Scope of Practice, Credentialing, and Negotiation

Scope of Practice, Credentialing, and Negotiation

Scope of Practice, Credentialing, and Negotiation
In this course, some Discussions will have two parts:

Part I will consist of a specific topic related to the week’s content.
Part II will consist of a pharmacology review of approximately 250 words. Please submit each posting separately but within the same Discussion thread.

You will be assessed on your posting and responses to both parts.
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As medical care evolves, so does the role and scope of practice of the advanced practice nurse in acute care settings. When providing patient care, however, you, as an advanced practice nurse, must always ensure that you are working within the scope of practice outlined by your state’s laws and institution’s regulations. For this Discussion, you examine these laws and regulations and consider how they might affect your future clinical practice, consider the credentialing process for your area, and discuss negotiation techniques you may use in a job search.
To prepare:

Locate a collaborative practice agreement. Based on this agreement, consider the scope of practice of an advanced practice nurse in your state.
Locate and select at least two hospitals where you would be interested in working at once you obtain your licensure.
Locate the hospitals’ credentialing documents and investigate the scope of practice at each hospital.

Note: All hospitals do not have the same scope of practice even if they are located within the same city and state.

Consider how the laws and regulations of the state and hospitals might affect your practice with medical and surgical patients in acute care settings.
Think about how you would negotiate your first Advanced Practice role. Consider issues such as salary range, Continueing Medical Education (CME), license and DEA costs, insurance, hours, on call requirements, etc.

By Day 3
Post an explanation of the scope of practice of advanced practice nurses, as outlined in the collaborative practice agreement. Then, identify the two hospitals of interest that you selected. Based on the credentialing documents, explain the scope of practice for acute care advanced practice nurses at each hospital. Explain how this might affect your practice in terms of caring for medical and surgical patients in acute care settings (i.e., medical treatments, procedures you can perform, interpreting diagnostics, etc.). Finally, describe job negotiation considerations.
Note: To support your Discussion post, you must include references (with URL links) from the state and the hospitals you selected.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on 2 different days who selected a different state or hospital from yours. Share additional insights or alternative perspectives.
Discussion Part II: Pharmacology
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
To prepare:
Read the following articles to enhance your knowledge of commonly prescribed medications:
Chalikonda, S. A. (2009). Alpha2-adrenergic agonists and their role in the prevention of perioperative adverse cardiac events. AANA Journal, 77(2), 103–108.
Note: Retrieved from the Walden Library databases.
Frankenstein, L., Katus, H. A., Grundtvig, M., Hole, T., de Blois, J., Schellberg, D., … Agewall, S. (2013). Association between spironolactone added to beta-blockers and ACE inhibition and survival in heart failure patients with reduced ejection fraction: A propensity score-matched cohort study. European Journal of Clinical Pharmacology, 69(10), 1747–1755.
Note: Retrieved from the Walden Library databases.
Hao, G., Wang, Z., Guo, R., Chen, Z., Wang, X., Zhang, L., & Li, W. (2014). Effects of ACEI/ARB in hypertensive patients with type 2 diabetes mellitus: A meta-analysis of randomized controlled studies. BMC Cardiovascular Disorders, 14, 148.
Note: Retrieved from the Walden Library databases.
Levy, P. D., Laribi, S., & Mebazaa, A. (2014). Vasodilators in acute heart failure: Review of the latest studies. Current Emergency and Hospital Medicine Reports, 2(2), 126–132.
Vasodilators in acute heart failure: Review of the latest studies by Levy, P. D., Laribi, S., & Mebazaa, A. in Current Emergency and Hospital Medicine Reports, 2(2). Copyright 2014 by Current Science, Inc. Reprinted by permission of Current Science, Inc., via the Copyright Clearance Center.
Shi, C. (2013). Blood pressure lowering efficacy of alpha blockers for primary hypertension. International Journal of Evidence-Based Healthcare, 11(3), 204–205.
Note: Retrieved from the Walden Library databases.
Tocci, G., Battistoni, A., Passerini, J., Musumeci, M. B., Francia, P., Ferrucci, A., & Volpe, M. (2015). Calcium channel blockers and hypertension. Journal of Cardiovascular Pharmacology and Therapeutics, 20(2), 121–130.
Note: Retrieved from the Walden Library databases.
Toppen, W., Sareh, S., Satou, N., Shemin, R., Hunter, C., Buch, E., & Benharash, P. (2014). Do preoperative β-blockers improve postoperative outcomes in patients undergoing cardiac surgery? Challenging societal guidelines. American Surgeon, 80(10), 1018–1021.
Note: Retrieved from the Walden Library databases.
Wang, A. (2012). Efficacy of class III antiarrhythmics and magnesium combination therapy for atrial fibrillation. Pharmacy Practice, 10(2), 65–71.
Note: Retrieved from the Walden Library databases.
All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage.

Alpha agonists
Alpha blockers
Beta blockers
Antiarrhythmics
Calcium channel
Vasodilators
ACE versus BBlocker with spironolactone in CHF
ACE versus ARB

Note: When sharing your initial post, select a topic that has not yet been discussed. If all topics have been discussed, then you may select that topic again, but select a different drug within the medication group.
By Day 3
For this Discussion, address 1 of the following options:
Option 1
Post a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose. Scope of Practice, Credentialing, and Negotiation
Option 2
Conduct an evidence-based drug search on the drug you selected and post an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication?
Option 3
Post an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Describe a patient to whom you would prescribe this medication.
Note: To be considered as one of your required responses, your pharmacology rationale must include a supporting reference.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Scope of Practice, Credentialing, and Negotiation

Discussion_Rubric

 

Outstanding Performance
Excellent Performance
Competent Performance
Proficient Performance
Room for Improvement

Main Posting:
Response to the discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

44 (44%) – 44 (44%)

Thoroughly responds to the discussion question(s)
is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.
supported by at least 3 current, credible sources

40 (40%) – 43 (43%)

Responds to the discussion question(s)
is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.
75% of post has exceptional depth and breadth
supported by at least 3 credible references

35 (35%) – 39 (39%)

Responds to most of the discussion question(s)
is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.
50% of post has exceptional depth and breadth
supported by at least 3 credible references

31 (31%) – 34 (34%)

Responds to some of the discussion question(s)
one to two criteria are not addressed or are superficially addressed
is somewhat lacking reflection and critical analysis and synthesis
somewhat represents knowledge gained from the course readings for the module.
post is cited with fewer than 2 credible references

0 (0%) – 30 (30%)

Does not respond to the discussion question(s)
lacks depth or superficially addresses criteria
lacks reflection and critical analysis and synthesis
does not represent knowledge gained from the course readings for the module.
contains only 1 or no credible references

Main Posting:
Writing

6 (6%) – 6 (6%)

Written clearly and concisely
Contains no grammatical or spelling errors
Fully adheres to current APA manual writing rules and style

5.5 (5.5%) – 5.5 (5.5%)

Written clearly and concisely
May contain one or no grammatical or spelling error
Adheres to current APA manual writing rules and style

5 (5%) – 5 (5%)

Written concisely
May contain one to two grammatical or spelling error
Adheres to current APA manual writing rules and style

4.5 (4.5%) – 4.5 (4.5%)

Written somewhat concisely
May contain more than two spelling or grammatical errors
Contains some APA formatting errors

0 (0%) – 4 (4%)

Not written clearly or concisely
Contains more than two spelling or grammatical errors
Does not adhere to current APA manual writing rules and style

Main Posting:
Timely and full participation

10 (10%) – 10 (10%)

Meets requirements for timely and full participation
posts main discussion by due date

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

Does not meet requirement for full participation

First Response:
Post to colleague’s main post that is reflective and justified with credible sources.

9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings
responds to questions posed by faculty
the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives

8.5 (8.5%) – 8.5 (8.5%)

Response exhibits critical thinking and application to practice settings

7.5 (7.5%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting

6.5 (6.5%) – 7 (7%)

Response is on topic, may have some depth

0 (0%) – 6 (6%)

Response may not be on topic, lacks depth. Scope of Practice, Credentialing, and Negotiation

First Response:
Writing

6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues
Response to faculty questions are fully answered if posed
Provides clear, concise opinions and ideas that are supported by two or more credible sources
Response is effectively written in Standard Edited English

5.5 (5.5%) – 5.5 (5.5%)

Communication is professional and respectful to colleagues
Response to faculty questions are answered if posed
Provides clear, concise opinions and ideas that are supported by two or more credible sources
Response is effectively written in Standard Edited English

5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues
Response to faculty questions are mostly answered if posed
Provides opinions and ideas that are supported by few credible sources
Response is written in Standard Edited English

4.5 (4.5%) – 4.5 (4.5%)

Responses posted in the discussion may lack effective professional communication
Response to faculty questions are somewhat answered if posed
Few or no credible sources are cited

0 (0%) – 4 (4%)

Responses posted in the discussion lack effective
Response to faculty questions are missing
No credible sources are cited

First Response:
Timely and full participation

5 (5%) – 5 (5%)

Meets requirements for timely and full participation
posts by due date

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

Does not meet requirement for full participation

Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.

9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings * responds to questions posed by faculty
the use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives

8.5 (8.5%) – 8.5 (8.5%)

Response exhibits critical thinking and application to practice settings

7.5 (7.5%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting

6.5 (6.5%) – 7 (7%)

Response is on topic, may have some depth

0 (0%) – 6 (6%)

Response may not be on topic, lacks depth

Second Response:
Writing

6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues
Response to faculty questions are fully answered if posed
Provides clear, concise opinions and ideas that are supported by two or more credible sources
Response is effectively written in Standard Edited English

5.5 (5.5%) – 5.5 (5.5%)

Communication is professional and respectful to colleagues
Response to faculty questions are answered if posed
Provides clear, concise opinions and ideas that are supported by two or more credible sources
Response is effectively written in Standard Edited English

5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues
Response to faculty questions are mostly answered if posed
Provides opinions and ideas that are supported by few credible sources
Response is written in Standard Edited English

4.5 (4.5%) – 4.5 (4.5%)

Responses posted in the discussion may lack effective professional communication
Response to faculty questions are somewhat answered if posed
Few or no credible sources are cited

0 (0%) – 4 (4%)

Responses posted in the discussion lack effective
Response to faculty questions are missing
No credible sources are cited

Second Response:
Timely and full participation

5 (5%) – 5 (5%)

Meets requirements for timely and full participation
Posts by due date

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

NA

0 (0%) – 0 (0%)

Does not meet requirement for full participation. Scope of Practice, Credentialing, and Negotiation

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