Medicolegal Considerations and the Role of the Advanced Practice Nurse

Medicolegal Considerations and the Role of the Advanced Practice Nurse

In this course, all 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.

As an advanced practice nurse (APN), it is essential to understand your medicolegal responsibilities as they relate to coding the services you provide to patients. Improper coding, undercoding, or overcoding can have serious implications for patients, providers, and the provider’s care setting. For this Discussion, you examine potential coding issues in case studies and consider the medicolegal responsibilities of the advanced practice nurse.

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Case Study 1

Sally Jones, an acute care advanced practice nurse, is making hospital rounds on the same patients her colleague nurse practitioner saw yesterday. Sally had five history and physicals to complete on admissions that came in overnight. At the beginning of her shift, she had to complete two emergency admissions and was then called to intensive care, where she spent most of the afternoon. She had to leave work early because of her husband’s retirement party. Because she knew most of the patients on her rounding list, she decided to visit each patient’s room quickly for about 10 minutes. She coded all of the visits the same way she had done the day before, with codes 99231 and 99232. Medicolegal Considerations and the Role of the Advanced Practice Nurse

Case Study 2

Lisa Smith, an acute care advanced practice nurse, is making hospital rounds on the same patients her colleague nurse practitioner saw yesterday. It took her 50 minutes to see 10 of her patients and 30 minutes to see each of the remaining patients on her list. She used the same code for all visits—99233. Medicolegal Considerations and the Role of the Advanced Practice Nurse

To prepare:

  • Select one of the provided case studies.
  • Review the patient documentation given for the case. Think about medicolegal considerations and the responsibilities of the advanced practice nurse.
  • Consider the medical codes selected by the advanced practice nurse. Reflect on how the selections might impact clinical practice and billing. Think about how the impact might differ from primary to acute care settings. Medicolegal Considerations and the Role of the Advanced Practice Nurse

By Day 3

Post a brief description of the patient documentation given for the case study you selected. Explain any medicolegal considerations, including the role and responsibilities of the advanced practice nurse. Then, explain how medical coding might impact clinical practice and billing, as well as how implications might differ from primary to acute care settings.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who selected a different case study than you. Share additional insights or alternative perspectives.

Discussion Part II: Pharmacology

Read the following articles to enhance your knowledge on commonly prescribed medications:

River-Bou, W. & Brown, D. (2014). Thrombolytic Therapy. Retrieved from http://emedicine.medscape.com/article/811234-overview

Thrombolytics are used for AMI, DVT, acute peripheral arterial occlusion, occlusion of indwelling catheters, pulmonary embolism, and stroke. Medicolegal Considerations and the Role of the Advanced Practice Nurse

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.

  • Activase
  • Retavase
  • Urokinase
  • Streptokinase
  • TNKase
  • Anistreplase.

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. Medicolegal Considerations and the Role of the Advanced Practice Nurse

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.

Medicolegal Considerations and the Role of the Advanced Practice Nurse

Although your roles and responsibilities may differ based on your practice setting (think emergency department versus inpatient hospital setting or outpatient specialty medicine clinic), they may also vary depending on the state in which you practice. Because each state has its own laws and regulations that determine the scope of practice for advanced practice nurses, it is your responsibility to understand your own state’s guidelines. This Assignment involves locating the Nurse Practice Act for your state and reviewing practice guidelines, licensing requirements, and the certification process.

To prepare:

  • Locate the Nurse Practice Act for your state, as well as any other state legislation that outlines practice for Advanced Practice Registered Nurses (APRNs). Reflect on the definition and scope of practice of the APRN according to your state. Medicolegal Considerations and the Role of the Advanced Practice Nurse
  • Consider which state board is responsible for licensure of APRNs. Determine whether your state requires nursing board approval, board of medicine approval, or joint board approval for APRN practice.
  • Consider the DEA (Drug Enforcement Administration) Drug Schedule categories approved for APRN prescribing. Think about how this might impact your clinical practice.
  • Research the national certifying board options and application processes for the Adult Geriatric Acute Care Nurse Practitioner. Think about which exams are recognized by your state board and which board options best suit your professional needs.

To Complete:

Address the following in a 1- to 2-page paper:

  • Explain the definition and scope of practice for APRNs according to the Nurse Practice Act in your state.
  • Identify the state board that is responsible for licensure of APRNs.
  • Identify the DEA Drug Schedule categories approved for APRN prescribing in your state. Explain whether this might impact your clinical practice, and if so, explain how.
  • Identify which national certifying board options are recognized by your state board. Explain which options best suit your professional needs and why. Describe the application processes for these options. Medicolegal Considerations and the Role of the Advanced Practice Nurse

By Day 7

This Assignment is due.

Note: You must include references to support your paper. The School of Nursing also requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements. All papers submitted must use this formatting. Medicolegal Considerations and the Role of the Advanced Practice Nurse

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the following naming convention: “WK1Assgn+lastname+first initial”.
  • Click the Week 1 Assignment link.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK1Assgn+last name+first initial.(extension)” and click Open. If you are submitting multiple files, repeat until all files are attached.
  • Click on the Submit button to complete your submission.

Medicolegal Considerations and the Role of the Advanced Practice Nurse

Excellent Good Fair Poor
Quality of Work Submitted:
The extent of which work meets the assigned criteria and work reflects graduate level critical and analytic thinking.
27 (27%) – 30 (30%)
Assignment exceedsexpectations. All topics are addressed with a minimum of 75% containing exceptionalbreadth and depth about each of the assignment topics. Medicolegal Considerations and the Role of the Advanced Practice Nurse
24 (24%) – 26 (26%)
Assignment meets expectations. All topics are addressed with a minimum of 50% containing good breadth and depth about each of the assignment topics.
21 (21%) – 23 (23%)
Assignment meets most of the expectations. One required topic is either not addressed or inadequately addressed.
(0%) – 20 (20%)
Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed.
Quality of Work Submitted:
The purpose of the paper is clear.
(5%) – 5 (5%)
A clear and comprehensive purpose statement is provided which delineates all required criteria.
(4%) – 4 (4%)
Purpose of the assignment is stated, yet is brief and not descriptive.
3.5 (3.5%) – 3.5 (3.5%)
Purpose of the assignment is vague or off topic.
(0%) – 3 (3%)
No purpose statement was provided.
Assimilation and Synthesis of Ideas:
The extend to which the work reflects the student’s ability to:

Understand and interpret the assignment’s key concepts.

(9%) – 10 (10%)
Demonstrates the ability to critically appraise and intellectually explore key concepts.
(8%) – 8 (8%)
Demonstrates a clear understanding of key concepts.
(7%) – 7 (7%)
Shows some degree of understanding of key concepts.
(0%) – 6 (6%)
Shows a lack of understanding of key concepts, deviates from topics.
Assimilation and Synthesis of Ideas:
The extend to which the work reflects the student’s ability to:

Apply and integrate material in course resources (i.e. video, required readings, and textbook) and credible outside resources.

18 (18%) – 20 (20%)
Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 2-3 course resources to suppport point of view.
16 (16%) – 17 (17%)
Integrates specific information from 1 credible outside resource and 2-3 course resources to support major points and point of view.
14 (14%) – 15 (15%)
Minimally includes and integrates specific information from 2-3 resources to support major points and point of view.
(0%) – 13 (13%)
Includes and integrates specific information from 0 to 1 resoruce to support major points and point of view.
Assimilation and Synthesis of Ideas:
The extend to which the work reflects the student’s ability to:

Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, textbook) and outside, credible resources by comparing different points of view and highlighting similarities, differences, and connections.

18 (18%) – 20 (20%)
Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice.
16 (16%) – 17 (17%)
Summarizes information gleaned from sources to support major points, but does not synthesize.
14 (14%) – 15 (15%)
Identifies but does not interpret or apply concepts, and/or strategies correctly; ideas unclear and/or underdeveloped.
(0%) – 13 (13%)
Rarely or does not interpret, apply, and synthesize concepts, and/or strategies.
Written Expression and Formatting

Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance.

(5%) – 5 (5%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity. Medicolegal Considerations and the Role of the Advanced Practice Nurse
(4%) – 4 (4%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 80% of the time.
3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 60%- 79% of the time.
(0%) – 3 (3%)
Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity < 60% of the time.
Written Expression and Formatting

English writing standards: Correct grammar, mechanics, and proper punctuation

(5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
(4%) – 4 (4%)
Contains a few (1-2) grammar, spelling, and punctuation errors.
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) grammar, spelling, and punctuation errors.
(0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting

The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.

(5%) – 5 (5%)
Uses correct APA format with no errors.
(4%) – 4 (4%)
Contains a few (1-2) APA format errors. Medicolegal Considerations and the Role of the Advanced Practice Nurse
3.5 (3.5%) – 3.5 (3.5%)
Contains several (3-4) APA format errors.
(0%) – 3 (3%)
Contains many (≥ 5) APA format errors.
Total Points: 100

Medicolegal Considerations and the Role of the Advanced Practice Nurse

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