Advanced Nursing Roles – Flashcards
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What states are responsible for being the first to have advanced practice language in their nurse practice act?
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Idaho
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How is the NP role different from PA role?
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PA is a physician extender NP independent
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Who created the 1st NP?
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1965 Loretta Ford/Henry Silver University of Colorado Peds
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What are three major research outcomes NP role should address?
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Reimbursements affect on quality of care. DPN on # of APN's/shortage of primary HC. Prescriptive authority affect on pt care.
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What three major HC system issues can be impacted by NP?
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1 Access to care 2 Quality of care 3 Cost of care
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What issues can impact NP positively or negatively?
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DNP Reimbursement Prescriptive authority
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Who is NONPF and what is their role for APRN's?
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National Organization of Nurse Practitioner Faculty Help establish domains and competencies for NP's
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How is PA different from NP?
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NP=nursing models independent and depentent PA= regulated by medical practice acts under supervision of a physician
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What are the three stages of transition from RN to NP?
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Identity loss-Novice at one and Expert at another. New skill affect their work. Transitional Role Evolution Phase-Role limbo, feel invisible or inept, peers are very important, leads to resocialization into the new role identity. Incorporation Phase-change in relationships between RN and peers
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What should a theoretic NP framework be based on?
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EBP, research, collaboration, consultation
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What are the 6 recognized NP roles by the consensus model?
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family adult gerontology neonatal pediatrics women's health psychiatric-mental health
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What percent does medicare/aide reimburse NP?
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85% care 92% aide 100% Texas healthy steps
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CNAP
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Coalition for Nurses in Advanced Practice
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NONPF
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National Organization of Nurse Practitioner Faculty
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NAPNAP
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National Association of Pediatric Nurse Practitioners: organization for PNP's
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NANN
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National Association of Neonatal Nurses
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AANP
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American Association of Nurse Practitioners
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ANCC
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American Nurses Credentialing Center
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Tri Council
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organized to advance policy at national level
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AACN
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American Association of Critical-Care Nurses
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TNP
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Texas Nurse Practitioner
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What is specialization of NP role?
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intersection of another body of knowledge with NP role that causes specialization
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What is expansion of NP role?
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Often can loose skills due to focused roles.
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What is the ideal evolution of the APN role?
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To have a broad base of theoretical knowledge that expansion or specialization can build from. IE you must know the broadness of your NP role to function in your specialty
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What are some examples of subspecialty in the NP role?
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Diabetes, forensic, palliative care, substance abuse, sexual assault, child abuse
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What are the three key elements of any healthcare system?
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Triangle: Cost Access Quality
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What drives healthcare change?
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Cost Access Quality Fear of government takeover Employers having a hard time paying with increased costs Not enough primary care Not enough people insured
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HMO
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Health maintenance organization Share financial risk between insurer and provider Fixed cost
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What are the three types of HMO's?
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Staff model-provider works for insurance Independent Practice Association-contracts made with providers for services Network-combination Staff and IPA
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PPO
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Preferred provider organization discounted fees for using certain providers on list
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POS
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Point of service plan select provider at time of service, requires a primary provider to refer
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UR
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Utilization Review Company Monitors use of insurance for healthcare
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EPO
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Exclusive Provider Organizations Use one hospital and group of providers, pay out of pocket for going else where
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Managed Insurance
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Rely in UR to manage cost of care, Blue cross Aetna Cigna Kaiser Humana
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What does LACE stand for?
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licensure accreditation certification education
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What are the three components of the consensus model?
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Roles Foci Specialties
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What are the 6 foci identified by the consensus model?
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1. Family/individual across the lifespan 2. Adult gerontology 3. Neonatal 4. Pediatrics 5. Women's health/gender-related 6. Psych/mental health
