clinical Nurse Specialist, 16(3), 140-144.
Morrisey, L. J., & DeBourgh, G. A. (2001). Finding evidence: Refining literature searching skills for the advanced practice nurse. AACN Advanced Critical Care, 12(4), 560-577.
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Laura Saldivar
FNU
Advanced Primary Care of Family I Practicum
Discussion 2
5/5/2020
My name is Laura Saldivar and I am practicing in an intensive care unit at this time. Working in the intensive care unit I have learned to take initiative and play a more independent role as a registered nurse by titrating drips to my better judgment, without needing the approval of others. This was the first step into taking on a greater role in patient care. This has been a motivating and inspiring stepping stone for me that pushed me to further my education and become a nurse practitioner. The advanced Nurse practitioner plays a big role in the overall patient care, both preventative and curative. The Advanced Nurse Practitioner has greater independence and autonomy in treating the patient, as well as a more personal bedside manner which promotes gaining patient trust and loyalty.
The world is facing reduced numbers in primary care physicians as many medical students choose to specialize, in combination with the number of retiring primary care physicians. Overall this has equated to an increase in the number of physicians providing primary care to patients in the outpatient setting (Poghosyan, L., Liu, J., & Norful, A. A. 2017). Policy makers and administrators have been searching for solutions to increase the primary care capacity. Fortunately, Nurse practitioners fit the bill and are filling in the gaps for underserved communities. NPs can help meet the increasing demand for primary care by taking responsibilities as primary care providers, and organizations can assign NPs their own patient panels (Côté, N., Freeman, A., Jean, E., & Denis, J. L. (2019).
Nurse Practitioners can do a through history on chronically ill patients to assess what medications have been prescribed in the past to understand what medications have been most affective and have shown best results. During practice it is often difficult to obtain medical history due to multiple factors such as poor historians, lost documentation, unfamiliar with medications etc. Often times patients do not have a consistent primary care provider and move around from place to place making continued care difficult. It is important that we, as NP’s can attempt to put the pieces together and transition the patient to our services while providing best outcome.
Personality traits that are important while providing patient care is friendliness, clear communication, and being a good listener. We must be considerate and remember that our patient’s feelings are relevant, and they have a say in their plan of care.
References
Côté, N., Freeman, A., Jean, E., & Denis, J. L. (2019). New understanding of primary health care nurse practitioner role optimisation: the dynamic relationship between the context and work meaning. BMC health services research, 19(1), 882. https://doi.org/10.1186/s12913-019-4731-8
Poghosyan, L., Liu, J., & Norful, A. A. (2017). Nurse practitioners as primary care providers with their own patient panels and organizational structures: A cross-sectional study. International journal of nursing studies, 74, 1–7. https://doi.org/10.1016/j.ijnurstu.2017.05.004
