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NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion

NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion

Chamberlain University NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion– Step-By-Step Guide

 

This guide will demonstrate how to complete the Chamberlain University   NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion  assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

 

How to Research and Prepare for  NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion                                

 

Whether one passes or fails an academic assignment such as the Chamberlain University   NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion    depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

 

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

 

How to Write the Introduction for  NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion                                

 

The introduction for the Chamberlain University   NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion    is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

 

How to Write the Body for  NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion                                

 

After the introduction, move into the main part of the  NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion       assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

 

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

 

How to Write the Conclusion for  NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion                                

 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

 

How to Format the References List for  NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion                                

 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion

Jessica, a baccalaureate prepared registered nurse, has been practicing for 8 years. Throughout her nursing career, she has worked in pediatric, surgical, and emergency departments. She worked as a floor nurse, a charge nurse, and she was recently offered a position in Nursing Administration. A stipulation for becoming a nurse administrator is that Jessica must attain a Master of Science in Nursing degree within 2 years of accepting the position. The offer prompted Jessica to contemplate her career. She is interested in returning to college, and wants to have greater impact on patient care but isn’t sure she will find that in an Administrative role, nor is she sure is ready for the responsibility of becoming a Nurse Practitioner. Jessica has decided to explore the advance practice roles available in nursing in order to determine the best MSN track for her. Jessica must choose

NR 510 Week 1 dq 2 Week 1 Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion
NR 510 Week 1 dq 2 Week 1 Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion

one role (CNP, CRNA, CNS, CNM) and apply to a program, but she is unsure about the different roles and their individual scopes of practice. One colleague states, “You know, Jessica, working as an NP is great because you can diagnose and write prescriptions, and the accountability will fall on the physician you are working with.”

Discussion questions:

  • Is Jessica’s colleague right? Why or why not?
  • Explore the four APN roles, and compare and contrast the pros and cons of each role against each other in order to determine the best choice for Jessica. Consider issues such as work environment, level of accountability, patient population, salary, and scope of practice. Include each role of the APN on the list, and be certain to provide appropriate rationales and citations.

Currently, certain rules must be followed to determine if the NP is reimbursed 100 percent. NP billing is done one of two ways: independent or “incident-to”. Independent billing is allowed when the patient is billed directly under the National Provider Identification (NPI) number of the NP providing the service. Incident-to billing occurs if the patient is treated by an NP, but the bill is submitted using the doctor’s NPI number. The first thing that needs to change are measures that require NPs to bill for their services under a physician-colleague’s name and provider number (Pickard, 2014). This makes it look like the NP cannot do his or her job without guidance like an intern; therefore, third party payers do not feel NPs should command top dollar for their services (Pickard, 2014). Furthermore, the difference in reimbursement has to do with multiple regulatory factors: billing guidelines at the state and federal level; credentialing, whether the patient is designated as outpatient or inpatient, and third-party payer policies (NAPNAP, 2018). Billing regulations must be strictly followed because they determine how much the NP can charge for his or her services, govern what services NPs can provide, who they provide services to, where these services can be rendered (NAPNAP, 2018). Each third-party payer (i.e. commercial or government insurer) has different rules on reimbursing NP services on these grounds. For example, reimbursement from private insurance agencies is distinct from the Medicare reimbursement process and may require a credentialing process. In order for reimbursement rates across the roles to be equal, third party payers, such as Medicaid and private insurers, would have to agree on service costs and reimbursement scales (Pickard, 2014). This is unlikely to happen for quite some time since the difference in reimbursement rates has to do with the bundling of services and who pays the bulk of the bill. While the billing process is meant to reflect the NPs productivity, I believe the current billing process is biased toward NPs and favors physicians when both parties provide the same service simply because of the title after the name. For example, if the Physicians Fee Schedule rate for a preventative care visit is $100, Medicare pays the physician $80; the patient then pays the $20 balance to the physician. If an NP performs the same service, Medicare pays the NP $68; the patient pays the NP $17. NPs should be reimbursed the same amount when performing the same service; the only way this will change is for NPs to document the clinical and financial outcomes related to the care they provide (Pickard, 2014). Consistent and thorough documentation from all NPs will support changes in coverage and reimbursement rules (Pickard, 2014).

References:

National Association of Pediatric Nurse Practitioners (NAPNAP). (2018). NP billing, coding, and reimbursement. Retrieved from https://www.napnapcareerguide.com/np-billing-coding-reimbursement/

Pickard, T. (2014). Calculating your worth: Understanding productivity and value. Journal of the Advanced Practitioner in Oncology5(2), 128–133. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093517/

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Sample Answer 2 for NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion

I enjoyed reading your post.  Your initial sentence is absolutely correct – as nurses education and scope increased, so does the responsibility and liability for performing the correct actions on behalf of a patient.As health care delivery has continued to evolve, many Americans are using NPs for much of their health care needs, making nurse practitioners a critical component of the modern system. This growth in demand and responsibility has also increased and evolved the many risks NPs face in their work environments.As future nurse practitioners, the need to purchase our own professional liability insurance policy is a reality.

A recent review of NP claim report insights show that the majority of claims against NPs developed from a failure involving competencies, such as diagnosis, medication prescribing, or treatment and care management. Allegations related to failure to diagnose and improper prescribing/managing of controlled drugs were found most frequently. This reality displays that nurse practitioners are responsible for reviewing, following up on, and documenting the results of appropriate tests and consultations in a timely manner, as well as properly evaluating each patient prior to prescribing medications. As always, remaining current regarding clinical practice, the need to document al medical treatment, including the care plan, laboratory and diagnostic testing, procedures performed, and medication provided in a timely and objective manner, and engage in an informed consent discussion are some ways to prevent errors and create liability.  Increased liability has increased with our soon to be scope of practice. Knowing this in advance can help us prepare appropriately.

Reference:

Stanik-Hutt J, Newhouse RP, White KM, et al., (2013). The Quality and Effectiveness of Care Provided by Nurse Practitioners. J Nurse Practice;9(8):492–500.

Sample Answer 3 for NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion

Currently, certain rules must be followed to determine if the NP is reimbursed 100 percent. NP billing is done one of two ways: independent or “incident-to”. Independent billing is allowed when the patient is billed directly under the National Provider Identification (NPI) number of the NP providing the service. Incident-to billing occurs if the patient is treated by an NP, but the bill is submitted using the doctor’s NPI number. The first thing that needs to change are measures that require NPs to bill for their services under a physician-colleague’s name and provider number (Pickard, 2014). This makes it look like the NP cannot do his or her job without guidance like an intern; therefore, third party payers do not feel NPs should command top dollar for their services (Pickard, 2014). Furthermore, the difference in reimbursement has to do with multiple regulatory factors: billing guidelines at the state and federal level; credentialing, whether the patient is designated as outpatient or inpatient, and third-party payer policies (NAPNAP, 2018). Billing regulations must be strictly followed because they determine how much the NP can charge for his or her services, govern what services NPs can provide, who they provide services to, where these services can be rendered (NAPNAP, 2018). Each third-party payer (i.e. commercial or government insurer) has different rules on reimbursing NP services on these grounds. For example, reimbursement from private insurance agencies is distinct from the Medicare reimbursement process and may require a credentialing process. In order for reimbursement rates across the roles to be equal, third party payers, such as Medicaid and private insurers, would have to agree on service costs and reimbursement scales (Pickard, 2014). This is unlikely to happen for quite some time since the difference in reimbursement rates has to do with the bundling of services and who pays the bulk of the bill. While the billing process is meant to reflect the NPs productivity, I believe the current billing process is biased toward NPs and favors physicians when both parties provide the same service simply because of the title after the name. For example, if the Physicians Fee Schedule rate for a preventative care visit is $100, Medicare pays the physician $80; the patient then pays the $20 balance to the physician. If an NP performs the same service, Medicare pays the NP $68; the patient pays the NP $17. NPs should be reimbursed the same amount when performing the same service; the only way this will change is for NPs to document the clinical and financial outcomes related to the care they provide (Pickard, 2014). Consistent and thorough documentation from all NPs will support changes in coverage and reimbursement rules (Pickard, 2014).

References:

National Association of Pediatric Nurse Practitioners (NAPNAP). (2018). NP billing, coding, and reimbursement. Retrieved from https://www.napnapcareerguide.com/np-billing-coding-reimbursement/

Pickard, T. (2014). Calculating your worth: Understanding productivity and value. Journal of the Advanced Practitioner in Oncology5(2), 128–133. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4093517/

Sample Answer 4 for NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion

I enjoyed reading your post.  Your initial sentence is absolutely correct – as nurses education and scope increased, so does the responsibility and liability for performing the correct actions on behalf of a patient.As health care delivery has continued to evolve, many Americans are using NPs for much of their health care needs, making nurse practitioners a critical component of the modern system. This growth in demand and responsibility has also increased and evolved the many risks NPs face in their work environments.As future nurse practitioners, the need to purchase our own professional liability insurance policy is a reality.

A recent review of NP claim report insights show that the majority of claims against NPs developed from a failure involving competencies, such as diagnosis, medication prescribing, or treatment and care management. Allegations related to failure to diagnose and improper prescribing/managing of controlled drugs were found most frequently. This reality displays that nurse practitioners are responsible for reviewing, following up on, and documenting the results of appropriate tests and consultations in a timely manner, as well as properly evaluating each patient prior to prescribing medications. As always, remaining current regarding clinical practice, the need to document al medical treatment, including the care plan, laboratory and diagnostic testing, procedures performed, and medication provided in a timely and objective manner, and engage in an informed consent discussion are some ways to prevent errors and create liability.  Increased liability has increased with our soon to be scope of practice. Knowing this in advance can help us prepare appropriately.

Reference:

Stanik-Hutt J, Newhouse RP, White KM, et al., (2013). The Quality and Effectiveness of Care Provided by Nurse Practitioners. J Nurse Practice;9(8):492–500.

Sample Answer 5 for NR 510 Week 1 dq 2 :Week 1: Historical Development of Advanced Practice Nursing and Evidence-Based Practice Discussion

Salaries for the different APN specialties vary quite a bit and they vary depending on what state one practices in.  I live in Illinois which seems to be within the national average-slightly higher than average in salaries for all the APN positions.  I did a general Google search to identify salary averages for my state.  Certified Nurse Midwives in Illinois make between 111-139k per year.  Their education requires a BSN for entry into the program and approximately a 3 year masters program and certification exam.  A CNM is the most specialized degree that focuses specifically on women and their needs throughout pregnancy and childbirth along with the infant while in utero and during and immediately after birth.  Family nurse practitioners in Illinois make on average 95-108k and their degree is a masters which averages 2-2.5 years to complete and requires a national certification exam.  A clinical nurse specialist in Illinois averages 96-107k per year and is also a masters degree requiring on average 2 years to complete.  A CRNA  in Illinois makes between 165-187k per year and the degree requires 24-36 months of schooling full time.  CRNA school is considered by many to be the most difficult to gain entry into, and the most difficult program of the APN degrees.  They are also very specialized program that focuses on anesthesia during surgery and pain control.  I believe that Jessica would best fit in a FNP program.  Jessica stated that her goal was to gain greater impact on patient care and since she didn’t have experience in or express interest in anesthesia or maternal health that leaves her with the choice between a CNS or an NP.  As an NP Jessica would have the ability to work directly with patients and prescribe and treat patients as their primary provider.  She would also be given the flexibility to teach if she felt like working with students and the ability to work with doctors in a variety of settings.  The scope of a CNS is more limited and I feel that the flexibility of a NP would offer Jessica many opportunities that would fit best with her career goals.

When I was researching salaries for APN positions I came across an article that discussed the difference in APN salaries related to gender differences.  The article stated that male NP’s earned $12,859 more than female NP’s after adjusting for individual differences in demographics and work characteristics and that recent graduate male NP’s earned $7,405 more than females with a continued increase in earnings and gap between genders (Greene, El-Banna, Briggs, & Park, 2017).  I have to admit that this statistic bothered me.  I know that there are increased salaries identified for males in similar roles as females, but when it is identified in the nursing profession I find it offensive.  I have worked side by side with males, females, homosexual nurses, and transgender nurses.  In my experience gender and gender identification do not matter, especially in the role of a nurse and advanced practice nurse.  What matters is the individual’s ability to perform the job overall.  There shouldn’t be such a huge difference in salaries between genders for nurses doing the same job and it bothers me that there is.  I do realize that gender differences still remain, but it surprises me that such a big salary difference between genders remains in a profession that is female dominant.

References

Greene, J., El-Banna, M., Briggs, L., & Park, J. (2017).  Gender differences in nurse practitioner                   salaries.  Journal of the American Association of Nurse Practitioners 29(11). 667-672.                         http://doi.org/10.1002/2327-6924.12512

APA Writing Checklist

Use this document as a checklist for each paper you will write throughout your GCU graduate

program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center.

☐ APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and format is correct throughout.

☐  The title page is present. APA format is applied correctly. There are no errors.

☐ The introduction is present. APA format is applied correctly. There are no errors.

☐ Topic is well defined.

☐ Strong thesis statement is included in the introduction of the paper.

☐ The thesis statement is consistently threaded throughout the paper and included in the conclusion.

☐ Paragraph development: Each paragraph has an introductory statement, two or three sentences as the body of the paragraph, and a transition sentence to facilitate the flow of information. The sections of the main body are organized to reflect the main points of the author. APA format is applied correctly. There are no errors.

☐ All sources are cited. APA style and format are correctly applied and are free from error.

☐ Sources are completely and correctly documented on a References page, as appropriate to assignment and APA style, and format is free of error.

Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and usually written by an expert in the same subject field. Scholarly resources are written for an academic audience.

Examples of Scholarly Resources include: Academic journals, books written by experts in a field, and formally published encyclopedias and dictionaries.

Peer-Reviewed Journals: Peer-reviewed journals are evaluated prior to publication by experts in the journal’s subject discipline. This process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article in that subject discipline.

Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that reports the original finding of an observational or experimental research study. Common aspects found within an empirical article include: literature review, methodology, results, and discussion.

Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.

☐ The writer is clearly in command of standard, written, academic English. Utilize writing resources such as Grammarly, LopesWrite report, and ThinkingStorm to check your writing.