Advanced Practice Nursing: Scope of Practice, Ethical Dilemmas, and Quality Care

  Advanced Practice Nursing: Scope of Practice, Ethical Dilemmas, and Quality Care 1. Scope of Practice for Advanced Practice Nurses State Chosen: California In California, Advanced Practice Nurses (APNs) have a broad scope of practice that includes independent practice authority to assess, diagnose, interpret diagnostic tests, prescribe medications, and initiate treatments. APNs in California can work autonomously or collaboratively with other healthcare providers to deliver comprehensive care to patients. Comparison to Florida In Florida, APNs also have prescriptive authority and can provide a range of healthcare services independently. However, Florida requires APNs to have a written protocol with a supervising physician for the prescribing of controlled substances, which is not a requirement in California. Overall, both states empower APNs to deliver advanced healthcare services, but California offers more autonomy in certain practice aspects. 2. Ethical Dilemma in Practice SituationIn my practice as a Nurse Practitioner, I encountered a situation where a patient requested that I withhold certain medical information from their family members. This posed an ethical dilemma as I had to balance patient confidentiality with the principles of beneficence and non-maleficence. Resolution: After discussing the situation with the patient and explaining the potential consequences of withholding information from their family, we reached a compromise. The patient agreed to allow me to share limited information with their family regarding the treatment plan while still respecting their privacy. This resolution upheld the patient's autonomy while ensuring that their well-being was prioritized. 3. Measuring and Monitoring Quality of Care by APNs Measurement: 1. Patient Outcomes: Assessing patient outcomes such as symptom improvement, adherence to treatment plans, and overall satisfaction with care can provide insights into the effectiveness of care delivered by an APN. 2. Clinical Indicators: Monitoring clinical indicators like blood pressure control, vaccination rates, and screening compliance can help gauge the quality of preventive care provided by an APN. 3. Peer Review: Engaging in peer review processes where colleagues evaluate the quality of care provided by an APN through case reviews and feedback can enhance clinical practice. Monitoring: 1. Documentation Review: Regularly reviewing patient records to ensure accurate documentation of assessments, interventions, and outcomes is essential for monitoring the quality of care. 2. Quality Improvement Projects: Participating in quality improvement initiatives within healthcare settings helps identify areas for enhancement and ensures continuous monitoring of care quality. 3. Patient Feedback: Seeking feedback from patients through surveys or interviews can provide valuable insights into their experiences and perceptions of the care delivered by an APN. By implementing these measurement and monitoring strategies, Advanced Practice Nurses can uphold high standards of care delivery, evaluate outcomes effectively, and continuously strive for quality improvement in their practice.  

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