Client Questions

Discussion: Reimbursement Issues for Nurse Practitioners Understanding the complex process of accurate coding and billing is essential to a sustainable practice. As NPs, we are ultimately responsible for ensuring all coding and billing is accurate for each patient seen. For this Discussion, you will search the health care literature and summarize a peer-reviewed journal article published within the last five years. To prepare: Select one of the following topics: Applying for Medicare and Medicaid Provider Numbers Application process for National Provider Identifier Number Incident to billing Coding-Evaluation & Management Fraudulent billing Billing Self-Pay patients Managed Care Organizations Conduct a search and select a peer-reviewed journal article published within the last five years related to the topic you selected. Note: For this Discussion, all students are to avoid all written work, which reviews or outlines coding and billing at previous or current worksites as well as previous or current practicum sites. By Day 3 Post a brief summary of the article you selected. Include the key reimbursement issue addressed and how they would impact the NP in a collaborative practice versus and independent practice. Discuss an ethical or legal implication(s) associated with your article.

What are your thoughts?? Before conducting a study in the nursing field, the researcher has to ensure that they have all the necessary information about the selected topic. Research in any discipline is vital in providing enough evidence about a certain condition. Therefore, when conducting research, combining both qualitative and quantitative methods increases the chances of having efficient results. Also, the limitations posed by one method will be reduced and covered by the other method. However, when combining both methods, various approaches could be used. The researcher could opt to use the two methods sequentially. Through this method, one research approach is first applied before the second methodology is applied. Besides, this approach could engage one methodology first to collect the data than the second methodology to analyze the results. Also, the researcher could apply a parallel data gathering approach where all the methods are used at the same time.

Advocacy for patients is important to ensure that they are receiving the proper care (Helbig, 2018), and when they can’t voice for themselves, we, as nurses, should stand up for them and make sure the proper care and needs of our patients are given if at any time it is denied or is in need of investigation or proper resources. Communication and collaboration are key in the work environment in order to provide patient-centered care (Helbig, 2018). I had an experience where the patient was seen and the doctor determined she had not been taking her medication as prescribed and had not attended PT.  The doctor came out of the room and instructed me to document non-compliance and to discontinue her treatment at the office.  I asked him what the problem was and asked if I could talk to the patient and see what may be the cause.  He gave me permission and I was able to determine the issues within twenty minutes.  As he was seeing another patient, I waited until he was done and asked to speak to him.  I explained to him the issue was the patient was in the hole with medication through Medicare and could not afford it, and was also having problems with transportation.  He gave instruction to document the result and find the resources and samples of medications the patient needed and we would supply them until she was out of the hole. Had I not intervened or advocated for the patient, she would have been labeled non-compliant as well as had to go through the process of looking for another doctor.

Discuss a clinical problem or issue in your area of practice that would be appropriate for an EBP project and formulate a researchable question using PICOT format. The discussion should not be too long about 2-3 paragraphs. The initial posting (IP) and the response to peer  posting each (RTP) require one reference from an English titled, peer reviewed NURSING journal less than 5 y/o. The references must be from different journal articles. IMPORTANT: The articles posted in each unit are to facilitate your understanding of the topic and help you meet the identified learning objectives. They are not to be used as references for any of your course work.  However, FOR THIS WEEK ONLY:  I want you to use the articles in Unit 1 as your sources. *The initial posting also requires a reference from the course textbook. Professional, governmental, or educational organizations (.org, .gov, or .edu)  may be used as supplemental references. *The maximum number of references:  IP = 2, RTP = 2. Postings with more than the maximum number of will be returned to the student. APA format required. See grading criteria and rubric for discussion postings. Please see the attached articles  Please also use the following textbook:   Polit, D. E & Beck, C. T. (2018). Essentials of nursing research: Appraising    evidence for nursing practice(9th. ed.). Philadelphia, PA: Wolters Kluwer ISBN: 978-1-4963-5129-6

In a 2- to 4-page paper, create an interview transcript of your responses to the following interview questions: Tell us about a healthcare program, within your practice. What are the costs and projected outcomes of this program? Who is your target population? What is the role of the nurse in providing input for the design of this healthcare program? Can you provide examples? What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design? What is the role of the nurse in healthcare program implementation? How does this role vary between design and implementation of healthcare programs? Can you provide examples? Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?

comment1 The clinical aspect is patient medication education.  Nurse patient education is a core and fundamental aspect of nursing practice. “Today nurses assume more and more responsibility for education of patients and helping them to become responsible for their own health status… and work to stabilize and  prevent or minimize complications from any chronic illness”. (Tips to Improve Patient Education, 2018). Providing structured medication education and monitoring of therapy especially, with patients on long-term therapy taking medication that require strict adherence to complex processes for treatment effectiveness is an important clinical practice. Financial aspect: there is no heavy financial burden on organization in the implementation of this practice proposal. The only financial obligation will be in developing educational training materials such as video programs for training nurses or the human resources and time required to provide training and evaluation of change outcomes. Financial benefits will include decreases in healthcare cost from treatment of osteoporotic complications due to non-compliant to treatment regimen, also, decreased hospitalization and financial burden on patients and community in general. Comment2 The quality aspect of my EBP involves taking an active approach on safety, monitoring and re-evaluation of new safety practices.  Creating an atmosphere of healing benefits everyone.  Quality of care, best possible outcomes, and effective problem solving can only take place when there is teamwork and communication.  We have learned from research literature that workplace violence in healthcare settings can be reduced with the implementation of enhanced safety measures, and the safety our facilities is importance to staff, patients, and visitors.  Workplace bullying is a top reason for high nurse turn-over rates and low retention-especially with new nurses.  With this knowledge, we can make the changes within our teams necessary for success.

Malpractice refers to an action or lack thereof by a physician or licensed person that differs from the standard of care stated and results in damage or injury to the patient (Bal, 2009). For this malpractice to be acknowledged there must be four elements. These elements include duty to treat the person, a violation of this duty, a direct cause of injury from the actions performed and damages from the malpractice (Bal, 2009).

Discussion 3 Currently, the societal population is increasing, so does the need for quality, affordable, comprehensive, and accessible healthcare. For the healthcare system to advance, the Family nurse practitioners (FNP) must be ready to provide an extensive range of family-focused health care amenities diligently and without any discrimination. FNPs are graduate-educated, practitioners who have been certified and licensed by the state, to care for patients across the world ranging from infants to geriatric patients. Individuals who would prefer to train as certified family nurse practitioners are required to have a Master of Science degree in nursing and are also expected to enroll in different programs which are accredited (Nursejournal, 2020). The program comprises of courses related to administrative leadership, nursing, and evidence-based practice society (Nursejournal, 2020). The American Association of Colleges of Nursing (AACN) is a program established to protect and advocate for a nationwide opinion on academic nursing. In 2004, the members affiliated to the AACN program agreed in unison that persons who may want to become nurse practitioners must undertake a degree title of Doctor of Nursing practice by 2015 (American Association of Colleges of Nursing Practitioners, 2020). The members argued that a person with a doctorate in nursing is well equipped to completely implement the knowledge developed by nurse researchers.  The National Board of Nursing of each State is a panel that comprises of members who are authorized to determine the scope of practice for FNPs. On the other hand, the Nurse Practice Act defines the range of training for family nurse practitioners. Generally, the American Nurses Credentialing Center certifies medics to train as family nurse practitioner in any medical organization (Nursejournal, 2020). Professional organizations in nursing are important in defining the role of a family nurse practitioner since they help in generating the flow of ideas, energy and proactive work required to maintain a healthy profession that promotes the needs of patients and nurses in the society (Nursejournal, 2020). Additionally, the professional organizational role is to educate professional nurses about the importance of a broad-based membership participation to assist the profession improve and advance to greater levels. On the other hand, political organizations play a key role in defining the role of a nurse practitioner. The organizations enable nurses to fully involve themselves in political activism which is essential for patient advocacy and professionalism (Nursejournal, 2020). The political organizations enable the nurses to be active politically and to be informed of the current health regulations to protect patients and improving the health care system. Among the imposed regulations includes Rule 64B9-4.002(3), F.A.C. which provides the expert or national nursing specialty boards acknowledged by the bond and Section 464.012(4), FS which allows a psychiatric nurse to prescribe controlled substances for treatment of psychological disorders. Another regulation includes Section 464.012(3), F.S. that provides for an APRN to perform functions within established protocol (Florida Board of Nursing, 2020a). Finally, division 64B9 of the Florida Administrative Code is a rule that offers procedures for accreditation of APRNs. The rule similarly permits for either establishments recognized by AHCA to be eligible as a provider for CNA in-service preparation (Florida Board of Nursing, 2020b). I would not like to change these regulations since they are properly conversed, articulated, and understood in the Act. References American Association of Colleges of Nursing Practitioners. (2020). Nurse Practitioner Curriculum. Retrieved from https://www.aanp.org/advocacy/advocacy-resource/position-statements/nurse-practitioner-curriculum? Florida Board of Nursing (2020a). Advanced Practice Registered Nurse (APRN). Retrieved from   https://floridasnursing.gov/nursing-faqs/advanced-practice-registered-nurse-aprn/ Florida Board of Nursing (2020b). Florida Administrative Code: Rule 64B9-5.012. Retrieved              from https://floridasnursing.gov/florida-administrative-code-rule-64b9-5-012/ Nursejournal.Org. (2020). Role & Scope of Practice of a Family Nurse Practitioner. Retrieved from https://nursejournal.org/family-practice/role-scope-of-practice-of-a-family-nurse-practitioner/ Toney-Butler, T. J., & Martin, R. L. (2019). Florida Nursing Laws and Rules. In StatPearls              [Internet]. StatPearls Publishing.

Assignment 5.1: Endocrine System Organs Endocrine System Organs Objectives Identify the anatomical structures of the endocrine system and their functions Describe selected endocrine system diseases and disorders Describe issues and changes related to the endocrine system at different points in the lifespan Assignment Overview This exercise reviews the major organs of the endocrine system and their associated hormones and diseases. Deliverables A table of the major endocrine organs and their associated hormones Step 1 Create a table. Create a table of the major endocrine organs of the human body. For each organ, include: Hormones associated with each organ and the target cells affected by those hormones One example of a disease or disorder

Complete a SWOT (Strengths, Weaknesses, Opportunities & Threats) Analysis of a private, government funded or non-profit hospital within your state. You must analyze internal or external factors that could negatively affect or assist the organization with accomplishing their goals. Please begin the assignment by reviewing this week’s classroom lecture notes and locating a nearby hospital. After discovering a suitable hospital, you should research the social media accounts, accreditation reports, newspaper articles, or Joint Commission updates.