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NUR 658 Topic 1
DQ 1
You have graduated from the ACNPC-
AG program
and have been offered
a position with a pain management physician. The
expectation is that you will assist with rounds at City Hospice as well as
Downtown Hospital. Discuss the actions and associated steps that you must
complete prior to you first day of work.
NUR 658 TOPIC 1 DQ 2
Topic
1 DQ 2 5.0 As part of your commitment to
provide quality care to individuals
experiencing pain, you are obligated to understand the rationale for special
licensure procedures in order to obtain a Drug Enforcement Administration (DEA)
number. Discuss the measures you must take on the state and national levels
regarding these procedures prior to implementation of this privilege.
NUR 658 TOPIC 2
DQ 1
Discuss the implications
of the expanded scope of practice for the nurse practitioner compared to that
of the registered nurse.
NUR 658 Topic 2
DQ 2
You have accepted a
position as the ACNPC-AG with a group of three cardiologists, and your role
will include hospital rounds as well as afternoon clinic for office visits
during in office cardiac stress-testing hours. You may be the only provider
available in the office at times. Your employer will provide a $1,000,000.00
limit claims-made malpractice policy as part of your contract. Discuss the pros
and cons of a claims-made policy. What other options are available?
NUR 658 Topic 3
DQ 1
As the ACNPC-AG for the
hospitalist service at Downtown Hospital, you carefully craft each admission
note to maintain compliance with documentation requirements. Discuss
documentation as it relates to reimbursement.
NUR 658 Topic 3
DQ 2
As you work on your
curriculum vitae (CV), discuss options for professional formatting,
recommendations for inclusion and exclusion of specific information, and the rationale
for these suggestions.
NUR 658 Topic 4
DQ 1
You will be rounding with
the neurosurgeon after lunch and see five patients in the neuro step-down unit
in the morning to prepare for the surgeon's rounds when he finishes surgery
after noon. Once a.m. surgery is complete, you make rounds together and the
patient's billing is submitted to the billing office as a "shared
visit," as previously instructed by the practice manager regarding billing
practices. Discuss the requirements for this form of billing. Is the practice
manager correct?
NUR 658 Topic 4
DQ 2
Dr. Stat is at the annual
2-week society meeting in New York, and this is the first time in 4 years that
he has gone. He is a famous workaholic and does not even take vacations. You
are proud of the fact that he trusts you enough to leave his patients in your
capable hands. To maximize reimbursement, billing has always been handled as
"incident to." Discuss your plans regarding billing during his
absence.
NUR 658 Topic 5
DQ 1
Discuss the potential causes
of medication errors during patient transfers and ways the process of
medication reconciliation should alleviate this problem.
NUR 658 Topic 5
DQ 2
Discuss reasons that the
medication history may be inaccurate and/or incomplete and the implications of
these situations.
NUR 658 Topic 6
DQ 1
The prospective payment
system (PPS) provides reimbursement based upon the patient diagnosis. When
there are complications during the patient's stay that are considered
preventable, hospitals are no longer reimbursed for increased length of stay or
therapies required to treat those complications because these complications can
be prevented. Discuss examples of these preventable complications for
hospitalized patients and specific ACNP-AG initiatives that could improve
patient outcomes and avoid increased length of stay (LOS).
NUR 658 Topic 6
DQ 2
Discuss ways that the
documentation of diagnosis, differential diagnoses, and documentation of
co-morbidities affect reimbursement. What are possible implications of inaccurate
documentation for the patient, the health care staff, and reimbursement?
NUR 658 Topic 7
DQ 1
You are paged to the ED
to admit an elderly female with suspected sepsis. She was brought to the ED at
the instruction of the charge nurse at the long-term care facility where she
resides. On presentation she has altered level of consciousness, is
disoriented, and has a temperature of 101.0. You suspect urosepsis, but perform
a careful physical exam that reveals several areas of grade-1 skin breakdown
and a grade-2 ulcer on the coccyx. Discuss your documentation and orders for
this patient, including rationale for your documentation and orders as they
relate to reimbursement.
NUR 658 Topic 7
DQ 2
Discuss coding for
inpatient billing in the context of the post-op consultation.
NUR 658 Topic 8DQ 1
Consider the value of a
comprehensive electronic medical record (EMR). How could the EMR be of value on
a facility versus a state or national level? What kinds of barriers to
widespread use of an EMR are present today?
NUR 658 Topic 8
DQ 2
Discuss local resources
available to the ACNP-AG for developing professional collegial relationships.
What are the benefits of these resources? What local or regional concerns
related to AG-ACNP practice could be addressed by a local or regional ACNP-AG
initiative?
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