Advanced Nursing Assignments: Research, Policy, and Population Health, Exams of Nursing

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APN Capstone Portfolio Part 2 Chamberlain College NR 661- Capstone Practicum Table of Contents Exemplar 1..............................................................................................................................Page 3 Exemplar 2..............................................................................................................................Page 5 Exemplar 3..............................................................................................................................Page 7 Exemplar 4..............................................................................................................................Page 9 Exemplar 5............................................................................................................................Page 11 Exemplar 6............................................................................................................................Page 13 Exemplar 7............................................................................................................................Page 14 Exemplar 8............................................................................................................................Page 16 Exemplar 9............................................................................................................................Page 18 Exemplar 10..........................................................................................................................Page 21 Concept Map........................................................................................................................Page 24 Exemplar #1 NR510 Week 6 – APN Professional Development Plan Paper In week 6 of NR510, Leadership and Role of the APN, students completed an APN Professional Development Plan. In this assignment, I was required to complete a personalized professional development plan for myself, based on my goals, gaps in experience, and plans for clinical practice. Additionally, I had to explain the scope of practice in my planned state of practice, discuss networking and marketing strategies related to professional nursing organizations, and complete a curriculum vitae. I found this assignment to be incredibly useful and worthwhile because it allowed me to think critically about professional development opportunities, areas of opportunity in my clinical experience, pros and cons of practicing in Florida, and the availability of professional organizations relating to nursing practices. Identify and Explain The APN Professional Development Plan Paper allowed students to meet NONPF competency areas Leadership Competencies and Policy Competencies. The Chamberlain Program Outcomes that were met include #3: Use contemporary communication modalities effectively in advanced nursing roles, #5: Develop a plan for lifelong personal and professional growth that integrates professional values regarding scholarship, service, and global engagement, and #9: Compose a plan for systematic inquiry and dissemination of findings to support advanced nursing practice, patient-care innovation, and the nursing profession. The MSN Essential II: Organizational and Systems Leadership was also met with this assignment. In this assignment, the above competencies were met as students were required to research and reflect on APN leadership roles, the relationship between advanced practice nursing and healthcare delivery, the impact of professional nursing organizations on professional development, health care delivery, and research, and the differing nursing policies from state to state. Connect Two concepts related to this exemplar are networking and leadership. Through this assignment, students learned the importance of networking through professional organizations and clinical contacts in order to create possible professional development and career opportunities. Networking involves taking advantage of engagement opportunities through conferences, leadership roles, or professional organizations, with the goal of creating a web of professional/like-minded contacts. Leadership has many different definitions, characteristics, and goals, but is important in nursing as it advances knowledge, policy, and healthcare delivery. Thus, it is important for advanced nursing professionals to seek out and take on leadership roles. These two concepts can interrelated in numerous ways; Through networking, nursing professionals may learn of leadership opportunities or advancements, and by taking on leadership roles, nursing professionals can widen their professional network. Reflect I appreciate the research, reflection, and thought that this assignment required, especially that related to the scope of practice in my state and the opportunities available to nursing professionals through professional organizations. This assignment will influence my nursing practice by prompting me to participate in professional development that will allow me to bridge the gap in my nursing experiences, reflect on areas of improvement, participate in leadership opportunities that will strengthen and challenge me, and will encourage me to get involved in the development and advocacy of nursing/healthcare policy. By meeting the above competencies and participating in the aforementioned opportunities, I will be able to provide the best possible care to my patients and improve the overall healthcare delivery within my practice. Exemplar #3 NR507 Week 2, 5, & 7 – Disease Process Presentation Assignments Parts 1-3 During weeks 2 and 5 of NR507 Advanced Pathophysiology, students were required to thoroughly explain and present, through use of Kaltura and PowerPoint presentation, the pathophysiology of an assignment disease (I was assigned cardiac failure). This assignment was split into two parts between weeks 2 and 5, with a final complete presentation in week 7. The disease process presentation assignments required students to professionally articulate an understanding of the definition of their assigned disease. Students were graded on their understanding of the cause, progression, risk factors, diagnosis, both pharmacological and non- pharmacological interventions, presenting signs and symptoms, and provider implications related to the disease. Additionally, in week 7, students were required to provide peer reviews to fellow students. Identify and Explain The Disease Process Presentation Assignment Parts 1-3 allowed me to meet MSN Essentials III: Quality Improvement and Safety and VIII: Clinical Prevention and Population Health for Improving Health. Additionally, NONPF competency areas Technology and Information Literacy Competencies and Health Delivery System Competencies were met through this assignment. Finally, Chamberlain Program Outcomes #7: Design patient-centered care models and delivery systems using the best available scientific evidence and #8: Manage human, fiscal, and physical resources to achieve and support individual and organizational goals were also met. This assignment required such a deep dive into all the related aspects of our particular disease that many outcomes/essentials were met. In this assignment, students were required to reflect on the different demographics of their assigned disease, to consider how the disease impacted population health, and to discuss the financial and health-related implications. comprehensive knowledge on nursing informatics as a whole, but more specifically on digital therapies. By reflecting on the pros and cons of digiceuticals, thinking critically on the impacts they may have on my practice, and making future recommendations on the use and implementation of these technologies, I was able to meet the above-mentioned competencies. In my paper, I discussed how I might initiate the use of digital therapies, the impact they would have on healthcare outcomes and my patients, and what negative implications they may have on healthcare. As we manage the COVID-19 pandemic, the concepts of digital therapies and utilization of technology to deliver healthcare was thrust upon us and we have seen just how importance these competencies are. Connect Two concepts related to this exemplar are health informatics and medical technology. These two concepts intersect quite a bit, especially as we consider new and improved ways to provide healthcare during pandemics or to populations without access to routine healthcare. While health informatics is a form of medical technology, medical technology does not necessarily have to relate to health informatics. Medical technology can include robotic surgery, advances in treatment and procedures, while healthcare informatics focuses more closely on the gathering and exchange of information and data. Reflect I have no doubt that completing this assignment and meeting the above-mentioned competencies will help me to become a more effective and innovative healthcare provider, especially in these new and ever-changing times of managing the COVID-19 pandemic. By staying abreast of new and transformative technologies, and being current on trends in nursing informatics, I will be able to customize my healthcare delivery based on patient needs, healthcare population, clinical needs, and available resources. I appreciated the opportunity to complete this assignment because I do believe that nursing informatics and new technologies will play a major role in my practice as a family nurse practitioner. Exemplar #5 NR506 Week 2: Identification of Healthcare Policy Concern During week 2 of NR506 Health Care Policy, students submitted a paper on a selected healthcare policy concern and healthcare community concern, and determine how those issues could be improved upon with policy change. In this assignment, we were required to choose a healthcare concern, identify a way that policy change or development could resolve/improve the concern, and propose the policy to an identified elected official. For this assignment, I chose homelessness as the community healthcare concern, and identified Gainesville, FL politician Charles Chestnut IV as the elected official who would assist in policy implementation to effectively transform homelessness healthcare outcomes. Identify and Explain Completion of the NR506 Identification of Healthcare Policy Concern assignment met the MSN Essential VI: Health Policy and Advocacy and Essential VII: Interprofessional Collaboration for Improving Patient and Population Health Outcomes. NONPF competency areas Policy Competencies and Ethics Competencies were also met through this assignment. Additionally, Chamberlain Program Outcomes #6 Apply legal, ethical, and human-caring principles to situations in advanced nursing practice and #8 Manage human, fiscal and physical resources to achieve and support individual and organizational goals were met. This assignment required me to think critically about healthcare policies, community health concerns, and the impact that healthcare policy has on my practice and ability to treat patients. This assignment also allowed me to reflect on my personal contributions to healthcare policy, and to imagine my ability to advocate for necessary policies and implications. Additionally, this assignment gave me the opportunity to think about the opportunity for professional and interprofessional collaboration with the goal of improving healthcare outcomes. Connect Advocacy and healthcare policy are two concepts related to this exemplar. Advocacy is the use of support to influence positive on a particular topic, population, or issue. Healthcare policy involves laws, legislation, or guidelines related to the implementation of healthcare, at an organizational, state, or federal level. Advocacy is an important part of healthcare policy, as it is important for healthcare professionals to properly advocate for the implementation of healthcare policies that will provide the best outcomes for population health, and to dismantle policies that are not in the best interest of healthcare professionals or patients. Reflect This assignment allowed me to imagine my role in healthcare advocacy and policy implementation. Prior to this assignment, I hadn’t thought much about my contribution to politics or my role in advocacy, but this assignment allowed me to see how important it is for nursing professionals to get involved in healthcare politics, whether at local, state, or federal levels. When I thought about leaders in the nursing profession, I never considered a political facet or gave thought to the many nursing professionals who must have contributed to nursing policy in order to advance our profession. I am thankful for the opportunity to complete this assignment because it allowed me to gain a better understanding of my ability to influence healthcare policy. this assignment, I had to recommend vaccines to patients based on their age, labs, family health history, contraindications, and family beliefs. I chose this assignment as an exemplar because I am passionate about vaccinations and enjoy working with pediatric populations. Additionally, I enjoy case study-type assignments because they offer the student the ability to adapt their practices and policies to specific patient needs and provide individualized care. Identify and Explain The NR602 Immunization Case Study Assignment allowed students to meet MSN Essential I: Background for Practice from Sciences and Humanities, Essential VIII: Clinical Prevention and Population Health for Improving Health, and Essential IX: Master’s-level Nursing Practice. Chamberlain Program Outcomes #1 Practice safe, high quality advanced nursing care based on concepts and knowledge from nursing and related disciplines and #7 Design patient-centered care models and delivery systems using the best available scientific evidence were also met with this assignment. Finally, the Immunization Case Study Assignment allowed students to meet NONPF competency areas Independent Practice Competencies and Scientific Foundation Competencies. By applying evidence-based practices and research to create individualized care plans for each patient based on their health histories and needs, students were able to effectively meet the previously mentioned outcomes. In this assignment, students were asked to not only recommend vaccines by age, but to also tailor their plan based on characteristics such as if the patient’s mother tested positive for Hepatitis C, or if the patient’s parents only wanted the vaccines necessary for school. Students are also required to recommend future vaccines, plan next visits, discuss contraindications, and explain educational counsel as needed. Connect Two concepts related to the Immunization Case Study exemplar are immunizations and contraindications. Immunizations, or vaccines, are a form of preventative medicine that come in the form of a shot which contain a very small dose of the disease they are meant to prevent. While each vaccine may have varying side effects, most professionals agree that vaccines are a great way to protect yourself and your children from contracting major illnesses such as Hepatitis, Rotavirus, Influenza, Diphtheria, and Varicella, to name only a few. A contraindication is a reason in which a patient should not receive a certain medication or treatment based on the negative side effects or harm it could cause. For example, patients with a history of severe allergic reaction to a vaccine should not continue to receive that vaccine again. Reflect I enjoyed completing this assignment because as mentioned above, I am passionate about the topic of immunizations and the many benefits they have on patients and population health. Having completed this assignment and meeting the above-mentioned outcomes will allow me to be a better healthcare provider because I know there will be times when parents will not want their children to receive vaccinations and I will need to not only create a customized healthcare plan that will benefit both the child and the community, but also be able to articulate research and evidence to discuss why the immunizations are in the child’s best interests. This assignment also allowed me to learn more about contraindications with vaccines and when it is not in a child’s best interest to receive them. I do enjoy working with the pediatric population so I know vaccines will be a reoccurring topic in my profession. Exemplar #8 NR508 Weeks 2, 3, & 7: RX Writing Assignments During weeks 2, 3, and 7 of NR508 Advanced Pharmacology, students completed a prescription writing assignment. In these assignments, students were given a case study scenario and were required to write a prescription based on the study. The scenarios included information about the patients, their insurance coverage, and even if they chose to have the prescription delivered. Based on the scenarios, students had to accurate write a comprehensive prescription including the patient’s address, date of birth, the dosage of the prescription, how frequently it should be administered, how it should be taken, and whether substitutions were acceptable. I chose these assignments as an exemplar because while I found this course challenging, I did very well on the assignments and learned a lot about prescription writing and prescriptive authority. Identify and Explain The RX Writing Assignments in NR508 allowed me to meet MSN Essential VI: Health Policy and Advocacy, and Essential IX: Master’s-level Nursing Practice. Additionally, this assignment allowed me to meet NONPF competency areas Scientific Foundation Competencies and Leadership Competencies. Chamberlain Program Outcomes #8 Manage human, fiscal and physical resources to achieve and support individual and organizational goals #7 Design patient- centered care models and delivery systems using the best available scientific evidence. These outcomes were met through the creation of individualized prescriptions based on specific patient, provider, and drug characteristics. For example, students needed to think critically and within their scope of practice when a prescription was needed to be made for a patient who wanted his prescriptions delivered through a service that required 90-day prescriptions but whose insurance only covered prescriptions in 30-day intervals. In another study, I was conflicted while writing the prescription because the dosage called for a table to be split in half, but I know that instructing patients to split pills is not always advised or considered a best practice. nursing roles, and #5 Develop a plan for lifelong personal and professional growth that integrates professional values regarding scholarship, service and global engagement. These outcomes were met through the comprehensive patient simulations which required students to interact with patients, complete social, health, and family histories, conduct physical exams and assessments such as examining and treating wounds and completing chest auscultation, recommending treatments and future visits, and completing SOAP notes. Connect Two concepts from this exemplar include patient health history and social health history. The patient health history includes a comprehensive interview about the patient’s past medical conditions and health, including surgeries, previous hospitalizations, history of health conditions, and other health-related factors that are pertinent to providing the best treatment possible for the patient. The patient social history is a comprehensive interview regarding the patient’s personal life and activities, including information about their job, hobbies, children, spouse, stressors, and other items that might be clinically significant to the patient’s health. Reflect I am incredibly thankful for these assessment simulations because they allowed me to see just how many gaps in my experience and knowledge I had, and how much information I was missing out on by not asking the right questions in my patient interviews. My first assessment simulation was quite a flop, but after reviewing all of the possible questions and information that could have been uncovered, I was armed with a better understanding of how to garner information from patients and was able to do much better in my next simulations. Because these assessments were so interactive and life-like, I know that they will help me be a better provider to my patients and will positively influence my provider-patient relationships. Exemplar #10 NR603 Week 6: Mental Health Clinical Presentation Plan Part 1 & 2 In week 6 of NR603 Advanced Clinical Diagnosis and Practice across the Lifespan Practicum, students were assigned a mental health disorder frequently seen in primary practice. Rather than being assigned a case study, students had to develop a case study for their peers based on the mental health concern they were assigned. Students could either create a case study or use an example from clinical practice, but had to include a comprehensive patient overview including chief complaint, symptoms, demographic data, history of present illness, previous mental health history, previous social history, medications, and subjective and objective findings. In the first part of this assignment, students lead the discussion for their peers around the case study they created without divulging the assigned mental health illness diagnosis. In addition to creating the case study, students were also required to respond to their peer’s studies, and based off the information provided, they had to recommend a primary diagnosis with additional differential diagnoses. In part two of the assignment, students created a final diagnosis and treatment plan including recommended diagnosis, labs, interventions, medications, referrals, and follow up. In this portion of the assignment, students addressed pathophysiology of their assigned mental illness, coding and billing, and reflected on the quality of care provided. Identify and Explain Similar to the Shadow Health Assessment simulations discussed in exemplar 9, this assignment was extremely comprehensive and required thorough responses and thought, therefore, many competencies were met. Outcomes addressed in this exemplar include MSN Essential VII: Interprofessional Collaboration for Improving Patient and Population Health Outcomes, Essential VIII: Clinical Prevention and Population Health for Improving Health, and Essential IX: Master’s-level Nursing Practice. NONPF competencies addressed with this assignment include Scientific Foundation Competencies, Ethics Competencies and Independent Practice Competencies. Chamberlain Program Outcomes met through this assignment include #6 Apply legal, ethical and human-caring principles to situations in advanced nursing practice, #7 Design patient-centered care models and delivery systems using the best scientific evidence, and #10 Collaborate interprofessionally in research, education, practice, health policy and leadership to improve population health outcomes. Due to the comprehensive and extensive nature of this assignment, students used an array of skills and competency areas to not only create their case studies, but to also respond to their peers and create their final treatment plan. Although this assignment focused on mental health, the concepts can be applied to many other areas of primary care. Connect Concepts related to the Mental Health Clinical Presentation assignment include non- pharmacological interventions and coding/billing. Non-pharmacological interventions include methods of treatment that do not involve pharmaceuticals, such as diet, physical activity, meditation, social distancing, and other things that a patient can do personally to improve their health. Coding and billing are parts of a provider’s job that involve selecting the proper codes for assessment and treatment, and billing the patient’s insurance provider. If the incorrect codes are utilized, it is likely that the insurance provider will not cover the patient’s expenses. Reflect Non- Pharmacolog ical Interventio ns Advoca cy Healthcare Policy Coding/Billing Health Informatics Patient Social History Medica l Technolo gy Patient Health History Healthcare Implications Frequen cy Exemplar Concept Map Population Health Route Networking Contraindications Leadership Immunizations Evidence- Based Practice Morbidity Mortali ty Researc h Evaluati on