Walden University – NURS 6565 Week 4 Discussion: Clinical Challenges for the NP

Walden University – NURS 6565 Week 4 Discussion: Clinical Challenges for the NP

NURS 6565 Week 4 Discussion: Clinical Challenges for the NP – Each state has laws that differ in regard to the role of the Nurse Practitioner. They also may significantly impact the NP’s practice. Legislative changes may occur annually, bi-annually, or during an emergency legislative meeting at the state or federal level. These legislative sessions and any subsequent changes may significantly impact your scope of practice as a Nurse Practitioner. Remaining current with the laws in your state is essential. For example, the recent change at the federal level changing hydrocodone-containing drugs from a Schedule III drug to a Schedule II drug has impacted NPs in some states. For states that allow for Nurse Practitioners to write Schedule III-V drugs, these NPs are now unable to write for hydrocodone- containing medications, which significantly impacts their ability to provide care for their patients. The Pearson Report, which is updated almost annually, provides a national overview of each state’s current legislature. As a future NP, you should become familiar with The Pearson Report and stay abreast of state and federal legislation.

For this Discussion, you will post an explanation that defines the legal implications for standard of care, the key components of a malpractice policy in regard to a case study. Additionally you will explain the collaborative agreements and rules for your state in regard to your NP practice and the case study you select.

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To prepare FOR NURS 6565 Week 4 Discussion: Clinical Challenges for the NP:

Review the following case studies and select one to research in depth:

NURS 6565 Week 4 Discussion: Clinical Challenges for the NP Case Study One: Dismissing the non-compliant patient.

Gwen, a 52 year old Caucasian LPN, recently joined your practice as a new patient. She currently has a BMI of 32, B/P of 142/88. Pulse is 89, Respiratory rate is 22, Pulse Ox is 96% on Room Air. She is taking Lisinopril 10mg po daily (when she can remember), Metformin 1000mg po BID and refuses lab work. Her physical exam is unremarkable and foot exam is normal. She refuses all vaccinations including Prevnar and Influenza. Gwen’s last mammogram and pap smear were “years ago.”

NURS 6565 Week 4 Discussion: Clinical Challenges for the NP Case Study Two: Preventive care, why is it so important to document?

John, a 62 year old attorney, who has been a long-term patient of yours, comes to you to discuss his erectile dysfunction. You note that he has refused lab work for the past two years. He is a 30 pack/year smoker, and has not had a chest x-ray or ECG in three years. He does take his HCTZ 25 mg po daily. His BMI is 29 and all vital signs are within normal limits. He does agree to his Prevnar Vaccine today.

NURS 6565 Week 4 Discussion: Clinical Challenges for the NP Case Study Three: Patient and professional relationships.

Jennifer, a 45 year old Caucasian returns to your clinic for a refill of her hydrocodone. She was diagnosed with Ovarian Cancer last year, followed by successful removal and treatment. All vital signs are stable and preventive care is up to date. She wants to discuss filing a lawsuit against the surgeon that initially turned her away and told her she had gastritis and needed to eat healthier.

Review the following articles found in this week’s Learning Resources:

  • Miller, K. P. (2013). The National Practitioner Data Bank: An Annual Update. The Journal for Nurse Practitioners, (9)9, 576-580.
  • Stelmach, E. I. (2015). Dismissal of the Noncompliant Patient: Is this What We Have Come to? The Journal for Nurse Practitioners, 11(7), 723-725.
  • Review endocrine disorders and erectile dysfunction in your Primary Care Medicine text (Gorrol, Ah. & Mulley, A.G., 2009).

Consider strategies and treatment options that would be most effective for these patient scenarios to improve compliance and health outcomes.

Reflect on how to approach the non-compliant patient and the importance of a separate preventive care visit.

By Day 5

Post an explanation that addresses the following for the Case study you selected:

  • Identify and briefly summarize the case study you selected
  • Explain any legal implications for standard of care related to the case study you selected
  • Identify and explain the key components of a malpractice policy related to the case study you selected
  • Explain the collaborative agreements and knowledge the rules for your state in regards to NP practice the case study you selected.

NURS 6565 Week 4 Assignment 1: Recognizing the Role of Adhering to the Standard of Care

Assignment 1: Recognizing the Role of Adhering to the Standard of Care

When providing health care, there are standards of care which a reasonably prudent provider should follow. Providers at all levels are held to these standards of care. Failure to provide competent care to your patients will put you at risk for malpractice. Remaining current with the evidenced-based guidelines and providing optimal care will minimize the risk of liability.

For this Assignment, you will create a PowerPoint presentation that explains any legal implications that exist for failure to adhere to a standard of care, the key elements of malpractice, and compare the differences in malpractice policy options.

To prepare:

  • Consider the importance of using professional resources such as the National Guideline Clearinghouse to guide care delivered
  • Create a PowerPoint presentation no more than 15 slides in length that addresses the following:
  • Identify and explain any legal implications that exist for failure to adhere to a standard of care
  • Identify and explain the key elements of malpractice
  • Compare the differences in malpractice policy options

Rubric Detail – Blackboard Learn

https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16307207_1&rubric_id=_200592_1 1/4

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 exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics.

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 (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 (5%) A clear and comprehensive purpose statement is provided which delineates all required criteria.

4 (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 (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 (9%) – 10 (10%)

Demonstrates the ability to critically appraise and intellectually explore key concepts.

8 (8%) – 8 (8%) Demonstrates a clear understanding of key concepts.

7 (7%) – 7 (7%) Shows some degree of understanding of key concepts.

0 (0%) – 6 (6%) Shows a lack of understanding of key concepts, deviates from topics.

Rubric Detail Select Grid View or List View to change the rubric’s layout.

Name: NURS_6565_Week4_Assignment1_Rubric Exit

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9/16/2017 Rubric Detail – Blackboard Learn

https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16307207_1&rubric_id=_200592_1 2/4

Excellent Good Fair Poor

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 (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 (0%) – 13 (13%)

Rarely or does not interpret, apply, and synthesize concepts, and/or strategies.

9/16/2017 Rubric Detail – Blackboard Learn

https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16307207_1&rubric_id=_200592_1 3/4

Excellent Good Fair Poor

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 (5%) Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity

4 (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 (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 (5%) Uses correct grammar, spelling, and punctuation with no errors.

4 (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 (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 (5%) Uses correct APA format with no errors.

4 (4%) – 4 (4%) Contains a few (1-2) APA format errors.

3.5 (3.5%) – 3.5 (3.5%)

Contains several (3-4) APA format errors.

0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors.

Total Points: 100

Name: NURS_6565_Week4_Assignment1_Rubric

9/16/2017 Rubric Detail – Blackboard Learn

https://class.waldenu.edu/webapps/bbgs-deep-links-BBLEARN/app/course/rubric?course_id=_16307207_1&rubric_id=_200592_1 4/4