NR 661 APN Capstone Practicum Chamberlain College of Nursing
1 Running head: PORTFOLIO 2
PORTFOLIO 2 Hinal Patel
NR661-APN Capstone Practicum
... [Show More] Chamberlain College of Nursing March 20202
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Table of Contents
Exemplar 1 – NR 503: Reflection of the course----------------------------------------------------4
Program outcome, MSN essential, and NONPF ---------------------------------6
Concept ----------------------------------------------------------------------------------7
Reflection---------------------------------------------------------------------------------7
Exemplar 2 NR 508: Class Discussion ------------------------------------------------------------8
Program outcome, MSN essential, NONPF ---------------------------------------10
Concepts-----------------------------------------------------------------------------------11
Reflection---------------------------------------------------------------------------------11
Exemplar 3 NR 509: Reflection of the course ----------------------------------------------------12
Program outcome, MSN essential, NONPF-------------------------------------12
Concepts -------------------------------------------------------------------------------14
Reflection ------------------------------------------------------------------------------14
Exemplar 4 NR 510 APN development Paper -----------------------------------------------------15
Program outcome, MSN essential, NONPF---------------------------------------19
Concepts --------------------------------------------------------------------------------20
Reflection -------------------------------------------------------------------------------20
Exemplar 5 NR 511Case Study-----------------------------------------------------------------------21
Program outcome, MSN essential, NONPF ---------------------------------------25
Concepts ---------------------------------------------------------------------------------26
Reflection ---------------------------------------------------------------------------------27
Exemplar 6 R601 Course Reflection -----------------------------------------------------------------28
Program outcome, MSN essential, NONPF -----------------------------------------29
Concepts -----------------------------------------------------------------------------------313
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Reflection ----------------------------------------------------------------------------------31
Exemplar 7 NR 601 Case study Assignment ----------------------------------------------------32
Program outcome, MSN essential, NONPF------------------------------------51
Concepts -----------------------------------------------------------------------------52
Reflection -----------------------------------------------------------------------------52
Exemplar 8 NR602Marginalized Women Paper -------------------------------------------------53
Program outcome, MSN essential, NONPF-------------------------------------62
Concepts ------------------------------------------------------------------------------63
Reflection------------------------------------------------------------------------------64
Exemplar 9 NR602 Case study discussion ---------------------------------------------------------64
Program outcome, MSN essential, NONPF--------------------------------------69
Concepts --------------------------------------------------------------------------------70
Reflection -------------------------------------------------------------------------------71
Exemplar 10 NR603Case study discussion --------------------------------------------------------71
Program outcome, MSN essential, NONPF--------------------------------------76
Concepts ---------------------------------------------------------------------------------78
Reflection --------------------------------------------------------------------------------78
Conclusion---------------------------------------------------------------------------------------------------79
Appendix # 1 Table of Exemplars ---------------------------------------------------------------------80
Appendix # 2Nursing Concept Map------------------------------------------------------------------ 81
References-------------------------------------------------------------------------------------------------- 824
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The primary purpose of a master portfolio is to document, categorize, and, skills, and abilities;
growth; and progress of a student, and as a professional. This is especially critical for healthcare
providers and students learning and working in increasingly complex communities of education
and practice. This has achieved through class discussions, case studies, assignments, clinical
rotation, clinical encounters, and reflection. The paper will discuss this learning using exemplars.
The purpose of this paper will introduce the student personal and professional goal, as well as
her professional career and plan of study using evidence-based resources and core competency at
chamberlain university. The summary of reflections is based on the evidences of the knowledge
that this student has learned during the entire course of MSN.
Exemplar 1:
NR 503 Population Health Epidemiology and Statistical Principles
Summary of Reflection: This class helps the student to gain knowledge regarding the current
issue and data of epidemiology. As a nurse practitioner that is the duty to provide the care across
the life span without any judgment, bias and option. This class helped the student to establish a
good base to be able to recognize the origin of disease processes, how to extract medical
information in order to discern the problem, and how to choose the best diagnostic test and
treatment options based on the disease process. During this class the student wrote the paper on
Hepatitis B as well as Diabetes Mellites that provide education and emotional support are
necessary to assist in coping with this potentially life-threatening disease. Student learned about
the Epidemiologic Triage which provide the information on disease progression through
susceptible host, causative agent and environment (CDC, n. d.).5
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This class help the student to applied and integrates broad, organizational, client-centered
and culturally appropriate concept in planning, delivery, management and evaluation of
evidence-based clinical prevention and population care and services to individuals, family and
population (AACN, 2011 P. 5). This Class helps to screening, Identify the risk factors which
helps people on primary, secondary and tertiary level prevention. FNP incorporate AACN
essentials to delivery of optimal care.
This class was a very informative class that greatly increased her knowledge of
epidemiology and its use in the medical field. She did not realize how important epidemiology
was to the medical field and how it can be used to guide public health policies to promote health
in our communities and across our nation. The student write one Healthy People 2020
assignment gave her the opportunity to identify sources of epidemiological data as it related to
the Hepatitis B, review demographic and epidemiological data on morbidity and mortality risk,
research screening and diagnostic tests available for Hepatitis , and finally identify a program
plan to decrease the incidence of Hepatitis through the Healthy People 2020 goals and
objectives.
References:
American Association of Colleges of Nursing (AACN) Essentials. (2011). Retrieved April 10,
2018, from http://www.aacnnursing.org/Education-Resources/AACN-Essentials (Links to
an external site.)
CDC. (n.d). Introduction to epidemiology. Retrieved March 23, 2018, from
https://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson1/section 8.html Master of Science
in Nursing (MSN) in Advanced Clinical and Non-Clinical Roles. (n.d.). Retrieved April
10, 2018, from https://www.msnedu.org/ (Links to an external site.)6
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Chamberlain Program Outcomes, MSN Essential and/or NONPF Competencies Met by
Exemplar #1
Program Outcome #1: Provide high quality, safe, patient-centered care grounded in holistic
health principles: This class has helped this understudy accomplish her program result # 1 by
learning the ideas of the study of disease transmission and coordinate that proficient information
into network and recognize the individuals in danger by utilizing abilities and information on
evaluation, hazard factors, rate, predominance rate, existing observation techniques, screening
tests to analyze diabetes and distinguishing their affectability and particularity and assist them
with developing healthy lifestyle..
MSN Essential IV: Translating and Integrating Scholarship into Practice: This understudy
accomplished this fundamental by composing task on epidemiological issue of diabetes mellitus,
where she led insightful research on subtleties of diabetes mellitus and utilized it in her
evaluation, conclusion, the board plan, observation strategies, and treatment plan. This data gas
helped this understudy in teaching her recently determined and existing patients to have diabetes.
According to Richardson, nurture experts have improved the patient results and self-viability for
diabetes patients in the essential consideration groups (2014).
NP Core Competency # 6 Policy Competency: Focuses on being competent with healthcare
policies and utilize the knowledge of clinical practice to improve the patient outcomes (The
National Organization of Nurse Practitioner Faculties [NONPF], 2017). The job of APN includes
concentrating on illness avoidance and wellbeing advancement. Finding out about clinical
practice rules of diabetes during this class and applying it to clinical turn has helped this
understudy recognize in danger patients and has helped her met this competency. It is significant
for another NP to approach social insurance arrangement to guide and bolster their training and7
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give protected, productive, and quality consideration to the patient. This class has helped in
remain concentrated on recent developments in the study of disease transmission to guarantee the
conveyance of confirm based practice.
Concepts:
Health Care Systems: healthcare system, is the organization of people, institutions, and
resources that deliver health care services to meet the health needs of target populations.
(Pallipedia, 2019). Such healthcare infrastructure includes, home, physician’s office, nursing
homes, hospitals, community centers. The role of APN varies based on the type of infrastructure
and type of the patients in providing primary, specialty, and emergency care. NPs have proven
their effectiveness in delivering high quality, lower cost heath care services.
Interprofessional collaboration: This exemplar describes how interprofessional
collaboration is active and ongoing partnerships of different healthcare professionals (HCP) who
work together in solving problems and providing healthcare services. This knowledge helps her
to promotes safe, cost-effective, quality care through engaged in partnerships and collaboration
to other health care personals like pharmacy, other specialist, agency hospital and other health
care facility. As a new NPs she should found to create respectful relationships among
professionals, relay information through timely, open, and effective communication, and share
decision-making activities to encourage critical discourse supporting a common plan of care
(Christina et al., 2016).
Reflection
This class helps the student to gained insightful knowledge on how to understand and
verified studies and statistics within epidemiology. This class also supported on how to use
public health policies in promoting health and quality care to our communities and future8
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patients. This course showed the importance of screening for conditions and providing
interventions to provide patients with the best possible health outcomes. Evidence-based research
should be the foundation for practice and this research evidence must be disseminated to ensure
the utilization of the most up-to-date information. This course connected research to practice
through our assigned discussion posts and papers. This will help the student to individualize care
for patients based on their identified risk factors to promote health. This class has really opened
my eyes to all of the thought that must go into who to screen for a disease and with what
methods and tests, and how to determine the accuracy of the results and need for further follow-
up.
Exemplar# Two
NR 508
Discussion Threads
This class mainly focus on the medication, prescribing authorities as per state and safety
and precautionary measured taken before prescribing the medication to all ages specially the
elderly. This class also discussed about the cost-effective health care provided by healthcare
workers. This class also includes medication, side effect and interaction with other medication.
Mostly emphasis on what placed on the decision-making process utilized to safely and
effectively prescribe and monitor pharmacotherapeutics for the treatment of acute and chronic
diseases appropriate to the patient situation.
In the community, however, drug addiction is becoming more prevalent. Many people
misuse medications such as heroin, antidepressants and powerful pain medication. Illegal and
abuse of these medications induces high rates of morbidity and mortality. It affects not only a9
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patient's health condition but also their physical, social, psychological and financial status. To
prevent this, a comprehensive history and assessment of pain and other non-pharmacological
treatments should be done first before administering pain medicines. When narcotic analgesics
are administered, constant monitoring, testing for any possible risk factors, urine drug screening,
informed consent, pain consent and agreement should be done to help mitigate the risk of
dependency (Hudspeth, 2016).
Some measures that could be effective in reducing dependency include making patients
aware of all potential treatment choices, their costs and benefits, and the effects of opioid
addiction or overuse (Hudspeth, 2016). It is the professional duty of all nurse practitioners to
prescribe within their field of practice and to follow state and federal laws and guidelines for
patient safety and legal issue affected to licensure. By taking the pharmacology class, this student
has helped understand the pharmacokinetics and pharmacodynamics of the medications and the
appropriate prescription steps to prevent adverse reactions, reduce side effects and risks.
The advent of electronic health records (EHRs) and pharmacy interfacing has
significantly eliminated many such medication reactions and complications. This also helps
clinicians monitor prescribing trends for opioids and other controlled drugs and prevent harmful
drug adverse effects. That ensures patient and provider privacy and protection (Health IT, 2019).
Health care providers should help patients understand whether or not there is a genuine medical
problem that supports the use of controlled drugs, adequate treatment time and referral to
specialists, and rehabilitation target to minimize opioid dependence and dependency (National
Institute on Drug Abuse, 2018).
References:10
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Health IT. (2019). How can electronic health records help me prevent adverse medication
events? Retrieved September 2019 from, https://www.healthit.gov/faq/how-can-
electronic-health-records-help-me-prevent-adverse-medication-events
Hudspeth, R.S. (2016). Safe opioid prescribing for adults by nurse practitioners: Part 2.
Implementing and managing treatment. Retrieved September 2019 from,
https://www.npjournal.org/article/S1555-4155(15)01186-1/pdf
National Institute on Drug Abuse. (2018). How can prescription drug misuse be prevented?
Retrieved September 2019 from, https://www.drugabuse.gov/publications/research-
reports/misuse-prescription-drugs/how-can-prescription-drug-misuse-be-prevented
Chamberlain Program outcomes, MSN Essential and/or NONPF Competencies Met by
Exemplar #2
Program Outcome #4 Integrate professional values through scholarship and service in health
care: This course has helped me translate my current knowledge into practice while building
confidence in caring for patients at all level in health care delivery system. I think this class
really help to provide knowledge about prescription authority, medication information, errors and
how to reduce risk among patient. This student also learned the process and importance of
reconciling medicines particularly in elderly patients to avoid polypharmacy complication. On
the same hand, it is very important for this student as a primary care provider to regularly interact
with other specialists in order to prevent overlap and missed orders.
MSN Essential IX: Master’s-Level Nursing Practice: This student accomplished this vital by
actively engaging in all the class discussion, presentations and questions of the teacher using
academic, revised and peer-reviewed articles that endorsed the purpose of practice on the basis of
evidence (Hudspeth, 2016).11
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NP Core competency # 6 Policy Competencies: Many local, state, and federal programs are
available to support clinicians in preventing and mitigating drug abuse and how to administer
safe medicine. This student was able to achieve this ability by studying and knowing and
incorporating these policies into her practice (Hudspeth, 2016). This experience was also gained
by understanding the risks of abuse of the drugs on patients and their quality of life.
Concepts
Safety: This exemplar explains the value of maintaining patient health both from real and
possible harms. This example focuses on how NP can use its learning to provide patient-centered
treatment and use available tools and evidence to ensure their health in all types of patient care
(Hudspeth, 2016). Patient safety is most important part for all healthcare provider.
Clinical Decision Making: This example illustrates how a new NP will use its clinical
decision-making capabilities to evaluate their patient care preparation, diagnosis, implementation
and assessment. Clear clinical decision taking is key to health outcomes and patient care (ANA,
2019). This expertise includes knowledge of different types of medicine that are administered to
the patient with and without any other comorbidities.
Reflection
Throughout this class, this student regularly engaged in discussion threads and
assignments focused on creating care plans for patients with various comorbidities, considering
their experiences with other current medicines and medical diagnosis, and predicted medication
outcomes. Advanced pharmacology awareness is very important for a good career in NP. Patient
awareness about their medication was essential to this class because many drug related concerns
can be easily avoided if patients have knowledge about their own medication and its effect on
their body (Hudspeth, 2016).12
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As a primary care provider, we need to educate our patient, and to do so, this student uses
on her phone apps like epocrates to search for drug knowledge. Use EHRs makes it easy to warn
patients about reactions and drug interactions with other medications. It also makes it easier to
share the patient's drug history with a specialist and pharmacy who initiates the treatment process
faster than to drop the script personally to the pharmacy and wait for the drugs to be ready
(Porterfield, Engelbert, & Coustasse, 2014).
Exemplar # Three
NR 509 Advanced Physical Assessment
Summary of Reflection: This course has helped student to achieve the program outcome
number one in many ways. The Shadow Health assignments enabled to gain experience in
providing quality and safe patient care while focusing on the holistic principles of the patients.
Although the weekly shadow health assignments were system focused, other health systems were
evaluated to assess and treat the patient’s overall health and wellbeing. This course has been
challenging as student learned to expand knowledge and help to make assessment skills perfect.
This course has strengthened assessment skills and knowledge on how to adequately obtain a
thorough health history. The Student learned the importance of building a good rapport with the
patient and family member that could help divulge pertinent information to help identify a
diagnosis. The immersion weekend was a weekend full of very useful knowledge.
Appearing at the Immersion Weekend was also one of the ideas for achieving the
program's outcome. This weekend, the student learned assessment techniques, such as palpation,
percussion, and auscultation, which provided her with a thorough assessment of her patients.3P
Exam helped the student to identify her weak areas that need more attention. The three areas that
she scored less was Men’s health, urology and pregnancy. After this, this student made sure to13 PORTFOLIO 2
read and prepare herself for next APEA exams and national licensure exam. I plan to incorporate studying not only these three categories, but all domains to increase my knowledge and understanding of my future role. Chamberlain Program outcomes, MSN Essential and/or NONPF Competencies Met by Exemplar #3 [Show Less]