Nurse Practitioners as Primary Care Providers: Transforming the Legislative and Regulatory Practice Landscape to Improve Access to Health Care using Evidence-Based Research
1. The learner will be provided a selection of barriers that impede implementation of health care policy that supports access of nurse practitioners as primary care providers, 2. The learner will be exposed to a strategic framework using a dissemination model that may be individualized to support the need for legislative and regulatory changes, 3. The learner will be able to discuss the role of evidence-based research to create change in health care policy.
State statutes and regulations that grant nurse practitioners (NPs) the right to practice through licensure, do not necessarily sanction their autonomy to perform as practitioners (Cooper, Henderson, & Dietrich, 1998). Securing the authority of NPs to practice autonomously require legislative actions to change laws and regulations to existing Nurse Practice Acts (NPAs) that would grant NPs to perform in this capacity. Rising health care costs and access issues have provided NPs with new opportunities to meet the changing health care needs of society and to affirm the professional identity and role of the advanced practice registered nurse (APRN) within the health care system (Pruitt, Wetsel, Smith, & Spitler, 2002). State statutes and regulations influence the practices of NPs and are powerful determinants of authority that can shape their future clinical practice roles and advance their professional autonomy (Cooper et al, 1998). This presentation examines a case example from the State of California that will illustrate how the use of a legislative strategy to advance the clinical and professional autonomy of advanced practice nurses can be successful in changing scope of practice (SOP).
Manual for the Spread of Evidence Based Practice: Pilot Proposal
Objectives: After the presentation, the participants will be able to: 1. Identify the DNP role in practice research, 2. Name the important components/resources necessary in the creation of an EBP and research program, 3. Explain how the shared governance concept can be applied in creating the spread of EBP within an organization.
As the DNP role in healthcare organizations still unfold, there is an opportunity for the practice doctorates to take on the role of a practice leader who is knowledgeable in the application of research as well as the ethical, conceptual and methodological aspects of translational science and evaluation of its impact on healthcare (Magyari, et al 2006). This presentation focuses on the DNP role in the creation of an EBP and research program in a healthcare organization. It will discuss the necessary components of an EBP and research program and how utilizing Shared Governance department leaders as EBP champions is a cost effective strategy in addressing performance improvement and standards compliance issues.
Speaker B – 1
Shawn Collins, DNP, CRNA
Evidenced-Based Practice and Standards of Care: Which Way Should I Go?
Objectives: 1. Differentiate between standards of practice and evidenced-based practice and how they affect outcomes, 2. Discuss legal implications of using evidenced-based practice over standards of practice, 3. Analyze best-practice models for use in day-to-day practice.
Evidence-based practice is the buzzword in healthcare. While all health care providers want to deliver the most up to date care in order to achieve the best possible outcomes, evidence-based practice, and thus clinical practice guidelines, are not without pitfalls. This presentation explores Standards of Practice, Evidence-based Practice, their legal implications for practitioners, and how to make an informed decision in choosing what works best for your practice.
Speaker B – 2
Theresa Sander, MSN, FNP-C, DNP Student
Barriers to Nurse Practitioner Practice in North Central PA
Objectives: 1. Identify Barriers to Nurse Practitioner Practice in Rural areas, 2. Describe how these barriers impact Nurse Practitioner Practice and quality of health care, 3. Identify how Nurse practitioners can eliminate some of these barriers.
This presentation is the result of research comparing barriers to Nurse Practitioner practice in a 2001 study by Lindeke, Bly, and Wilcox and the present 2008 study. The purpose of the research is to identify barriers to Nurse Practitioner practice in rural areas in order to increase access to underserved populations. It is a mixed method descriptive study that includes eight demographic questions, a twenty eight question checklist, one open ended question, and one ranking question. A total of 101 completed surveys were returned identifying the most frequent barriers identified in the current, 2008 study. These barriers are: lack of public knowledge of NP practice, lack of understanding of advanced practice roles, inadequate salaries compared to other nursing positions, resistance from physicians and psychologists, and inadequate physical space and facilities. Many of the same barriers that were identified in 2001 have remained substantive barriers in 2008.
Speaker C – 1
Deborah Schofield, DNP, CRNP
Blunt Cervical Vascular Injuries: A Systems Analysis at a Level One Urban Trauma Center
Objectives: 1. State two recommendations from Institute of Medicine (IOM, 2004) on bridging the gaps in healthcare quality and access across populations, 2. Identify two barriers to changing practice in complex systems such as hospitals, 3. Identify two stakeholder groups to consider when designing systems change, 4. State two potential mechanisms causing blunt cervical vessel injuries, 5. State two major adverse outcomes of untreated or unrecognized blunt cervical vessel injuries.Doctoral prepared Nurse Practitioners employed in hospital settings are well equipped to both identify gaps in patient care and devise creative solutions, which integrate existing patient limitations. These solutions, however, must include the collaboration of stakeholders such as specialty physician groups and existing resources in order to keep costs at a minimum and to ensure success.This presentation outlines for the audience the application of an empiric approach using “Innovation of Diffusion Theory” by Everett Rogers (2003) to address an existing gap in the follow-up care of a patient population at a large, urban, level 1, tertiary care hospital. Participants will be guided through the five stages of the Innovation-Diffusion process used by the presenter to address an actual problem-based patient population scenario.
Speaker C – 2
Danielle Sebbens, MSN, CRNP
Evidence-Based Education: The Use of a Digital Video Disk to Educate Parents on the Care of a Central Venous Catheter -a DNP Capstone Project
Objectives: 1. To outline risk factors for development of a catheter-related blood stream infection, 2. To describe the process of developing an educational tool designed to provide information to patients and families, 3. To acknowledge the importance of using evidence when creating tools for parent education of pediatric line infections.
This presentation will describe the creation and validation of a DVD teaching module that will be used for educating families in the care of central venous catheters in the home. This project was undertaken to satisfy requirements of a DNP capstone project. Evaluation of content validity of the teaching tool using expert reviewers will be discussed with implications for use in clinical practice.
Speaker D – 1
Stephanie Ahmed, DNP, FNP-BC
Creating Value for the Role of the Nurse Practitioner in the Academic Medical Center: A Business Analysis
Objectives: 1. Provide an Example of the Application of Advanced Organizational and Systems Leadership Skills for Quality Improvement – the Foundation for the Administrative DNP, 2. Outline the Business Planning Practicum – A Systematic Method Utilized to Evaluate the Role of the Nurse Practitioner in the Academic Medical Center, 3. Identify Methods to Create Value for the Role of the Nurse Practitioner in the Academic Medical Center – Organizational Structure, Practice and Revenue Generation.
The American Association of Colleges of Nursing goals for transformational change in APRN education include either roles that are clinical or those that specialize in practice at the organizational, systems or aggregate levels. This presentation outlines a process utilized by an administrative DNP student seeking to create value for the role of the Nurse Practitioner (NP) in the Academic Medical Center (AMC). The business-planning practicum was conducted at a major AMC located in the Northeast region of the United States during the winter of 2008. In the fall of 2006, APRNs were participatory in Massachusetts Nurses Association (MNA) picket. In tandem, the Accreditation Council for Graduate Medical Education (ACGME) mandate seeking voluntary compliance to reduce resident work hours was enforced and NPs began to assume duties and expand roles in areas typically under resident or physician domain within the acute care setting. AMCs have typically relied heavily upon the resident workforce; however an article by Mitchell, Ashley, Zinner, and Moore (2007) identified hospital administrators were challenged by reduced resident work hours and exploring alternate labor sources, including nurse practitioners. With the implementation of universal healthcare coverage in Massachusetts, a sizable influx of previously uninsured patients migrated into the already-burdened healthcare system. These events provide the context in which the value of the role of the NP in the Academic Medical Center was explored. The business analysis specifically sought to evaluate the following areas: organizational structure, NP regulatory and practice trends, and methods to create value for the NP role within the organization.
Speaker D – 2
Juli Maxworthy, DNP, MBA, RN, CNL, CPHQ
Collaborating in Complex Adaptive Systems: The DNP Improving Care Management Outcomes Objectives: 1. Understand the 2009 National Patient Safety Goals, 2. Describe the Role of the DNP relative to the National Patient Safety Goals, 3. Describe how the DNP can work in a complex adaptive system to keep patient safe from harmThe DNP in the clinical setting is challenged by many unfunded mandates. The Joint Commission’s National Patient Safety Goals (NPSGs) are one set of mandates that have caused great angst amongst some of the greatest nurses. How can the role of the DNP make a difference in the challenge of getting members of the healthcare team on the same train towards decreasing patient harm? This presentation will provide background on the NPSGs and how the DNP can develop the infrastructure to provide optimal outcomes.
Thursday, October 1, 2009
Kathleen M. White, PhD, RN, CNAA, BC
Evidence-Based Practice After the DNP
Dr. White is an Associate Professor and Director for the Doctor of Nursing Practice Program at The Johns Hopkins University School of Nursing. She holds a joint appointment as a Clinical Nurse Specialist at the Johns Hopkins Hospital and as Nurse Research Liaison at Howard County General Hospital. She is a member of a collaborative team between the JHH and JHUSON that developed the Johns Hopkins Nursing Evidence-based Practice Model and Guidelines. This model has been highlighted in several publications, including the Journal of Nursing Administration and the Advisory Board Practice Exemplar series. The research conducted on the model won the 2005 Sigma Theta Tau International Research Utilization award. Dr. White has been an active participant in several quality and safety initiatives and has received numerous practice grants. Kathleen is a member of the Maryland Health Care Commission’s Hospital Performance Evaluation Guide Advisory Committee, is the Chairperson of the ANA Congress on Nursing Practice and Economics, and in 2007 was appointed the Chairperson of the Maryland Patient Safety Center’s Board of Directors.
Speaker E – 1
Ying Mai Kung, FNP-BC, MN, MPH, DNP
The DNP: A Need for Standardized Educational Policy (Reprinted with permission from NP Communications, LLC, The American Journal for Nurse Practitioners, May 2009,13(5), 34-46.)
Objectives: 1. Name one rationale that makes DNPs natural nursing educator candidates, 2. Discuss ramifications of the DNP movement and potential impact on stakeholders, 3.Identify one DNP educational policy that needs standardization across programs.
Participants will appreciate that DNPs are natural nursing educators. Utilizing DNPs as faculty will be one of the solutions to relieve nursing shortage, nursing faculty shortage, and one step towards realizing bachelor as entry to professional nursing practice ideology. Transitioning advanced specialized nursing practice from the master’s level to the doctorate level requires educational policy decisions be made and analyzed. These decisions also need to be standardized across programs and administered consistently to ensure that these programs’ outcomes are consistent with the mission and the ideology of the movement and to ensure that educational quality is upheld and stakeholders’ needs are met. DNPs are pioneers who have been through DNP program curriculum. They have a special appreciation for needs of DNP curricula, needs of health care environments, and needs of stakeholders. DNPs and PhDs, together, will play a pivotal role in shaping the future of the nursing profession.
Speaker E – 2
Elizabeth Rash, PhD, ARNP, FNP-C
Improving Patient Outcomes Through an Understanding of Clinical Decision Biases Objectives: 1. Describe common clinical decision biases that result in medical errors, 2. Use metacognitive strategies to identify personal cognitive dispositions to respond to clinical situations, 3. Reduce potential for clinical decision biases through self-awareness of cognitive dispositions to respondThis presentation will use a case study approach to describe selected common cognitive dispositions (CDRs) to respond, also known as clinical decision biases, their implications and methods to reduce CDRs and improve patient outcomes.
Speaker F – 1
Terri Ades, DNP, FNP-BC, AOCN
Addressing Health Literacy in Educational Materials
Objectives: The aim of this project was to determine the effectiveness of a lower-literacy print educational booklet on women’s beliefs and attitudes about breast cancer screening and motivation to have a mammogram and women’s satisfaction with brochure appeal, comprehension, and utility.
Health literacy is a major health problem in the U.S. with approximately 36% of our adult English-speaking population having basic or below-basic health literacy skills. Low health literacy has major implications for health outcomes and how health professionals use printed educational materials to deliver the importance of preventive health behaviors. This presentation will review study results regarding the effectiveness of a lower-literacy print educational booklet on women’s beliefs and attitudes about breast cancer screening and motivation to have a mammogram and their satisfaction with an easier-reading print educational booklet. Results of this study will guide practice change within a voluntary non-profit health organization and can be used by nursing professionals to initiate change within their practice.
Speaker F – 2
Debra Woda, DNP, CNM
The DNP Role: Creating a Vision for Practice Teaching Tools for Online Learning
Objectives: Explore the development of a visionary role in DNP students, Identify the steps necessary for students to see themselves as visionaries in advocating for their patients population in health care reform, Compare and contrast teaching strategies that assist students in discovering their vision in practice.
To become a doctoral level practitioner that can make the biggest difference in the health of their patient population it is important that the DNP student develop a vision for practice. This development as a visionary leader in clinical practice can assist the student in identifying their place in health care reform and the role evidence based practice can make in their patients’ health care outcomes. This presentation will discuss the teaching strategies available in an online program to facilitate the development of this type of role using technology possible in an online or hybrid course(s).
Speaker G – 1
Marilyn Wise, DNP, MSN, FNP-BC
What Happened to Care in the Word Healthcare, and How Can We Pull it Back?
Objectives: 1. Identify specific provider behaviors that enhance or detract from the patient experience, 2. Describe why an understanding of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) is relevant to practitioners, 3. Apply evidence-based interventions in their own practice setting to enhance the pt. experience.
From her perspective as a nurse, nurse practitioner, and wife of an acutely ill spouse, Dr. Wise will discuss patient care and satisfaction. The goals of physicians, nurses, nurse practitioners, hospital administrators, payers, politicians, and patients have become increasingly disparate with the progression of time. Examples of these disparities will be shared, followed by methods for creating harmony in the goals of all interested groups. At this pivotal time for healthcare in the United States, nurse practitioners, using the patient care perspectives of humanism and compassion, must be leaders in overhauling a system seems to have forgotten that “healthcare” is a compound word in which “care” is an integral component.
Speaker G – 2
Eileen G. Scarinci, DNP, APN-BC
Spirituality in Women with HIV
Objectives: 1. Describe the spiritual practices and spiritual well-being of HIV positive women, 2. Determine the relationship between spiritual practices, spiritual well-being and CD4 counts in HIV positive women, 3. Determine differences in spiritual practices and spiritual well-being based on CD4 counts of HIV positive women.
This presentation will show the importance of a spiritual assessment of all patients and the statistical significance of spirituality as a benefit in the care of the chronically ill. It also increases health providers awareness of their own spiritual needs.
Speaker H – 1
Jill Cunningham, DNP, APN
Integrating the Publication Process in DNP Course Design
Objectives: 1. Explain the rationale for the DNP course design and teaching strategies, 2. Describe the DNP course and objectives, 3. Explain the course design and module set up (step by step – leading to manuscript completion), 4. Identify student examination of research and literature for evidence based practice recommendations.
This presentation involves the explanation of a method of course design within the DNP curriculum at Samford University. The course addresses issues associated with vulnerable populations and the need for dissemination of scholarly work by DNP’s in this area. The course design offers a step-by-step method that results in student preparation of a manuscript to be submitted for publication.
Speaker H – 2
Ruth McCaffrey, DNP, ARNP, FNP-BC, GNP-BC
Creating a Program to Provide DNP Students with an Understanding of Diversity in Health Care
Objectives: 1. Discuss the need for cultural competence in health care across the US and around the world, 2. List several models of cultural competent care that would be useful in practice, 3. Describe a program that exists where DNP students complete a cultural emersion experience and present their experiences to the class as a whole.
This presentation describes a cultural immersion class and clinical that is part of the DNP program at the Christine E Lynn College of Nursing at Florida Atlantic University. The program was designed to assist DNP student explore the cultural basis for healthcare and to understand the barriers and difficulties faced by providers and patients regarding cultural norms and beliefs. Examples of the different immersion experiences will be provided and a discussion of the benefits of increased cultural competence will be provided.
Think Sepsis Initiative: Implementation of the Iowa Quality Outcomes Model in the Improvement of Emergency Department Sepsis Care
Objectives: 1. Outline the steps included in the Iowa Model of EBP, 2. Identify the importance of screening Emergency Department patients for signs of sepsis, severe sepsis and septic shock, 3. Name the resuscitation bundle components of Early Goal Directed Therapy.
Think Sepsis Initiative is an evidence based practice application of sepsis screening and treatment guidelines in the Emergency Department. The Iowa Model of EBP was used as the framework for the planning, implementation and evaluation of this outcomes improvement project. Results show that the use of an evidence based electronic sepsis screening tool in the Emergency Department made a significant difference in the length of stay, cost of hospitalization and mortality of diagnosed patients.
Speaker I – 2
Jan Zdanuk, FNP-BC, MSN, RN, CNS, CWS, FACCWS, DNP Student
E-Prescribing: The Business Case for DNP Adoption
Objectives: 1. Define e-prescribing initiatives, their stakeholders and benefits, 2. Discuss Medicare provider incentive program for DNP’s, 3. Develop a business case for DNP adoption of e-prescribing and an implementation strategy.
The Institute of Medicine recommended all prescriptions be transmitted electronically by 2010. There are 4.5 billion prescriptions written annually. These result in 1.5 million preventable medication errors and 7,000 deaths annually ( Kohn, Corrigan & Donaldson, 2000). The e-prescribing initiative makes a compelling argument for improving patient safety and quality of care. e-prescribing offers DNP’s a powerful tool for safely and efficiently managing their patient’s prescription refills. The business case for DNP’s to operationalize electronic media to transmit prescriptions will be discussed. Utilizing e-prescribing to save time, enhance DNP office productivity, improve patient safety, and quality of care will be discussed. Resources to guide successful e-prescribing implementation and the incentive program will be described.
Speaker J – 1
Connie Zak, DNP, MBA, APRN-BC
The DNP Prepared Faculty’s Development of Scholarship
Objectives: 1. Understand the importance of the DNP prepared nurse as faculty, 2. Identify how DNP scholarship contributes to the advancement of the nursing profession, 3. Learn to redefine the traditional boundaries of scholarship.
This presentation will address how the DNP prepared faculty contributes to the enrichment of nursing through the scholarship of teaching, practice, integration, and research. The role of the DNP in academia is of utmost importance in educating the next generation of nurses. The DNP prepared faculty mentors students as the clinician, leader and teacher. DNP prepared nurses should demonstrate and verbalize their contribution to academia through their scholarship.
Opening New Career Doors with DNP
Objectives: 1. Explore how a DNP degree can enhance your already strong skill set, 2. Discuss limitations of current DNP practice and identify ways to reduce/eliminate them, 3. Review and discuss the development of one director position for a DNP candidate and how the process took place, 4. Collaborate regarding ways to support and advance DNP initiatives.
The speaker will present strategies and methods to open career doors that would not normally be opened to advanced practice nurses through negotiation, skill set building, and networking. Through examples provided from her own career, Tracy will discuss with the group how this can be readily achieved. Tracy will also discuss potential roadblocks, dead ends, and hurdles that the participants may encounter with helpful solutions to those areas as well. The discussion will incorporate an inter-dialogue between the speaker and audience to brainstorm strategies regarding specific situations that participants may have.
Speaker K – 1
Martha Anderson, DNP, CNS, FNGNA
Innovative DNP-Led Clinic for Mild Memory Concerns Improves Access, Assessment Accuracy, and Targeted Interventions for Older Clients
Objectives: 1. Identify innovative practices for nursing excellence as exemplified in development of a clinic for patients with mild cognitive concerns, 2. Explore strategies to improve the quality of care and maintain independence for community-dwelling older adult with Mild Cognitive Impairment (MCI), based on assessment, identification of needs, and implementation of stratified interventions, 3. Explore brief cognitive assessment strategies for everyday practice and identify referral options.
The emphasis in this presentation is on the development of a clinic to provide formalized cognitive and functional assessment for older adults frustrated with their memory concerns. The process will be shared, focusing on the skills and experience of the gerontological DNP – CNS, and the outcomes of improved patient access, assessment, advocacy for individual patients allowing care to be maintained in the community for as long as possible.
Expanding the Role of Pediatric and Family Nurse Practitioners in Mental Health Services
Objectives: 1. Gain awareness of evidence based screening, evaluation, and treatment interventions for common mental health disorders, 2. Understand the ways in which evidenced based screening, evaluation and treatment interventions for common mental health disorders can be delivered within a primary care visit, 3. Review the rationale, process, and outcomes of a DNP capstone intervention project that focused on increasing nurse practitioner knowledge and practice of integrated mental health services within primary care.
This presentation will describe the current state of identification and treatment of common mental health disorders in children and adolescents by primary care providers, as well as the opportunity for an expanded role for nurse practitioner working in primary care. Results of a pilot study which focused on increasing nurse practitioner knowledge and practice regarding the treatment of Attention Deficit Disorder, depression and anxiety disorders within the primary care pediatric population will be presented.
Juli Maxworthy, DNP, MBA, RN, CNL, CPHQ
The National Patient Safety Goals and the DNP: Keeping Patients Safe from Harm
Objectives: 1. Describe the role of the DNP within a Complex Adaptive System (CAS), 2. Describe the continuum of care management, 3. Describe the opportunities for the DNP in improving care management outcomes (LOS, IOI, CMI).
How does the DNP work in the complex adaptive systems that exist in healthcare today to provide exceptional patient care management outcomes? In this competitive environment there is an even more need to have knowledge of the care management continuum. There is opportunity for the DNP to provide the needed expertise to decrease length of stay (LOS), inlier opportunity index (IOI), and increase case mix index (CMI) to ensure appropriate payment. This presentation will discuss the role of the DNP working with multidisciplinary teams to ensure both positive patient outcomes and a positive bottom line!
Speaker M – 1
Julie Lindenberg, DNP, APRN, FNP-BC, DCC
Nurse-led Medication Reconciliation and Patient Education Using Electronic Health Record Tools
Objectives: 1. To classify discrepancies between the electronic health record (EHR) and actual drug use by the root cause of the discrepancy in order to guide quality improvement initiatives; a. to quantify and categorize the number and type of medication discrepancies that exist between the medication lists recorded in EHRs and the medication histories obtained from the patient; b. to determine which and how many of the medication discrepancies were system generated vs. patient generated, 2. To implement reliable systems to involve patients in routinely reconciling EHRs with actual medication use. 3. To implement a system of comparison of hospital discharge orders and a comprehensive medication assessment conducted after discharge.
Medication discrepancies in the outpatient setting are common and predominately system generated. Reliable systems to involve patients in routinely reconciling electronic medical records with actual medication use is warranted. The DNP prepared clinician has the leadership and informatics skill sets to be integral in implementing this system level quality improvement initiative.
Speaker M – 2
KT Waxman, DNP, MBA, RN, CNL
Development of the California Simulation Alliance
Objectives: 1. Describe the role of the DNP in providing leadership to the California Simulation Alliance, 2. Describe the purpose of the California Simulation Alliance, 3. Discuss how the DNP can apply evidence-based practice to a large scale statewide project.
This session will describe the evolution of the California Simulation Alliance (CSA), an academic/service partnership initiative. The CSA is comprised of over 1,000 members with the purpose of becoming a cohesive voice for simulation in nursing education in the state; to disseminate information to stakeholders, to create a common language for simulation, and to share best practice including scenarios. The CSA is being led by a DNP at the California Institute for Nursing & Health Care.
Speaker N – 1
Pamela Herendeen, DNP, RN, PNP-BC
Feasibility of Group Well Baby Visits in a Vulnerable Population Objectives: 1. The learner will recognize the current problems and barriers in the delivery of well childcare, 2. The learner will define the process of group well baby visit implementation, 3. The learner will discuss the results of the pilot group well baby visit model and the feasibility of implementation in diverse populations.
This presentation will review the challenges of the current well child care system and describe the feasibility and effectiveness of a pilot clinical program in which health care providers utilize a group format for delivering well child care to vulnerable infants of young mothers.
This program offers an opportunity to explore alternative mechanisms of care delivery for mother/baby well child visits with the purpose of providing enhanced parent education to ultimately improve parenting skills. The group model in pediatrics can provide the advantage of billable visits that increase available time for parent education.
Speaker N – 2
Sara Majors, DNP, MSN, PNP, MPH
Improving Access for Foster Children
Objectives: 1. Explain how a DNP faculty project can be turned into a Faculty Practice, 2. Describe the seriousness of increasing numbers of foster children in the US, and the implications on health care. 3. Discuss how to incorporate health care of foster children into your practice, with focus on mental health.
Children in foster care are the most vulnerable group of children in the United States, experiencing poorer health compared with any other group of children in the country. They have higher rates of all health problems than the general population, including acute and chronic illnesses, growth and developmental problems, serious mental health problems, and difficulties accessing health services. The number of children in foster care has increased dramatically in the last ten years, with over one half a million children in foster homes in the United States at this time. The drug culture contributes greatly to abandonment or neglect of children. Alcohol and drug abuse are factors in the placement of more than 75 per cent of the children who are entering care. Many children in foster care have had a high level of exposure to alcohol, tobacco, and illicit drugs in utero, which are known factors impacting brain development. While management of the complex health and developmental needs of these children is challenging, nurses in primary care have the expertise and obligation to serve these vulnerable children. Priorities for clinical practice include care coordination and screening, maintenance of health records, follow-up, and health-targeted advocacy.
Speaker O – 1
Patricia Yoder-Wise, RN, EdD, NEA-BC, ANEF, FAAN
Quality of Care and DNP Graduates
Objectives: 1. Describe how the practice of DNP graduates has changed advanced nursing practice, 2. Defend the need for additional education, 3. Predict the best possible credentialing system for nurses prepared to practice after completing a DNP program.
This interactive session is designed to provide the opportunity for attendees to identify and describe their perceptions of how their practice has changed and how they are perceived differently in the workplace. APRNs is used in the broad sense to include the leadership component of the DNP programs. Attendees will have the opportunity to provide information to a national task force on credentialing.
Speaker O – 2
Diane McGinnis, DNP, APN-FNP
A DNP Approach: Utilizing Informational Technology to Address Barriers of Evidence-Based Practice
Objectives: 1. The learner will become aware of a low-cost strategy to disseminate research that will address identified barriers to EBP and be able to describe elements of the strategy, 2. The learner will associate the quality chasm with lack of advertising, 3. The learner will be able to integrate marketing that addresses barriers to EBP acceptance to promote their own evidence-based research topics.
An innovative strategy to use current technology to promote the results of evidence-based research was developed, as a result of a literature search related to the barriers to evidence-based practice. The strategy was inexpensive, involved multi-disciplinary cooperation, and used existing information technology outlets to further reduce the costs. Specific identified barriers to EBP implementation will be addressed. The “Quality Chasm” will be discussed with a viewpoint of marketing and advertising as a weak point. A portion of the discussion will involve interaction with audience members to identify how the strategy can fit various research topics.
Speaker P – 1
Andrea Efre, ARNP, MS, CCRN, DNP Student
Nurse Practitioners Confidence and Competence in Interpreting Electrocardiograms
Objectives: 1. Identify significant findings on an electrocardiogram that indicate signs of Acute Coronary Syndrome, 2. Discuss the level of confidence of Nurse Practitioners in interpreting an electrocardiogram, 3. Discuss the competence of Nurse Practitioners in interpreting an electrocardiogram and identifying acute changes that present in Acute Coronary Syndrome.
Can Nurse Practitioners (NPs) identify an Acute Myocardial Infarction on a 12-lead ECG? This question provoced my initiation of a quantitative, descriptive correlational study exploring the confidence and competence of NPs in interpreting 12-lead ECGs and identifying acute changes. A questionnaire was developed using visual analog scales to measure confidence and five sample 12-lead ECGs to assess competence. Over 400 surveys were collected at the American Academy of Nurse Practitioners (AANP) 24th National Conference this year. The data was analysed and the results prove to be very interesting. This presentation will provide a brief overview on how to identify Acute Coronary Syndromes on a 12-lead ECG and review the results of the study exploring NP confidence and competence interpreting 12-lead ECGs and identifying acute changes.
Speaker P – 2
Mark Welliver, CRNA, DNP, ARNP
Sugammadex Sodium: A Synthesis of the Evidence Regarding Neuromuscular Blockade Reversal
Objectives: 1. Critically appraise current neuromuscular blockade reversal methodologies in patients receiving muscle relaxant drugs, 2. Analyze current research finding regarding new pharmacology to restore muscle function, 3. Review evidence-based guidelines for synthesizing, scoring, and grading data, 4. Interpret and implement evidence-based recommendations for best clinical practices.
This presentation is the culmination of the author’s DNP Capstone Project synthesizing the evidence regarding neuromuscular block (muscle relaxant) reversal using the clinical trial drug sugammadex sodium, Sugammadex is a modified cyclodextrin that appears to exert minimal side effects while significantly improving the speed and extent of recovery from muscle relaxant drug effects. Current muscle relaxant reversal therapy utilizes cholinesterase inhibitors along with anti-cholinergic drugs which exert multiple side effects. In addition to numerous side effects, the cholinesterase inhibitor/ anti-cholinergic muscle relaxant reversal therapy is limited in its effectiveness. Residual muscle relaxant effects resulting in post operative weakened protective reflexes, hypoventilation, hypoxia, and delayed recovery room discharge all contribute to increased post operative complications. A systematic evidence-based approach has led to the development of clinical guidelines that promotes the incorporation of the new reversal agent sugammadex into clinical practice. Also discussed is the process of developing a DNP Capstone project to completion.
Friday, October 2, 2009
Panel with Webinar
National Organizations Explore the Role of DNPs
American Association of Colleges of Nursing (AACN) Dr. Polly Bednash, Chief Executive Officer American Academy of Nurse Practitioners (AANP)
Mr. Tim “TK” Knettler, CEO and
Dr. Jan Towers, Director of Health Policy
American College of Nurse Practitioners (ACNP)
Dr. Susan Apold, Immediate Past President American Nurses Association (ANA)American Organization of Nurse Executives (AONE)
Dr. Carol Watson, Immediate Past PresidentNational Council of State Boards of Nursing (NCSBN)
Dr. Maryann Alexander, Chief Officer, Nursing Regulation National Organization of Nurse Practitioner Faculty (NONPF)
Dr. Mary Anne Dumas, President
Sigma Theta Tau International Nursing Honor Society (STTI)
Dr. Gwen Sherwood
Stephanie W. Ahmed DNP, FNP-BC, Sheila Davis, DNP, APRN-BC, FAAN, & Valerie Fuller, DNP, FNP-BC
What are the Values and Challenges of Forming a DNP Professional Organization?
Objectives: 1. Explore DNP Challenges in the Academic, Healthcare and Public Policy Arenas, 2. Outline the Strategy for the Development of a DNP Interest Group, 3. Identification of “Next-Steps” – Developing a Regional Agenda with National Implications The contemporary DNP faces new challenges in academic and healthcare arenas as traditional nursing roles expand and impact existing educational methods, practice and policy.
In an effort to better understand the aforementioned, three graduates from the inaugural DNP class of the MGH Institute of Health Professions partnered with the Institute for Nursing Healthcare Leadership, Inc. (INHL) to establish a DNP interest group and develop a forum for dialogue. Key stakeholders were identified at the organizational level and included New England-based schools of nursing offering a DNP, as well as Academic Medical Centers (AMC’s) in greater-Boston MA. While strategizing to attract DNPs and DNP students, given an enthusiastic response from nursing faculty and nurse scientists, the focus was re-conceptualized to embrace a broader agenda. On May 16, 2009, 27 nurses convened to discussThe DNP: Identifying the Unique Challenges and Opportunities of the Nurse Practice Doctorate, in Burlington, Massachusetts.Participants included DNP, EdD and PhD prepared faculty, DNP students, DNP clinicians and interested nurse practitioners. Discussion centered on AACN goals for transformational change in APRN education with respect to roles that are clinical or specialize in practice at the organizational, systems or aggregate level. As a result of this initiative it was clear that a need existed to establish a forum for DNPs in the Northeast region of the United States with a unified means of networking and advocating for professional issues unique to their educational backgrounds and practice. To meet this need, the New England Organization of Doctors of Nursing Practice (NEODNP) was announced at the 2009 Maine Nurse Practitioner Conference, in Portland ME. While NEODNP is regional, given the complexity of the issues affecting DNP practice, perhaps there is a need to address them in the context of a broader national nursing agenda.
Group Participation: Articulating a National DNP Agenda