Walden University - NURS 6550Brendis: Acute Care Nurse Practitioner (ACNP)ACNP Guide #1: Study Guide Summarized And/or Directly Quoted From The 2020 Barkley Review Manual.

AG-ACNP -Mentor: Instruct how to manage their conditions (asthma, DM, HTN); preceptor -Role modeling: Instructing patient through examples of healthcare process in action; leading by example-healthy behavior -Counseli ...

AG-ACNP -Mentor: Instruct how to manage their conditions (asthma, DM, HTN); preceptor -Role modeling: Instructing patient through examples of healthcare process in action; leading by example-healthy behavior -Counseling: Instructing on how to responsibly manage condition and courses of treatment -Health literacy: single best predictor of one’s health status; average American reads 8th grade level, so information should be written at 6-8th grade level Legislative/Regulatory Processes -Accreditation guidelines: laid out by Joint commission Economics Resource utilization: how consumers use healthcare services; how they interact with providers Multidisciplinary Response Teams (MRTs) Health Information Technology -EMR; database to optimize care Quality Improvement(QI)/Quality Assurance(QA)/Continuous Process/Quality Improvement(CPI/CQI) -Root cause analysis: tool to identify prevention strategies to ensure safety; multi-cause variable system. Focus on culture of safety-not culture of blame. Must be done after sentinel event. Must be thorough, interdisciplinary, all involved parties, continually digging, 5 why’s, identify changes to system, cause/effect diagrams, consider human factor, risks, facts, and credible (internally consistent). Risk Management -Systematic effort to reduce risk. Begins with formal written risk management plan. Includes: organization’s goals, scope, components, and method, delegation of responsibility for Standardized Assessment Tools: emotional/substance -Patient Stress Questionnaire: primary care use; assess for depression, anxiety, trauma, and alcohol use Pain Tools -Wong-Baker FACES: good for non-english speaking Sedation Tools -Ramsay Sedation Scale: assesses conscious state; 1 (anxious)-6 (unresponsive); Geriatric Assessment Tools -Mini-mental state examination (MMSE): assesses cognitive function; clock drawing test. 1-6. Assistive Devices -DME: durable, lasts >3 yrs, used for medical reason, not useful to noninjured/sick, used at home. Examples of Medicare covered: CPAP, WC, cane, crutch, commode, blood glucose Alternative/complementary Therapies -Complementary and alternative medicine (CAM): treatments that are used along with or instead NP Role Invasive/noninvasive test/treatment -NP responsible for preparing the patient, monitoring during procedure, and post-assessment. Informatics -Nursing informatics: integrates nursing science, computer science and information science to vAdvanced Practice Ownership -Benchmarking: comparison and measurement of services against similar organizations. Allows NP/Patient Relationship -Establish rapport/professional therapeutic relationship: -non-judgmental approach Advance Directives/Living Wills -Advance Directive: written statement about patient’s intent regarding medical treatment. Privacy and Confidentiality -Health Insurance Portability and Accountability Act (HIPAA): Health Care Delivery -Initiate change: start locally. Upward and outward. Hospital, then community, region, state, etc. Go up the proper chain of command. -Negligence: neglecting to do what a reasonable person would/should do, resulting in jury to the patient. Example: no EKG with CP Medicare -A: >65 yr, most qualify for free. Covers inpatient/hospitalization, SNF, home health/hospice associated with admission. Types of Exams -Problem focused: limited exam of affected body area/organ Professional Responsibility -Scope of practice: guidelines for nursing practice; determined by state board of nursing and individual state Nurse Practice Acts. Patient Abandonment -When caregiver-patient relationship is terminated without making reasonable arrangements for care. Determined by: Dismissing/Discharging a Patient or Closing Practice -Cannot withdraw from caring for a patient without notification -OK to discharge patient: abuse of NP/staff, refusal to pay for services, or patient’s persistent Informed Consent -Informed consent: indicates that the patient has received adequate instruction regarding aspects Ethics -Nonmaleficence: duty to do no harm -Beneficence: duty to prevent harm and promote good -Utilitarianism: the right act is the one that produces the greatest good for the greatest number Evidence-based Practice and Research Methods -NP can participate in any step -Formulate the research problem -Nonexperimental: “no experiment” design. 2 broad categories: -Descriptive: aims to describe situations, experiences, and phenomena as they exist -Experimental: experimental manipulation of a variable. Must have randomization and a control group to test the effects of an intervention. -Qualitative: observations and interview techniques are used to explore phenomena through detailed descriptions of people, events, situations, or observed behavior Cultural Competence -Culturally and Linguistically Appropriate Services (CLAS): the aim is to eliminate racial and ethnic health disparities and to improve the health of all Americans.