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NR506NP Healthcare Policy and Leadership
Barriers to Practice
Purpose
Discuss barriers to practice as an APN in one’s state from both a state and national perspective. Research methods to influence policy change from various forms of competition, state legislative and executive branches of government and interest groups.
Organizational Change and Ethical-Legal Influences in Advanced Practice Nursing Case Study
Purpose
The purpose of this discussion is to discuss organizational changes and ethical-legal influences in a clinical scenario at an out-patient family practice. Students will explore potential effects on patient outcomes and ethical and legal implications for members of the heath care team as a result of illegal behaviors. Students will develop strategies that result in prevention of untoward outcomes that result in a positive practice culture NR506NP Full Course Assignments.
You are a family nurse practitioner employed in a busy primary care office. The providers in the group include one physician and three nurse practitioners.
The back office staff includes eight medical assistants who assist with patient care as well as filing, answering calls from patients, processing laboratory results and taking prescription renewal requests from patients and pharmacies NR506NP Full Course Assignments.
Stephanie, a medical assistant, has worked in the practice for 10 years and is very proficient at her job. She knows almost every patient in the practice, and has an excellent rapport with all of the providers.
Mrs. Smith was seen today in the office for an annual physical. Her last appointment was a year ago for the same reason. During this visit, Mrs. Smith brought an empty bottle of amoxicillin with her and asked if she could have a refill. You noted the patient’s name on the label, and the date on the bottle was 1 week ago.
You also noted your name printed on the label as the prescriber. The patient admitted that she called last week concerned about her cough and spoke to Stephanie. You do not recall having discussed this patient with Stephanie nor do the other providers in the practice NR506NP Full Course Assignments.
What are the potential ethical and legal implications for each of the following practice members?
What strategies would you implement to prevent further episodes of potentially illegal behavior?
What leadership qualities would you apply to effect a positive change in the practice?? Be thinking about the culture of the practice.
Review the Hedis Measures and select ONE (1) measure. Briefly discuss the measure. Discuss how each intervention can result in improved patient outcomes and cost savings for the practice. Provide evidence to support your discussion.
Discuss how each intervention can result in improved patient ratings (an NP’s patient scorecard). Provide evidence to support your discussion.
Use the provided APA Paper Template to complete the assignment.
Review writing for grammar and mechanics. Consider using academic writing resources to support writing. Your paper should include a title page, introduction with a purpose statement, body with citations to support assertions, conclusion addressing the findings of the paper, and reference page.
Review APA formatting. Consider using APA resources to support citation and reference formation.
Enjoy the learning and reach out to me if you have questions.
Access the Webex Recording
Access the Webex Recording
Purpose
The purpose of this assignment is to have students research the measurement tools of NP performance. Through the use of quality patient outcomes, student will l ist and discuss three different patient interventions and how they would specifically measure the outcomes and h o w these primary care interventions result in improved patient outcomes and cost savings for the practice . In addition, students will discuss how these interventions result in improved patient ratings .
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
Employ strategies to impact the development, implementation, and consequences of holistic healthcare policies using evidence-based practice principles (CO1)
Critically analyze how healthcare systems and APRN practice are organized and influenced by ethical, legal, economic and political factors (CO2)
Demonstrate professional and personal growth concerning the advocacy role of the advanced practice nursing in fostering policy within diverse healthcare settings (CO3)
Analyze social, historical, ethical and political contexts of healthcare policies and advanced practice leadership (CO4)
Advocate for institutional, local, national and international policies that fosters person-centered healthcare and nursing practice (CO5)
Due Date: Sunday of week 3 by 11:59 PM MST.
Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.
Total Points Possible: 200
The National Committee for Quality Assurance (NCQA) was formed to ensure quality of patient care and measurement of patient outcomes with set standards.
Healthcare Effectiveness Data and Information Set (HEDIS) is a performance measurement tool used by millions of health insurance plans. There are 6 domains of care:
Effectiveness of Care.
Access/Availability of Care.
Experience of Care.
Utilization and Risk Adjusted Utilization.
Health Plan Descriptive Information.
Measures Collected Using Electronic Clinical Data Systems
You may access the 6 domains of care by clicking this link:
(NCQA, n.d. https://www.ncqa.org/hedis/)
As an APN, productivity will be an important measurement for the practice to determine reimbursement and salary. Fee-for-service practices will require a set number of patients per day to maintain productivity. A capitated practice will require the APN to have a large panel of patients but also will focus on controlling costs. This can be accomplished through effective primary care that is accessible, convenient for the patients and has a method of measuring quality of care.
Write a formal paper in APA format with title page, introduction, the three required elements below, conclusion and reference page.
You are now employed as an NP in primary care. Choose one performance measure from one of the six domains of care, i.e. Adult BMI Assessment, Prenatal and Postpartum care, etc.
Develop three different patient interventions for that one performance measure and how you would specifically implement the intervention and measure the outcomes for that particular performance measure in clinical practice.
How would these primary care interventions result in improved patient outcomes and health care cost savings?
How can these interventions result in improved NP patient ratings?
Category
Points
%
Description
List and discuss three different patient interventions and how you would specifically measure the outcomes.
60
30%
From the National Committee for Quality Assurance (NCQA) website, discuss three patient interventions for the one performance measure.
Develop a measurement tool to track patient outcomes.
How would these primary care interventions result in improved patient outcomes and cost savings for the practice?
60
30%
Discuss how the interventions can result in improved patient outcomes and cost savings for the practice.
How can these interventions result in improved patient ratings?
60
30%
Discuss how these interventions can result in improved patient ratings (an NP’s patient scorecard).
180
90%
Total CONTENT Points= 180 pts
Category
Points
%
Description
Clarity of Writing
10
5%
Excellent use of standard English showing original thought. No spelling or grammar errors. Well organized with proper flow of meaning.
APA Format
10
5%
APA format, grammar, spelling, and/or punctuation are accurate.
20
10%
Total FORMAT Points= 20 pts
200
100%
ASSIGNMENT TOTAL= 200 points
Healthcare professionals play a significant role in improving patient and community health and well-being. However, healthcare professionals face multiple challenges, including increased demands for quality care, nursing staff shortages, a high prevalence of chronic conditions, and the need to integrate technology into clinical practice. These issues can affect care providers’ performance, prompting the need to measure nurse practitioners’ performance consistently.
According to Kahya & Oral (2018), assessing the performance of healthcare professionals is a profound strategy for guaranteeing high-quality care and achieving the desired medical outcomes. The National Committee for Quality Assurance (NCQA) provides a set of standards for improving care quality and measuring patient outcomes consistent with nursing interventions. Consequently, this paper discusses BMI (Body Mass Index) assessment as a performance measure and identifies strategies for improving patient outcomes, cost saving, and enhancing patient ratings.
Adult body mass index (BMI) assessment is a profound approach for enabling people to maintain healthy body weights and preventing multiple overweight-associated conditions. According to the National Committee for Quality Assurance [NCQA) (n.d), BMI remains the most useful population-level measure of obesity and overweight. When justifying the rationale for frequent adult BMI assessment, it is vital to consider obesity as a significant population health problem that results in detrimental consequences, including a high prevalence of chronic conditions like diabetes, cardiovascular diseases (CVDs), and premature deaths.
The National Committee for Quality Assurance (n.d) contends that obesity contributes to approximately one in five deaths in the United States. Other consequences associated with obesity and overweight include social stigma, psychological stress, compromised quality of life, and increased care costs (Gutin, 2017). As a result, weight-for-height screening (BMI assessment) enables healthcare professionals to estimate and identify the amount of body fat.
Equally, careful BMI monitoring helps healthcare professionals to identify at-risk populations and develop individualized interventions for preventing and treating obesity, including involving adults in regulated physical exercises, practicing diet control mechanisms, and educating them on self-care interventions. Arguably, it is possible to ensure appropriate BMI assessment and improvement of patient outcomes by obtaining, documenting, and frequently updating records regarding weight, height, and BMI for all outpatient adults, educating at-risk populations on interventions for managing healthy body weights, and developing follow-up plans to ensure long-term effects of the enacted strategies for preventing obesity and overweight.
Healthcare professionals can adopt various ways of assessing adults’ BMIs and identifying at-risk individuals. According to Khanna et al. (2022), strategies for measuring and evaluating the body mass index include establishing the percentage of the body or visceral fat, measuring the waist circumference, and computing the waist-to-hip ratio. These criteria are fundamental in defining obesity and overweight. The World Health Organization [WHO] (2021) defines obesity as a body mass index (BMI) greater or equal to 30kg/m², while overweight represents a BMI greater or equal to 25kg/m². Based on the World Health Organization’s definitions of obesity and overweight, it is possible to detect the levels of risk and proximity to the risk factors for obesity and overweight.
After assessing adult BMI based on waist-to-hip ratios, waist circumference and computing the percentage of the body or visceral fat, healthcare professionals are responsible for keeping accurate documentation and frequently updating records to establish the effectiveness of interventions in preventing and treating overweight and obesity. Healthcare professionals should ensure accurate documentation of BMI by using electronic medical record systems (EMRS).
Verberne et al. (2018) contend that electronic health records (EHRs) contain complete and structured patient health status information documentation. Also, these technology-mediated modalities allow clinicians to accurately compute adult BMI by automating the process and leveraging data regarding patients’ heights and weights. Therefore, they enhance procedure accuracy and convenience. After applying these strategies to compute and assess adult BMI, it is possible to track and measure patient outcomes by creating spreadsheets and updating the team consistent with results from subsequent BMI assessments.
The second population-level intervention for improving BMI assessment and preventing obesity is educating at-risk people on appropriate strategies for managing weight and addressing risk factors for obesity and overweight. Hartmann-Boyce et al. (2018) contend that individual-level efforts for preventing and treating obesity are transferable to the broader population, providing opportunities for reducing the burden of obesity-related diseases, including cardiovascular conditions, some types of cancer, and diabetes. In the same vein, the World Health Organization [WHO] (2021) presents obesity as a multifactorial public health problem that prevails due to various risk factors, including an increased intake of unhealthy foods (high in fat and sugars), physical inactivity, and sedentary lifestyles. A lack of knowledge and awareness of self-management practices can increase an individual’s susceptibility to obesity and other associated problems.
Amidst the need to improve individual and population health literacy and awareness of preventive behaviors and activities, it is essential to tailor an educational program to enlighten people about self-management interventions. According to Hodgkinson et al. (2019), obesity awareness campaigns and educational programs focus on socio-behavioral factors that cause obesity. For instance, educating individuals and the community improves people’s knowledge of healthy diets and physical activity levels. It would be essential to assess the outcomes of this intervention by using Kirkpatrick’s evaluation model that evaluates educational programs based on participants’ training experience, learners’ learning outcomes, change in behavior and improvement, and the overall impacts of the educational program (Heydari et al., 2019). This approach can evaluate the program’s impact on staff satisfaction, behavior, and learning.
Although accurately recording BMI measurements and educating people about obesity and preventative measures can enhance interventions for preventing and treating obesity, these efforts are unsustainable if a proper follow-up plan is lacking. Welzel et al. (2018) argue that healthcare professionals should assist patients in continuous weight management. A comprehensive and well-timed follow-up can improve patient outcomes by fostering meaningful relationships with healthcare organizations, improving adherence to preventative and treatment options, and enhancing effective communication to support care coordination.
Implementing the identified population-level interventions aims to improve patient outcomes by reducing their susceptibility to obesity and overweight-associated conditions, such as cardiovascular diseases (CVDs) and diabetes. Also, early BMI assessment, community-based educational programs, and follow promote preventive behaviors by providing opportunities for early obesity detection, emphasizing preventative measures, and adherence to treatment interventions. According to Hodgkinson et al. (2019), educational interventions targeting at-risk populations can improve their health literacy, influence and promote preventive behaviors and activities, and enable people to sustain preventive and treatment strategies, including healthy diets and physical exercise. As a result, it is valid to associate the identified patient interventions with improved patient outcomes.
Obesity and overweight inflict a massive cost burden on individuals, families, and healthcare systems. According to the Centers for Disease Control and Prevention [CDC] (2022), obesity costs the United States government approximately $173 billion annually. More essentially, a high prevalence of obesity-related diseases, including cardiovascular conditions, some types of cancer, and diabetes, exacerbate and increase care costs. As a result, implementing the identified measures can reduce care costs by promoting preventive behaviors and acts, providing early obesity screening and detection opportunities, and improving people’s health literacy.
Patient ratings are products of consumer experiences and satisfaction levels. Positive experiences and highly satisfactory healthcare services can improve care acceptability, appropriateness, and utilization. The proposed patient interventions for preventing and treating obesity are engaging and evidence-based. Hong et al. (2019) argue that obesity is a stigmatized condition that leads to weight-based discrimination. As a result, engaging patients and at-risk people in early BMI assessment, education programs, and follow-up plans can enhance their health, reduce susceptibility to obesity-related conditions, and curtail care costs. Participative and practical approaches can improve patient safety and contribute to care acceptance.
Healthcare professionals encounter various tools for measuring their performance amidst dynamics in healthcare. Consistent measuring nurse practitioner performance is a profound approach to improving health quality and patient outcomes. The National Committee for Quality Assurance (NCQA) provides a set of standards for improving care quality and measuring patient outcomes consistent with nursing interventions. For example, adult BMI assessment is the primary measure of obesity and overweight. This performance measure enables healthcare professionals to identify at-risk adults and develop/implement evidence-based, population-oriented services. This paper discusses BMI (Body Mass Index) assessment as a performance measure and identifies strategies for improving patient outcomes, cost-saving, and enhancing patient ratings.
Centers for Disease Control and Prevention. (2022, July 14). Why it matters. https://www.cdc.gov/obesity/about-obesity/why-it-matters.html#
Gutin, I. (2017). In BMI we trust: Reframing the body mass index as a measure of health. Social Theory & Health, 16(3), 256–271. https://doi.org/10.1057/s41285-017-0055-0
Hartmann-Boyce, J., Aveyard, P., Piernas, C., Koshiaris, C., Velardo, C., Salvi, D., & Jebb, S. A. (2018). Cognitive and behavioral strategies for weight management in overweight adults: Results from the Oxford food and activity behaviors (OxFAB) cohort study. PLOS ONE, 13(8), e0202072. https://doi.org/10.1371/journal.pone.0202072
Heydari, M. R., Taghva, F., Amini, M., & Delavari, S. (2019). Using Kirkpatrick’s model to measure the effect of new teaching and learning methods workshop for health care staff. BMC Research Notes, 12(1). https://doi.org/10.1186/s13104-019-4421-y
Hodgkinson, A., Abbott, J., Hurley, M. A., Lowe, N., & Qualter, P. (2019). An educational intervention to prevent overweight in pre-school years: A cluster randomized trial with a focus on disadvantaged families. BMC Public Health, 19(1). https://doi.org/10.1186/s12889-019-7595-2
Hong, Y.-R., Pavela, G., Lee, A. M., Williamson, V. G., & Cardel, M. I. (2019). Satisfaction with health care among individuals with overweight and obesity: A nationally representative cross-sectional study. Journal of General Internal Medicine, 34(8), 1397–1399. https://doi.org/10.1007/s11606-019-04939-2
Kahya, E., & Oral, N. (2018). Measurement of clinical nurse performance: Developing a tool including contextual items. Journal of Nursing Education and Practice, 8(6), 112. https://doi.org/10.5430/jnep.v8n6p112
Khanna, D., Peltzer, C., Kahar, P., & Parmar, M. S. (2022). Body mass index (BMI): A screening tool analysis. Cureus, 14(2). https://doi.org/10.7759/cureus.22119
National Committee for Quality Assurance. (n.d.). Adult BMI assessment. Retrieved November 11, 2022, from https://www.ncqa.org/hedis/measures/adult-bmi-assessment/
Verberne, L. D. M., Nielen, M. M. J., Leemrijse, C. J., Verheij, R. A., & Friele, R. D. (2018). Recording of weight in electronic health records: An observational study in general practice. BMC Family Practice, 19(1). https://doi.org/10.1186/s12875-018-0863-x
Welzel, F. D., Stein, J., Pabst, A., Luppa, M., Kersting, A., Blüher, M., Luck-Sikorski, C., König, H.-H., & Riedel-Heller, S. G. (2018). Five A’s counseling in weight management of obese patients in primary care: A cluster-randomized controlled trial (INTERACT). BMC Family Practice, 19(1). https://doi.org/10.1186/s12875-018-0785-7
World Health Organization. (2021, June 9). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
This is a required, but not graded open forum. Your post should add further clarity to the assignment and content of the readings and lessons for the week. Please feel free to post questions related to content or assignments.
This presentation needs speaker notes with the presentation, since I have to present the power point presentation. please add speakers notes.
Now on to week four. Start by viewing the Student Assignment Recording in the week 4 assignment area.
Research healthcare issues that have been identified in your local community. Develop a power point presentation with speaker notes. You will then use the power point during your Kaltura recording. Structure a health policy analysis presentation that addresses the following topics particular to your health problem.
Problem Statement
Background
Landscape
Options
Recommendations
Next, record your Kaltura presentation showing your power point and yourself speaking. Upload your Kaltura presentation into the week 4 assignment. How to use Kaltura resources are in Home/Resources/Technology Resources.
Posting your recording:
This week you will be producing a power point on a health policy analysis. From what you learned in week three about national data on healthcare issues, you will now examine one healthcare issue that is predominant in your local community. From your weekly readings (be sure to read chapter 14 from the Teitelbaum text in detail) you will:
Structure a health policy analysis presentation that addresses the following topics particular to your health problem. Develop a PowerPoint offline to address:
Problem Statement
Background
Landscape
Options
Recommendations
Important: This is not a patient treatment plan. This is a change in health policy to prevent secondary and tertiary effects from a health problem or unhealthy behavior.
Next, record your Kaltura presentation and upload it into the week 4 assignment. Recorded instructions on how to use Kaltura is imbedded under Resources on the left side, then Technology Resources.
Purpose
This assignment will focus on developing a health policy analysis presentation that includes a problem statement, background, landscape, options and recommendations from the week’s readings. The health policy analysis presentation is based upon an identified healthcare issue in one’s local community.
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
Employ strategies to impact the development, implementation, and consequences of holistic healthcare policies using evidence-based practice principles (CO1)
Critically analyze how healthcare systems and APRN practice are organized and influenced by ethical, legal, economic and political factors (CO2)
Analyze social, historical, ethical and political contexts of healthcare policies and advanced practice leadership (CO4)
Advocate for institutional, local, national and international policies that fosters person-centered healthcare and nursing practice (CO5)
Ethical and Legal Implications
Purpose
Discuss potential complications in a clinical scenario at an out-patient family practice. Students will explore potential effects on patient outcomes and implications for members of the heath care team as a result of conflict among the healthcare team. Students will develop strategies that result in prevention of untoward outcomes that result in a positive practice culture.
Through this discussion, the student will demonstrate the ability to:
You are a family nurse practitioner working in an outpatient primary care office of a large hospital system. The practice has been operating for over 15 years, and many of the administrative and clinical staff were hired when the practice opened.
You have been in the practice for less than 3 months. In that short amount of time, you have witnessed several of the clinical staff engaging in heated arguments with each other, sometimes in patient areas NR506NP Full Course Assignments.
You overhear an argument occurring today between two staff. You pick up a patient’s chart and notice a very low blood pressure that the medical assistant failed to notify you about. When you confront the MA, she states that she was going to report the vital signs to you when she became engaged in the heated argument you overheard and forgot to notify you.
Unfortunately, this pattern of behavior is not unusual in this practice. Working with staff who cannot cooperate effectively can negatively influence your ability to spend time with patients, can impede the flow of patients through the office, and could impact patient safety.
Case Study Responses:
Analyze the case study for potential issues for members of the healthcare team from office conflict. Contrast the potential effects for each member of the healthcare team based upon the required readings from the week. Discuss the potential ethical and legal implications for each of the following practice members:
Scope of Practice and Patient’s Healthcare Accessibility
Purpose
The purpose of this assignment is to identify the scope of practice in one’s state including level of independence of practice, prescribing authority, any limitations of practice, process for obtaining licensure in your state, certification and education requirements for licensure. Next, students will discuss how the level of independence of practice in their state, i.e., reduced, restricted or full practice, affects patient’s access to care in their local community.
Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:
NR506NP Full Course Assignments Requirements
Discuss your state NP community in terms of scope of practice. Include the your state’s scope of practice for NPs including:
If you live in a restricted or reduced practice state, how has patient care been impacted in your local community from these barriers? For instance, is the ED used for primary care? Are the EDs overcrowded with long wait times? Are there urgent ca
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