NUR 658 Discussion Answers Week 1 – 8
NUR 658 Week 1 DQ 1:
You have graduated from the ACNPC- AG program and have ….. 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 Week 1 DQ 2:
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 Week 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 Week 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 …. 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 Week 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 Week 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 Week 4 DQ 1:
You will …. 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 Week 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 ….. handled as “incident to.” Discuss your plans regarding billing during his absence.
NUR 658 Week 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 Week 5 DQ 2:
Discuss reasons that the medication history may …. inaccurate and/or incomplete and the implications of these situations.
NUR 658 Week 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 …. 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 Week 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 Week 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 Week 7 DQ 2:
Discuss coding for inpatient billing in the context of the post-op consultation.
NUR 658 Week 8 DQ 1:
Consider the value of a comprehensive electronic medical record (EMR). How could the EMR …. 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 Week 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 … addressed by a local or regional ACNP-AG initiative?