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South University: Nursing 5000 - Role of the Advanced Practice Nurse Week 1 to 5 and Final Project 100% CORRECT
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South University:NSG 5000 Role of the Advanced Practice Nursing Week 1, Assignment Project 1
South University:NSG 5000 Role of the Advanced Practice Nursing Week 1, Assignment Project 1 Project 1 South University Online ... [Show More] NSG5000 Role of the Advanced Practice Nursing Week 1, Assignment Project 1 Instructor Name: Kelly Fisher The program for which I was admitted to the University is the MSN with a specialization in Family Nurse Practitioner. According to Nurse Journal, 2018 Family nurse practitioners (FNPs) are graduate-educated, nationally-certified and state licensed advanced practice registered nurses (APRNs) who care for medically stable patients across the lifespan, from infants to geriatric patients. Just like a primary care physician, FNPs provide continuous, comprehensive care through disease management, health promotion, health education, and preventative health services. They are qualified to … Manage chronic conditions, such as hypertension and diabetes Oversee the health and wellness of women, including providing preconception and prenatal care Provide health and wellness care to infants and children Treat minor acute injuries Provide episodic care for acute illnesses in all ages FNPs often co-manage the conditions of their patients with other specialists and provide case management for long-term illnesses and conditions. Their job duties include diagnosing illnesses and conditions, ordering and interpreting diagnostic tests, conducting examinations, providing counseling, and prescribing medications in many cases. FNPs may also earn additional specialty certification to further specialize in areas like cardiology, women’s health, and neurology, among many others. FNPs often co-manage the conditions of their patients with other specialists and provide case management for long-term illnesses and conditions. Their job duties include diagnosing illnesses and conditions, ordering and interpreting diagnostic tests, conducting examinations, providing counseling, and prescribing medications in many cases(Nurse Journal, 2018). FNPs may also earn additional specialty certification to further specialize in areas like cardiology, women’s health, and neurology, among many others. [ CITATION Fon17 \l 1033 ] Because of their ability to work with a broad patient population across all age ranges, life stages and genders, FNPs are found in an equally diverse number of settings from independent private practices with other NPs, physician’s offices and major hospitals, to schools, state and local health departments, community clinics and other ambulatory care facilities (Nurse Journal, 2018). Based on the Advanced Practice Nursing concept, we can effectively say that the FNP is part of this concept. According to [ CITATION Ham14 \l 1033 ] the ANA's Scope and Standards of Practice, Third Edition (2010) does not provide a definition of advanced practice nursing but uses a regulatory definition of APRNs: A nurse who has completed an accredited graduate-level education program preparing her or him for the role of certified nurse practitioner, certified registered nurse anesthetist, certified nurse-midwife, or clinical nurse specialist; has passed a national certification examination that measures the APRN role and population-focused competencies; maintains continued competence as evidenced by recertification; and is licensed to practice as an APRN. We can affirm that direct clinical practice is the central competency of any APN role and informs all the other competencies. [ CITATION Ham14 \l 1033 ] I have based my search on two research articles. The first one deals with “The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review”. The prevalence of chronic illness and multimorbidity rises with population aging, thereby increasing the acuity of care. Consequently, the demand for emergency and critical care services has increased. The objectives of this study were to present, critically appraise, and synthesize the best available evidence on the impact of advanced practice nursing on quality of care, clinical outcomes, patient satisfaction, and cost in emergency and critical care settings. This is a qualitative study, The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adhered to in the conduct and reporting of this systematic review. A comprehensive and systematic search of nine electronic databases and a hand-search of two key journals from 2006 to 2016 were conducted to identify studies evaluating the impact of advanced practice nursing in the emergency and critical care settings. Two authors were involved selecting the studies based on the inclusion criteria. Out of the original search yield of 12,061 studies, 15 studies were chosen for appraisal of methodological quality by two independent authors and subsequently included for analysis. Data was extracted using standardized tools. Narrative synthesis was undertaken to summarize and report the findings. This review demonstrates that the involvement of nurses in advanced practice in emergency and critical care improves the length of stay, time to consultation/treatment, mortality, patient satisfaction, and cost savings. This review suggests that the implementation of advanced practice nursing roles in the emergency and critical care settings improves patient outcomes. The transformation of healthcare delivery through effective utilization of the workforce may alleviate the impending rise in demand for health services. Nevertheless, it is necessary to first prepare a receptive context to effect sustainable change. [ CITATION Fon17 \l 1033 ] The second research study deals with “The Outcomes associated with nurse practitioners in collaborative practice with general practitioners in rural settings in Canada”: a mixed methods study. Three case studies where NPs were embedded into rural fee-for-service practices were undertaken to determine the outcomes at the practitioner, practice, community, and health services levels. Interviews, documents, and before and after data, were analyzed to identify changes in practice, access, and acute care service utilization. The study used a case study design based on an ecological framework .A case study involves constructing detailed and intensive knowledge about a single case or a small number of related cases. A case is a “phenomenon of some sort occurring within a bounded context and represents the unit of analysis in this type of design. Multiple types and sources of data were typically used to explore, describe, and explain the phenomenon of interest within each case. Multiple cases were used, when possible, to add confidence to the findings. The study was conducted in a rural area in one of the five geographically-based health authorities (government organizations responsible for health service delivery) in the province. The case study sites were primary care practices in which a NP had been ‘embedded’ to work in a collaborative practice model with the FFS GPs. Across the three cases, 25 individuals participated representing NPs, GPs, other practice staff, other community- based health care providers, and health authority representatives. The qualitative data were collected through interviews, direct observation, field notes, archival records, and documents. Semi-structured key informant interviews were undertaken with all participants to identify the components of the NP role and the positive and negative changes that had occurred since the introduction of the role in each setting. Direct observations included the physical arrangements of the practices, interactions between staff, and informal meetings; these were recorded as field notes. Documents were collected from both the government and the health authority relating to the implementation of the NP role, as well as newspaper, TV and radio clips, conference presentations, and letters. The quantitative data comprised practice and health authority service records. Before and after records were obtained from both the practices and the health authority to identify changes in patient access to and the volume of patients served by the practice, and utilization of acute care health services (emergency services and hospital admissions from emergency) by the patients of these practices. [ CITATION Roo14 \l 1033 ] This study has shown that the addition of a NP to the predominant delivery model for primary care services, namely FFS, can improve available care and result in substantial positive effects on fundamental problems facing the health system. Careful mapping of the relationships among variables and concepts using mixed methods analysis in a case study design demonstrated positive outcomes of NP practice at all levels of the system, both within and externally, to these primary care practices. The provision of care for patients was reported to have improved; relationships and teamwork involving the practitioners and the practice were perceived as enhanced; access to the practice for patients was documented to have significantly increased; the practices were perceived by many to become more connected with their communities; and the utilization of acute care services significantly decreased for the patients of the practices. These outcomes associated with the NP/GP collaborative practice primary care model demonstrate the importance of the NP role in this setting and support a conclusion that it can play an important role in meeting the primary care needs of the population. [ CITATION Roo14 \l 1033 ] Nurse Practitioner Interview Questions Name: Carol, MSN APRN FNP Facility: Christian Communities Healthcare Planned Date: 11/13/2018 Questions What has motivated you to become a nurse practitioner? What type of Nursing did you decide to focus on, and why? Can you tell us about your key responsibilities as a nurse practitioner? What are some of the challenges you face day to day as a nurse practitioner? 5- What skills do you consider to be essential for success as a nurse practitioner? What differences do you think exist between a Nurse Practitioner and a doctor? What do you do when a patient requests unnecessary pain medication? Have you ever disagreed with a physician over the diagnosis or treatment of a patient? How did you handle the situation? If you could do it all over again , would you still become a Nurse Practitioner? What is one piece of advice you give me to continuing my career as a nurse practitioner? [Show Less]
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South University: Nursing 5000 - Role of the Advanced Practice Nurse Week 2 Project,100% CORRECT
South University: Nursing 5000 - Role of the Advanced Practice Nurse Week 2 Project Running Head: CORE COMPETENCIES OF A NURSE PRACTITIONER Core Comp... [Show More] etencies of a Nurse Practitioner South University Nursing 5000 - Role of the Advanced Practice Nurse Week Two Project Professor Stroud January 18th, 2022 Each profession must have a set of core standards and competencies to ensure they are functioning at the highest level while working. This is especially vital in the healthcare field and why the National Organization of Nurse Practitioner Faculties (NONPF) has defined nine core competencies for the profession. In this paper, we will discuss and explain the nine core competencies developed by the NONPF, how one can meet basic mastery of those core competencies, define the leadership competency and the attributes they possess or need to build and explore how one can demonstrate mastery of two more of the nine core competencies. Each profession has a set of core competencies that define what is required to be considered knowledgeable in their work field. The National Organization of Nurse Practitioner Faculties (NONPF) has done the same in their area. The nine core competencies defined by the NONPF include scientific foundations, leadership, quality, practice inquiry, technology and information literacy, policy, health delivery system, ethics, and independent practice (What are, 2022). Each competency plays an integral part in the curriculum to educate future Nurse Practitioners to ensure the knowledge, skills, and abilities learned. At the same time while in school make them competent licensed independent practitioners. The scientific foundation’s competency requires NP’s to “critically analyze data and evidence, integrate knowledge from the humanities and sciences, translate research, and develop new practice approaches based on the integration of research, theory, and practice knowledge (Nurse Practitioner, n.d.). Mastering this competency allows Nurse Practitioners to enhance processes and outcomes in the nurse field and advance nursing practice as a whole. The leadership competency calls for NP’s to “assume complex and advanced leadership roles, provide leadership to foster collaboration with multiple stakeholders, demonstrate critical and reflective thinking, communicate practice knowledge effectively, and participate in professional organizations and activities” (Nurse Practitioner, n.d.). All of which help guide change and refine the way health care is delivered across the nation. The quality competency demands NP’s to “use the best available evidence to improve clinical practice, evaluate the relationship between access, cost, quality, and safety in health care, gauge how different organizations impact the quality of health care, promote a culture of excellence, and implement interventions to ensure quality” (Nurse Practitioner, n.d.). Conquering this competency permits Nurse Practitioners to ensure the best available care is delivered regarding access, cost, quality, and safety. The practice inquiry competency stipulates NP’s to “generate knowledge from clinical practice, translate new knowledge into practice, apply clinical investigative skills, lead practice inquiry, disseminate evidence to diverse audiences, and analyze clinical guidelines (Nurse Practitioner, n.d.). Becoming an expert in this competency allows Nurse Practitioners to incorporate new practices into how health care is delivered, thus improving the practice. The technology and information competency require NP’s to “integrate technologies for knowledge management, translate technical and scientific health information, assess the patient and caregivers educational needs, coach the patient and caregiver, demonstrate information literacy skills, contribute the to design of clinical information systems, and use technology that captures data for the evaluation of nursing care (Nurse Practitioner, n.d.). Proficiency in this competency grants Nurse Practitioners to improve personalized health care and encourage safe, quality, and effective care to all patients. The policy competency permits NP’s to “demonstrate an understanding of policy and practice, advocate for ethical policies, analyze ethical, legal, and social factors, contribute to the development of health policies, analyze the implications across disciplines, and advocate for policies for safe and health practice environments (Nurse Practitioner, n.d.). Expertise in this competency urges Nurse Practitioners to develop and integrate quality and cost-effective policies in the healthcare field. The health delivery system competency necessitates NP’s to “apply knowledge of organizational practices, effect health care change using broad-based skills, minimize risk to patients and providers, facilitate the development of health care in culturally diverse populations, evaluate the impact of health care delivery on patients, analyze organizational structure, function, and resources, and collaborate in planning for transitions across the continuum of care (Nurse Practitioner, n.d.). Excellence in this competency demands Nurse Practitioners to better the way health care is delivered on a personal and organizational level. The ethics competency calls for NP’s to “integrate ethical principles, evaluate ethical consequences of decisions, and apply ethically sound solutions to complex issues” (Nurse Practitioner, n.d.). Being accomplished in this competency commands Nurse Practitioners to make sound and fair decisions regarding patient care, ultimately bettering individual care, populations, and the care system. The independent practice competency challenges NP’s to “function independently as practitioners, demonstrate the highest level of accountability, provide patient-centered care recognizing cultural diversity, educate professional and lay caregivers to provide cultural and spiritual appropriate care, collaborate with both professional and other caregivers, coordinate transitional care services, and participate in the development, use, and evaluation of professional standards” (Nurse Practitioner, n.d.). Mastering this competency empowers Nurse Practitioners to practice and manage patients and achieve superior care outcomes independently. To attain basic mastery of these competencies, they must always be willing to step out of their comfort zone and continue their education in all aspects of health care and how patient care is delivered. It is essential to first look at every patient as a whole and consider their culture, background, and day-to-day life before making decisions regarding their care. When this is done, the Nurse Practitioner applies each core competency in how patients are cared for. Leadership is one of the most critical competencies a Nurse Practitioner can achieve in their role as an Advanced Practice Nurse (APN). When a NP encompasses this competency, they show their complete understanding of their scope and standards of practice, allowing them to deliver culturally sensitive care, a commitment in professional organizations, and enhanced communication skills to their staff and patients (What are, 2022). Working as a Registered Nurse gives individuals great leadership qualities that can be used in their new roles as an APN. Since RN’s are required to critically think and delegate tasks based on priority, they must be confident leading their team into those decisions. With that being said, RN’s play a different leadership role than Nurse Practitioners, so there is still a lot to master within this competency. The traits acquired from the leadership competency include critical thinking, advocating for quality care, and include incorporating changes to enhance practice, joining professional organizations, and advocating for cost-effective care. All Nurse Practitioners continue to educate themselves and achieve excellence of all nine core competencies. The two additional core competencies of a Nurse Practitioner chosen to be discussed are policy and independent practice. Policies are constantly changing in the healthcare field, from how care is delivered, to each role’s scope of practice. Learning the policies and standards set for NP’s by the NONPF will help strengthen the way they provide tasks to their staff and care to their patients. In turn, this will aid the Nurse Practitioner in practicing independently as a provider. There is a certain level of autonomy working as an RN, but they do not have full range over treatment plans. NP’s are the ones who come up with the plan of care and place orders to treat the patient’s condition. Utilizing everything learned while in school and conquering the nine core competencies allows the Nurse Practitioner to demonstrate and provide efficient care to all patients. In conclusion, it is easy to see why each profession has a set of standards and core competencies to follow. They lay a benchmark for how individuals are expected to perform their job duties and require it is the same standard for all people on the receiving end. One must be educated, honest, and noble to work in the healthcare field, and this is why all clinicians must master the competencies laid out for their role. As William Osler said, “the trained nurse has become one of the greatest blessings of humanity, taking place beside the Physician and the Priest.” (Gilbert & Greg, 2021). [Show Less]
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South University:NSG 5000 Advanced Practice Roles in Nursing week 3 Project,100% CORRECT
South University:NSG 5000 Advanced Practice Roles in Nursing week 3 Project Advanced Practice Roles in Nursing South Un... [Show More] iversity Online NSG5000- Role of the Advanced Practice Nurse CP02 Week 3 Project APN Interview I interviewed Doctor Priscilla Jones, who works at Tampa General Hospital as a family nurse practitioner, a recap of the interview. Dr. Priscilla has worked in many facilities with a vast experience of twenty years in nursing. At Tampa hospital, she is the head of the emergency unit and sits on several committees in the facility. Organization and Setting Tampa General Hospital is a high-ranking hospital in Florida specializing in cancer care, integrative medicine, surgeries, cardiac services, and general maintenance to the patient. Tampa Hospital is a teaching hospital that collaborates with many schools that teach medical causes and help students use the facility to further their education. The hospital setting is made up of different departments that are headed by departmental heads, and there are various health committees in the different departments that monitor how services are offered in the facility. Population and Colleagues At Tampa general hospital, the population is made up of different stakeholders that include the management, health care providers, patients, and the subordinate staff (Best Hospital in Tampa Metro U.S. News | Tampa General Hospital, n.d.). The facility receives so many patients daily, especially those that require specialized care and referrals from other facilities. The number of staff members is increasing every month due to the increase in the number of patients who seek health care services. Tampa hospital has employed a nurse informaticist that helps in offering telehealth services that patients can access online to help in decongesting the facility. Dr. Priscilla indicates that there are so many colleagues in the facility who handle different duties and responsibilities. The facility believes in teamwork and collaboration in the delivery of health care services to ensure that all stakeholders work towards a common goal. Colleagues have mutual respect and can learn from one another through teamwork. Every colleague is allocated duties and responsibilities in areas that they are best at. Regulatory and Legal Requirements The regulatory body mandated in regulating the delivery of health care services and licensing of nurses in Florida is the Florida Board of Nursing. Dr. Priscilla is a licensed practitioner who gained her license about twenty years ago, and since then, she has practiced in different levels of nursing. The legal requirements include having undertaken nursing from a recognized institution that offers nursing education, passing the licensure exam, and getting a license from a recognized regulatory body. The interviewee says that in nursing, some students think that it is easy to get a license, but it requires one to put the necessary effort to get the skill and put that skill into practice. Scope of Practice According to Dr. Priscila, her job includes servant leadership to those working under her, motivation, mentorship, supervision, offering services that are satisfactory to patients, ensuring that all colleagues work towards attaining the hospital goals and objectives, and complying with the set guidelines and regulations. The scope of her world as a departmental leader is not limited to the employment contract, but at times she goes the extra mile to offer assistance during off days or leave days. In her community, she heads a self-help group that mainly focuses on offering free medical camps to the community members. Her scope of practice is governed by her willingness to offer care and live in a healthy community. The Florida scope of practice allows FNP nurses to practice in primary care settings and offer general care services to the patients. With different certifications, FNP nurses can also take specialized roles depending on the areas that they have specialized in the certifications (Florida Association of Nurse Practitioners, 2020). Professional Organizations It is very important to be a member of a professional organization as this gives one advantage for employment, involvement in research studies, learning from colleagues, being able to network with other nurses, and having the ability to build one's career. At a personal level, under the license of the Florida Board of Nursing, I would like to be a member of the Alliance of Nurses for Healthy Environments, the American Academy of Nurse Practitioners, and the National Organization of Nurse Practitioner Faculties. The rationale for wishing to be a member of this organization is my passion for offering health care services that care for the environment, having a network with health care providers in different fields, and growing my career to international standards (Tracy & O'Grady, 2019). Competencies and Certification Requirements The core competencies for FNP nurses include technology and information literacy, promoting ethics and nursing code of conduct, policymaking, offering high-quality care, and advancement in education to fit in the changing nursing world. The certification requirements include undertaking a nursing program in the area that one wants to specialize in, passing the board examination, and satisfying the board that one is competent for a license to practice. Conclusion Based on the interview feedback and research, it is clear that nursing is a dynamic career with many areas that one can specialize in. One must get the required knowledge and skills before applying for a license from the licensing body to pass the board examination and be a competent nurse. Nurses should at all times embrace the art of working with colleagues, teamwork, and collaboration to achieve the intended main goal and learn from one another. References Best Hospital in Tampa Metro U.S. News (n.d.). | Tampa General Hospital. https://www.tgh.org/ Florida Association of Nurse Practitioners. (2020). New laws for 2020. https://www.flanp.org/page/NewLaws2020 Tracy, M. F., & O'Grady, E. T. (2019). Hamric and Hanson’s Advanced practice nursing: An integrative approach (6th ed.). Elsevier. [Show Less]
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South University: Nursing 5000 - Role of the Advanced Practice Nurse Week Four Project.100% CORRECT
South University: Nursing 5000 - Role of the Advanced Practice Nurse Week Four Project Advanced Practice Nurses are considered to be at the front line ... [Show More] of patient care and are proving to be one of the most popular career paths for individuals to choose. An APN can decide to pursue four specialties: a Nurse Practitioner, a Clinical Nurse Specialist, A Nurse Anesthetists, and a Nurse Midwife. Additionally, APNs play an invaluable role in promoting change and advancing the healthcare field as we see it. In this paper, we will be discussing how APN practice demonstrates cost-effectiveness, how APN practice can influence a reduction in errors, and how APN practice affects misuse or overuse of services. Nurse Practitioners have proven to be just as valuable as physicians in the healthcare field. NPs provide direct care to patients in primary, urgent, and specialty areas and have demonstrated their ability to enhance patient experiences. According to the U.S. Bureau of Labor and Statistics, the profession of Nurse Practitioners is projected to grow by forty-five percent from 2019-2029 (What’s the, n.d.). Over the years, Nurse Practitioners have “proven to be cost-effective providers of high- quality care, administering equivalent or improved medical care at a lower total cost than physicians” (Nurse Practitioner, n.d.). As a result, NPs are being integrated into primary care settings more and more, filling the gap in physician shortages and improving the quality of care, and decreasing the cost of care. According to a study, “evidence shows primary care practices that used more APNs in care delivery had lower labor costs per patient compared to practices that had minimal use of APNs” (Abraham et al., 2019). Additionally, Nurse Practitioners typically spend more time with their patients than physicians do, resulting in more accurate diagnoses, fewer visits to the hospital or urgent care, and a reduction in errors made. Nurse Practitioners play an essential role in reducing errors in the healthcare field. For example, visits to patients are made within forty-eight hours of discharge by the NPs, resulting in fewer plan of care and medication errors. In addition, a recent study shows “the implementation of the NP/APN role in the emergency and critical care settings improves patient outcomes and reduces errors” (Fong et al., 2017). Furthermore, having Advanced Practice Nurses (APN) in primary care settings ensures that patients are seen promptly, thus decreasing the risk of medical errors. This also assures that the misuse or overuse of services is less likely to happen. The misuse of medical services increases medical errors, causing healthcare providers to overuse services due to ineffective treatment (Overuse, 2020). The presence of Nurse Practitioners has filled the gap in physician shortages, allowing more patients to access primary care services, improving the way care is delivered, and diminishing the misuse or overuse of medical services. Unfortunately, studies have shown “there is strong evidence for the widespread overuse of several specific medical services in many countries, suggesting that overuse is common around the world and might be increasing” (Fong et al., 2017). This is why it is essential to implement APNs into more areas of the healthcare field and give patients more access to the care they require and deserve. In summary, it is clear that Advanced Practice Nurses play a vital role in cost-effective care, reducing medical errors and the effects of misuse or overuse of medical services. In addition, any of the four specialties an APN chooses will play an invaluable role in promoting change within the healthcare field, thus proving them to be at the forefront of patient care. As John Ruskin said, “quality is never an accident; it is always the result of intelligent effort” (80+ Best, n.d.). References Abraham, C. M., Norful, A. A., Stone, P. W., & Poghosyan, L. (2019). Cost-Effectiveness of Advanced Practice Nurses Compared to Physician-Led Care for Chronic Diseases: A Systematic Review. Nursing Economic$, 37(6), 293–305. Brownlee, S., Chalkidou, K., Doust, J., Elshaug, A. G., Glasziou, P., Heath, I., Nagpal, S., Saini, V., Srivastava, D., Chalmers, K., & Korenstein, D. (2017). Evidence for overuse of medical services around the world. The Lancet, 390(10090), 156–168. https://doi- org.su.idm.oclc.org/10.1016/S0140-6736(16)32585- 80+ Best John Ruskin Quotes from the English Writer, Painter, and Philanthropist. Free Ideas For Family Fun & Learning. (n.d.). Retrieved February 2, 2022, from https://kidadl.com/articles/best-john-ruskin-quotes-from-the-english-writer-painter-and- philanthropist Fong Yeong Woo, B., Xin Yu Lee, J., Wai San Tam, W., Woo, B. F. Y., Lee, J. X. Y., & Tam, W. W. S. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: a systematic review. Human Resources for Health, 15, 1–22. https://doi- org.su.idm.oclc.org/10.1186/s12960-017-0237-9 Nurse Practitioner Cost Effectiveness. American Association of Nurse Practitioners. (n.d.). Retrieved January 31, 2022, from https://www.aanp.org/advocacy/advocacy- resource/position-statements/nurse-practitioner-cost-effectiveness Overuse, Underuse and Misuse of Healthcare Quality (With Example). Eaton Business School. (2020). Retrieved February 2, 2022, from https://ebsedu.org/blog/healthcare-quality- conceptual-note/ What's the Difference Between a Nurse Practitioner and a Doctor? Regis College. (n.d.). Retrieved January 31, 2022, from https://www.regiscollege.edu/blog/nursing/nurse- practitioner-vs-doctor [Show Less]
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South University: NSG 5000 Role of the Advanced Practice Nurse Week 5 project,100% CORRECT
South University: NSG 5000 Role of the Advanced Practice Nurse Week 5 project Role of the Advanced Practice Nurse South University Role of the ... [Show More] Advanced Practice Nurse NSG 5000 Role of the Advanced Practice Nurse The advanced practice nurse is a vital part of the future of health care. Advanced practice nurses can fill many roles in nursing and healthcare. APRN’s are researchers, educators, administrators, involved in policy and legislature, and provide direct patient care. Advanced Practice Roles in Nursing An advanced practice nurse is a nurse with a Master of Science degree or higher that provides direct patient care to individuals and families. There are four advance practice nurse roles that are recognized: certified registered nurse anesthetist or CRNA, nurse practitioner or NP, clinical nurse specialist or CNP and certified nurse midwife or CNM. Advanced nursing practice is a general term for the various specialties in nursing (Hamric, Hanson, Tracy, & O’Grady, 2014). This paper will discuss the Master of Science in Nursing with a specialization in Family Nurse Practitioner (MSN-FNP) also referred to as an Advanced Practice Registered Nurse (APRN). A family nurse practitioner performs a variety services such as performing H&P’s; diagnosis, treatment, and management of disease; prescribing medications; educate patients about prevention of disease and health promotion; and performs some procedures. The nurse practitioner is required to have a minimum of a Master of Science degree, pass her state board and depending on the state in which she is licensed provide proof of a certain number of continuing education hours (US National Library of Medicine National Institutes of Health website, 2019) The role of family practitioner as an advanced practice nurse is a clinical role in patient care. The American Association of Nurse Practitioners’ state NPs are an important part of the health care system because they lower the cost of health care, increase patient satisfaction and addresses the primary care shortage (American Association of Nurse Practitioners website, 2019). A mixed method study outcomes of patients who used nurse practitioners was reported by patients as an improvement in care provided; the connections between the practitioners and the practice including teamwork were identified as an increase in quality; the accessibility the patients had to the practice was recorded as having a definite increase; the practices were recognized by several individuals as having become more linked or associated with their locality; and the implementation of acute care services dramatically declined for the patients of the practices (Roots & MacDonald, 2014). This study used case studies and collected data from interviews prior and post the utilization of the nurse practitioner at three rural fee-for-service practices. Family Nurse Practitioner A nurse practitioner is an advanced practice nurse that attends to all facets in caring for patients. This includes diagnosis, treatments and consultations. Family nurse practitioners educate patients about preventative care and prescribed treatments. Family nurse practitioners perform physicals, order tests and serve as a patient's primary healthcare provider. Nurse practitioners may also prescribe medications. Primary care nurse practitioners work in family health clinics or hospitals. They provide general and preventative care, conduct check-ups, treat illnesses, order lab tests and prescribe medication for children and adults (Hospital Authority of Miller County website, 2019). The person interviewed for this paper was Stephanie Phillips, FNP-C. She is a primary care provider at the local clinic. Miller County Medical Center, the facility Stephanie is employed, provides medical care to pediatrics and adults, including women's health. The facility employees two medical doctors, one doctor of osteopathy, and two family nurse practitioners. The three physicians round at the hospital, and two nursing homes in addition to seeing patients in the clinic. The physicians average five to seven patients daily at the clinic. The two nurse practitioners average 25-30 patients per day. The population for the county the clinic serves is 6,125 (69% white, 27% black, 1% other). The population consists of 53% female and 47% male. Of those, only 13% of the citizens are 60 years of age or older (United States Census Bureau website, 2018). Interview The interview was conduction on January 30, 2018 with Stephanie Phillips, FNP-C. Stephanie went to college at the University of Georgia immediately following high school. Initially, Stephanie was not sure of her major. Stephanie’s mother and step-father are both registered nurses. After spending two and a half years at the University of Georgia she transferred to Albany State University where she obtained her Bachelor of Science in nursing. The University of Georgia does not offer a degree in nursing. After graduation she began her nursing career working night shift on the medical-surgical unit at a thirty-two-bed rural hospital. With one year of nursing behind her, Stephanie began her Master of Science in nursing at Columbus State University. She continued to work full-time those the three years while obtaining her FNP. After graduation, she was hired as a family nurse practitioner providing primary care at the local clinic that is owned by the hospital where she was employed. Stephanie continues to work at the same facility where she was initially employed twelve years ago. Stephanie worked on the medical surgical floor for four years and has been an FNP at the local clinic for twelve years. Stephanie also took a national certification exam in adult health. This allows Stephanie to use the credentials FNP-C. Stephanie feels it was beneficial working as a floor nurse and charge nurse on the medical surgical unit prior to becoming a family nurse practitioner. Stephanie states those four years is where she learned “how to be a nurse” and thinks all advanced practice nurses need the experience of hands on patient care prior to entering the master’s program. Floor nursing is where she applied the knowledge she obtained in nursing school. Stephanie is licensed in Georgia. Georgia Board of Nursing requires registered nurses and advanced practice registered nurses to renew their license every two years. The nurse much submit proof of 30 contact hours of continuing education with each license renewal. She is a member of the American Academy of Nurse Practitioners and the Georgia Nurses Association. She feels being a member of a professional organization assists her to in staying up to date on current affairs, political and otherwise, related to nursing in Georgia and nationwide. In addition, it also has the added perk of a discount on her automobile insurance. Stephanie sees 25-30 patients per day of all ages. Most of her patients are adults, and many of those are age fifty and older. These patients are seen for routine exams for hypertension, diabetes, and hypothyroidism. The other common diagnoses are CHF and COPD. Stephanie does not know the economic level of her patients, it is not needed to treat her patients. She would guess given the demographics of the area that most are either average to below average income. She states has not paid attention to race, but she would guess that her patient population is 50-50 white/black (this contradicts the white/black ratio obtained from the US Census for the area). The organization that employs Stephanie does not have any extra restrictions in addition the requirements set forth by the state. Stephanie has prescriptive authority. As an APRN she submitted a nurse protocol agreement to the Georgia Medical Board. She then submitted an application to the DEA showing proof of her submission to the Medical Board and a letter stating the Medical Board reviewed her protocol. This allows Stephanie to write her own prescriptions including controlled substances schedule III-V without a physician co-signature (Georgia Medical Board website, 2019). While working as an FNP-C, Stephanie has had many ethical situations to occur. She states it comes with the territory. One ethical dilemma that stand out in her mind is the withholding a diagnosis from a patient. She had an elderly dementia patient that was diagnosed with lymphoma. The patient’s daughter was her designated medical surrogate. The daughter explained that she did not want to tell her mother about her diagnosis of lymphoma. She stated that due to the dementia, her mother would forget about her diagnosis and every time she is told, it’s as if it’s the first time being told. Her mother would go through the myriad of shock, grief and depression repeatedly. Stephanie stated, initially she felt the patient had the right to be informed of her diagnosis. After the daughter explained her reasoning and assessing the patient, Stephanie agreed with the daughter. In addition, Stephanie was complying with the wishes of the person in charge of the patient’s medical care. When asked, Stephanie stated she truly enjoys being a primary care FNP at the local clinic in the town she was raised. She looks forward to going to work every day and could not imagine doing anything else (S. Phillips, personal communication, January 30, 2019). Interview Questions 1. Please give a brief description of your educational background. Did you start as and LPN and continue your education up to the master’s level or did you start your education as an BSN? 2. What areas of nursing have you worked as you progressed with your degree? 3. What areas of healthcare have you worked as a nurse practitioner? 4. Do you feel you benefitted from working (x) years as an LPN, RN, BSN (whichever applies from previous answer) prior to completing your MSN? 5. Do you have to provide proof of continuing education hours to your state board when renewing your license? If so, how many hours are required? 6. What type of patients do you see daily? Do you see a larger number of a certain age population, economic level or health diagnosis? 7. Do your organization have any restrictions in addition to state restrictions regarding nurse practitioners? 8. Have you ever experienced an ethical dilemma? Can you describe it? Were you pleased with how you handled it? Would you have handled it any differently? (Please provide information so faculty, patients, etc. are not identifiable). 9. Are you a member of a professional organization? Why or why not? 10. Do you enjoy what you do? 11. If you could do anything different with your FNP, what would it be? Qualifications and Scope of Practice A family nurse practitioner in the state of Georgia is an advanced practice registered nurse. She must hold a registered nurse license and earn a national certification through an approved certifying agency. There are several organizations that are approved by the Georgia Board of Nursing. The list of the organizations can be found on their website. Advanced practice registered nurses renew their license every two years and must show proof of a minimum of 30 contact hours of continuing education. Georgia has recently become a member of the enhanced Nurse Licensure Compact, eNLC. To receive a multistate license in the eNLC, a nurse must meet the home state’s qualifications, graduate from a board of nursing-approved nursing education program, pass the NCLEX, have no active discipline on their license, submit to a criminal background check, have no prior state or federal felony convictions and have a valid Social Security number (Georgia Board of Nursing website, 2019). A nurse practitioner must have a written protocol between her and a supervising physician. The protocol specifically defines medical acts that are delegated to the physician and which acts require immediate consultation with the physician. A nurse practitioner in the state of Georgia can write prescriptions for schedule III-V controlled substance with a written protocol reviewed by the Medical Board and submitted to the DEA. Nurse Practitioner are not explicitly recognized in Georgia state policy as primary care providers (Georgia Scope of Practice Policy, 2019). Leadership Attributes This writer believes that her style of leadership is Leadership Trait Theory and the Democratic Leadership of Behavior Theory combination. This writer believes that she possesses many of the distinguishing features depicted by a good leader. She functions easily with others, has efficient oral skills, confronts conflict head on, feels gratified by ruminating resplendence of others’ achievements, congratulates and enjoys the success of others, and exhibits empathy (Weberg, Mangold, Porter-O’Grady, & Mallock, 2019). An example where this writer used the combined leadership styles is when she integrated using a variety of forms when asking for medical records from other facilities prior to accepting a patient to the Swing Bed program. Initially, this writer went to each department and requested information that department manager felt would be the most important in providing the best care. The writer took this information and condensed it to develop transfer forms. The respiratory report form is a simple form This is an easy form for the transferring facility to complete. It has vital information available for the respiratory therapist at a glance including the person’s name, title and contact number who completes the form. To better one’s own self is to have the accumulated knowledge to recognize one’s own shortcomings and purposely act on bettering those shortcomings. Maslow believed that people are “innately motivated toward psychological growth, self-awareness, and personal freedom” (Black, 2014, p. 44). This writer believes that her philosophy of leadership involves encouraging accomplishments, and admirable qualities of others while continuing to encourage advancement. Family Nurse Practitioner Reimbursement Currently Medicare reimbursement for family nurse practitioners is 85% for the same health care that medical doctors receive at 100% reimbursement. According to the Centers for Medicare and Medicaid Services (CMS), nurse practitioners can see patients in any setting, without a physician being present. The physician is not required to see the patient, only available by phone according to each state’s scope of practice guidelines (Centers for Medicare and Medicaid Services website, 2019). “This biased, inequitable payment system sometimes leads to questionable provider billing. Even worse, nurse practitioner outcome data are almost always obscured because their services are hidden under the higher-paid physicians’ provider numbers so a private practice or hospital can collect the maximum payment”(National Association of Pediatric Nurse Practitioners, 2018, para. 3). Organizations such as American Nurses Association and American Academy of Nurse Practitioners are advocates for nursing policy and politics. One way this writer can assist is by being a member of each organization. This writer is already a member of the ANA and plans to become a member of the AANP. Conclusion The advanced practice registered nurse impacts healthcare by improving patient outcomes. The increase in nurse practitioners will make access to rural and medically underserved areas more available to this patient population. Nurse practitioners are still nurses and will always be patient advocates. With continued support from national organizations, advanced practice nurses may be granted the autonomy and reimbursement of physicians for the same services provided. References American Association of Nurse Practitioners website. (2019). www.aanp.org Black, B. P. (2014). Professional nursing: Concepts and challenges (7th ed.). St. Louis, Missouri: Elsevier Saunders. Centers for Medicare and Medicaid Services website. (2019). www.cms.gov Georgia Board of Nursing website. (2019). sos.ga.gov Georgia Medical Board website. (2019). https://medicalboard.georgia.gov Georgia Scope of Practice Policy. (2019). www.scopeofpracticepolicy.org/states/ga Hamric, A., Hanson, C., Tracy, M. F., & O’Grady, E. (2014). Advanced practice nursing: An integrative approach (5th ed.). St. Louis, MO: Elsevier Saunders. Hospital Authority of Miller County website. (2019). www.millercountyhospital.com National Association of Pediatric Nurse Practitioners. (2018). www.napnap.org Roots, A., & MacDonald, M. (2014, December). Outcomes associated with nurse practitioners in collaborative practice with general practitioners in rural settings in Canada: A mixed methods study. Human resources for health, 12(69), 1-11. https://doi.org/10.1186/1478- 4491-12-69 United States Census Bureau website. (2018). www.census.gov US National Library of Medicine National Institutes of Health website. (2019). www.ncbi.nlm.gov Weberg, D., Mangold, K., Porter-O’Grady, T., & Mallock, K. (2019). Leadership in nursing practice: Changing the landscape of healthcare (9th ed.). Burlington, MA: Jones & Bartlett Learning. [Show Less]
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South University: NSG 5000 Role of the Advanced Practice Nurse Final project,100% CORRECT
South University: NSG 5000 Role of the Advanced Practice Nurse Final project Role of the Advanced Practice Nurse South University Fi... [Show More] nal project The purpose of this paper is to Compare and contrast the roles of the NP, nurse educator, nurse informatics, and nurse administrator in advanced practice nursing pertaining to clinical practice, primary care, education, administration, and research. In the health care sector, advanced practice nurses are those nurses that have advanced specializations in different areas. These nurses are registered as certified medical practitioners in their fields. In some cases, these certified advanced practice nurses venture in to independent practice. Their qualifications give them an advantage as they perform their services professionally and often at a lower cost. These nurses include those certified to give prenatal and gynecological care to women. The other kind of these nurses is those that deliver medical services to community clinics. The clinical nurse specialists are those that deliver medical services in a range of specialized areas. Then there are those that administer anesthesia in surgical centers. All of these nurses are well qualified to perform the activities they deliver (Curley & Vitale, 2012). Advanced role of nursing In this section, I will be discussing advanced roles of nursing. Advanced practice nurses deliver quality medical services to all the patients. Most of the nurses in this category can administer and practice medicine independently. Advanced practice nurses are all very capable of functioning without the presence of a physician. This exception is because they have advanced training than the other nurses. These nurses either have master’s degrees or doctorates or additional years of clinical training. This extra training is what brings out the difference between these advanced practice nurses and the medical nurses. As already said, these advanced practice nurses have the authority to practice medicine independently. In the healthcare sector, there are different categories of nursing practitioners that perform different tasks. However, only the advanced practice nurse passes as qualified enough to practice independently. The extra efforts and training on the usual curriculum are what gives them the extra title (Curley & Vitale, 2012). Nurse Practitioner (NP) These are licensed clinicians who focus on managing the health of individuals and preventing illnesses. These NPs also fall under the advanced practice nurses, according to the American Associations of Nursing Practitioners. They are not restricted to particular patients, thus can deliver medical services across the field. I. Help in all clinical procedures They can deal with pediatrics and adults both male and female (McBride, & Tietze, 2016). They also deal with dermatology, oncology and cardiovascular health. These professionals require a master’s degree for them to qualify as practitioners. All these services are dependent on the specialization of the NP in question. However, the roles of these practitioners are evolving fast, thus preferring those with a doctor in the same. Before becoming independent practitioners, the NPs are required to meet the set standards. Meaning, they have to have the right medical requirement, the license, and certifications that give them the mandate to be the independent. These requirements are basic for one to qualify as an independent medical practitioner (Hamric, Hanson, Tracy, & O'Grady, 2014). II. Make sure that patients are all attended to All patients under the care of the NPs have high satisfaction in their in the quality of medical care given to them. These patients tend to recover quicker with few readmission cases that those under patients. It is, therefore, safe to say that the nurse practitioners take their time with all their patients. The costs of medication from an NP is lower than that from a doctor due to their schooling costs. The schooling cost of the NP is lower than that of doctors, which are why their services are cheaper (Sullivan-Marx, 2013). It is actually better to receive treatment from nursing practitioners than from doctors. In recent years, most Americans seek medical attention from NPs than from doctors due to their affordability. Research shows that most people opt to study as nurse practitioners than as doctors. Hence, there has been a flood in the sector due to these benefits. All the patients who pass through these nursing practitioners well taken care of by NPs. There are minimized readmissions in this case since the customer satisfaction is on a high rise (McBride, & Tietze, 2016). III. Performing physical evaluations and diagnostic tests The NPs examine their patients looking at their medical histories, performing physical evaluations and diagnostic tests. They perform these tests considering the unique factors of these patients and their families. It is from these tests that they come up with appropriate treatment plans and follow-up of the treatment plans. They work in collaboration with other healthcare professionals to maintain a detailed record. The NPs also have an obligation to engage in continuing education so as to keep up with technological advancement. Depending on the state in which they practice, they can deliver medical services not solely to their specialty. Some states allow for full practice, other restricted and others reduced the practice. Full practice gives them full independence; reduced practice requires them to liaise with other healthcare services. Restricted practice requires direct supervision or manager to the NPs (Hamric, Hanson, Tracy, & O'Grady, 2014). Nurse Educators These individuals combine their clinical expertise with teaching to make up their career. They have advanced training which gives them the role as an educator. The nurse educators are responsible for the preparing and mentoring the present and future nurses. They are the ones accountable for all the nursing curriculum and ensuring that all the nurses are up to the task. The nurse educators are prepared at the masters and doctorate level and are the faculty in their respective work area. Their experiences allow them to deal with high school graduates, college students and those that are hoping to advance their education. These individuals have an obligation to make sure that all learning taking place is quality and meet the standards (McBride, & Tietze, 2016). The nursing educators are responsible for designing the right curricular for all the nurse trainees. This curricular has to be relative to the studies of these trainees; this will help cover all the necessities of the course. They are liable to developing courses and programs of study that has to be followed as they teach and guide the learners. They are the ones that evaluate the competence of the learners and document the outcomes of the learning process. They are the people responsible for teaching all NPs. Nurse Informatics These are the nurses who work in developing communication and information technologies. They do all the research as well as ensure there is a good communication system in the healthcare sector. They deal with data and communication collection and analysis; research methodologies integrate new knowledge into the system. Nurse informatics take part in the planning, designing, and implementation of electronic health records in the system. Ideally, this group deals with improving the healthcare system through technology and other advancements. They apply new information received to improve clinical and administrative performance. They may not take part in the actual medical practices with the patients, but they make it easy for the NPs (Sullivan-Marx, 2013). Nurse Administrator A nurse administrator is responsible for the management of the nursing staff in the healthcare facility. They have licensed nurses with advanced experience in the nursing field which is a mandatory qualification. Therefore, a nurse administrator is in charge of all the other nurses, ensuring that everything goes as expected. These administrators are responsible for hiring, training, scheduling of shifts, and evaluating their performance (Stanley, 2017). This check-up is to make sure that the services are efficient and well presented. They are also the body in charge of the budgeting for the department and the healthcare facility. This gives them the authority to communicate the required changes in the facility. Their freedom to make the budget gives them control over on dictating the facilities that need to be purchased. The nurse administrator requires a master’s degree in nursing administration for them to qualify as one. Meaning that they are in charge of the hospital and the nursing staff entirely (Sullivan-Marx, 2013). The Family Nurse Practitioner These are the most popular NPs amounting to more than fifty percent of them. These nursing practitioners provide special care to patients throughout their lives. Acute care is the most common of all the services offered by the NPs. These are emergency situations which require immediate attention from these family nurse practitioners. They deal with the sudden emergence of health conditions of the patients. The next in line is adult-gerontology NPs who deal with adults and adult aging populations (McBride, & Tietze, 2016). They focus on providing care to these specific groups of people to ensure their satisfaction. There are the neonatal NPs who focus on the needs of the newborns up until they are of age to deal with the pediatric NPs. The women’s health NPs have a diverse knowledge of the needs of women from puberty through to menopause. These NPs give their expertise in this area with no limit to any category. Lastly, there are the psychiatric mental health NPs who offer a holistic approach to deal with the mental and physical health of the patients. All these nursing practitioners have their own disciplines that they deal with thus making them equally helpful (Hamric, Hanson, Tracy, & O'Grady, 2014). Licensing and certification needed The first and most basic requirement is the nursing education from the university or college. This is the most important qualification lack of which is an automatic disqualification. The department of health and human services, the board of nursing under public health division is in charge of the licensing of registered nurses in the state. This department is the one in charge of regulating the licensing of all the advanced practice registered nurses. The family nurse practitioners who fall under the nurse practitioners are not any different. They have to get their license after meeting the required specifications. The family nurse practitioner has to apply for their license by examination. This application also relates to foreign educated nurses as long as their education is relative to the one in this country. If one was previously licensed, they could just apply for a reinstatement by contacting the department (Sullivan-Marx, 2013). One needs a graduate degree and the advanced practice nursing education program that equips them with the right tools of specialization. Then, one has to earn their national certification under the advanced specialized program. The registered nurse then has to apply for the license by offering necessary information for the department. They have to attach their transcript, their national certification, their registered nursing license. On top of that, they have to provide their criminal record, their practice agreement and pay the processing fee. All these are addressed to the Nebraska state health department (Sullivan-Marx, 2013). Getting the right group for this task is important as they contribute to how the work will be done. Having a group often is enough to interchange between shifts and carry out their duties effectively. The staff has to be competent enough to deal with all the medical cases presented to us regardless of its nature. To begin with, it is important to target a small population of about one community. This selection makes it easy to avoid too many risks that may emanate from the newly started project. It is not a guarantee that the entire community will embrace the project, which is why it is important to take precautions (McBride, & Tietze, 2016). Leadership attributes The quality of democratic leadership is already in check when it comes to my leadership skills. Therefore, this makes me a democratic leader, meaning that although I am willing to listen, it does not mean I can respond in their favor always. Sometimes, being strict is the best way to deal with things since it keeps you informed and in control. This control is what drives the project to run since there will be few disputes. Keeping everything in check is an assured strategy of promoting the growth of the project altogether (Kendra, 2016). Qualities I need to process It is imperative for all leaders to improve their leadership skills and fine-tunes their relations with their staff. This need is raised by the fact that the system receives new graduates time and again, who have different approaches to the system. Therefore, as the leader, they have to learn how to accommodate all these differences and work towards an improved program. Sensitivity to the staff is very important as it shows that the leaders care about the needs of the staff. Working with an insensitive person is hard as they cannot relate to you. It is for this reason that a leader ought to be compassionate of the staff and relate with them (Kendra, 2016). Improve professionalism; this makes work easier as the entire body will be aware of what is expected of them. Enhancing professionalism not just as a leader nut also as a body gives the clients confidence in the project. The main reason for starting the project is to provide medical services to the patients in this area. Therefore, this means that the staff led by the leader have to have a sense of professionalism. As a leader, therefore, it is my obligation to ensure that I have fulfilled this requirement. Professionalism is a must have in the nursing field, not to say that this staff does not possess this quality. It only asserts that improving professionalism will improve the chances for improved services (Stanley, 2017). How to attain these qualities The best way to attain these qualities is by interacting more with nurse practitioners or any other staff in the health care department. This association brings me closer to attributes that are relative to my course. This is an improvement on my side as I move a step closer to being a better leader. Good leaders are hard to come by, mainly because they lack the right role models. My next step would be to re-evaluate the people I associate with as they could be the fall of me. Reorganizing my personal interactions and my circle will help me improve my leadership skills. Exposure is very important in taming and shaping good leadership skills. Therefore, the other agenda would be to attend seminars which will help me learn new things. In these seminars, one can actually learn more than they can with their colleagues. Through the seminar, I can learn how to improve my leadership attributes (Stanley, 2017). The Robert Wood Johnson Foundation The Robert Wood Johnson Foundation comes up with policies that help in the healthcare sector. These policies aim at improving the healthcare system of the country which is why they are raised. Pointing them out gives a chance to addressing them and finding solutions to the same. This foundation simply raises concerns on the matters that seem to be failing to fulfill their function to the health of the public. This address then receives the attention it deserves and thus improves the services altogether (Robert Wood Johnson Foundation, 2017) The relationship between school attendance and health policy The article deals with the fact that there has been prolonged absenteeism in schools which raises the alarm to the concerned eye. This malingering has been going on for a long time, which results in poor academic performance of the students. Of course, there is a reason for this absence which led to the implementation of the policy. The reason is children who are mostly absent from school to suffer from health issues. Although one cannot dismiss the fact that other factors could be the cause. These include bullying, hunger or unstable housing and transportation; these could be other contributors to the absenteeism of the children. The most culpable children for this crime are children from a poor background, coloured families, and minority populations (Robert Wood Johnson Foundation, 2017). Missing more than ten percent of school days is what is known as severe absenteeism. Health can be the contributing factor to this absence due to children with physical health issues. The most common case in this category is asthma. However, it is not the only health problem that drives these children to miss school days. There are cases of poor dental health which of course with interfering with the concentration of the pupil. There is vision impairment, diabetes, and obesity. These are health factors which can really interfere with the learning of the child and thus result in their absence from school (Robert Wood Johnson Foundation, 2017). a. Mental health The mental health of the child is another reason that drives them to miss school. These cases include fear, depression and social anxiety. These are all factors that drive the children into trauma if they are not addressed. The mental state of the child is unstable, thus cannot even concentrate when in class. This mental unrest makes these children hate school, thus do not see the loss of missing classes. Then there are the safety issues which drive the children to absenteeism. These are as a result of bullying of the victims by other children in school. This is mostly practiced through racial segregation or just minority population segregation. This makes the children feel unsafe in schools and thus skip school altogether (Robert Wood Johnson Foundation, 2017). b. Family background The most affected children are those who come from the financially unstable background. Therefore, they are always picked on by the bullies of the school, which gradually instil fear in them that results in their absence. Sometimes these children are mentally traumatized and stressed, which then develops into something bigger which may refuse to settle. It is these little things that do not seem to make any sense that contributes in causing absenteeism. c. Major contributors The key players in this field are the teacher, the student leaders, the parents and the law. It is up to the four players to synchronize their efforts and come up with a long-term solution for the same. There should be strict rules that govern the children in school so as to enhance equity and respect among them. Every child should feel safe going to school since it is their right as American citizens. The law does not allow for such chronic truant behavior which is why the collaboration of the four bodies mentioned above is important. If at all of them played their required role, then the cases of absenteeism would reduce rapidly. The parents have to ensure that they provide a good home for their children with an ample environment for growth. The teachers should ensure that all the children in school feel safe and secure. It at any time the teacher notices strange behaviors of the children, they should address it immediately. The student leaders should tell on the bullies so as to prevent extreme cases of bullying. And the federal law should come up with strict policies to diminish malingering (Robert Wood Johnson Foundation, 2017). How to make sure the policy works I would ensure all the players have done their part to completion and create a free and open communicative teacher-pupil forum. It is hard for children to relate to their teachers if they are always hard on them. Therefore, the best step is to ensure that the teachers loosen up a bit so as to relate well with children. In other words, the children have to trust these adults for them to open up to them. This should be the key agenda initiated to reduce absenteeism. The healthcare sector will experience a rise in the services provided due to the focus on this population. Research shows that many children suffer from either of the categories named above. Thus a large number of them miss school days. Therefore, the healthcare sector will have an improved flow of clients thanks to the new policy. The clients who sought to eliminate absenteeism from their families will definitely want medical help. And with the new health policy that accommodates the majority, then the healthcare sector will definitely thrive (Robert Wood Johnson Foundation, 2017). Conclusion The Advanced Practice Nurse are more preferred to the doctors. Most students are advised to pursue this training rather than train as doctors. They are more equipped to deal with patients and satisfy their needs. With the new policy in place at least more students will be at ease with attending school regularly. With the support of the key players in the education and health sector, this problem will be addressed accordingly. The recovery of all patients is dependent on the trust that they have on their physicians. Otherwise the process will take longer than expected. References Curley, A. L. C., & Vitale, P. A. (2012). Population-based nursing: Concepts and competencies for advanced practice. New York, N.Y: Springer Pub. Co. Hamric, A. B., Hanson, C. M., Tracy, M. F., & O'Grady, E. T. (2014). Advanced practice nursing: An integrative approach. St. Louis, Mo: Elsevier/Saunders. Kendra, C. (2016, June 16). Reviewed by a board-certified physician. What Type of Leadership Do You Have? Retrieved April 05, 2017, from https://www.verywell.com/whats-your-leadership-style-3866929 McBride, S., & Tietze, M. (2016). Nursing informatics for the advanced practice nurse: Patient safety, quality, outcomes, and interprofessionalism. Robert Wood Johnson Foundation. (2017, March 16). Providing research, insight, and analysis on key issues affecting health and health care in the United States. Retrieved April 05, 2017, from http://www.rwjf.org/en/library/collections/health-policy.html Stanley, D. (2017). Clinical leadership in nursing and healthcare: Values into action. Sullivan-Marx, E. (2013). Nurse practitioners: The evolution and future of advanced practice. New York [N.Y.: Springer Pub. [Show Less]
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