In this assignment I need a peer response for the main discussion, that show below.

The peer’s responses

Discussion Grading Criteria: Agreeing and disagreeing do not mean just voicing one’s opinion. The focus of the discussions should remain on the ideas posed in the readings. Agreeing and disagreeing mean making scholarly arguments from the literature that may support your own ideas. Faculty expects you to support your ideas from the readings or similar scholarly writing about the topic in nursing literature. Always cite your source(s) and reference in APA format.

Remember the post and responses should include scholarly writing about the topic in nursing literature.

Note por the professor:

Hello class,

Please refer to your APA format in your postings. The journal name and volume is italicized font. Ex.

…The American Nursing Journal,7(9),,,,

Please update your APA to reflect doi 

Thalia T. Ayra

Advanced Nursing Practice

From above identify three challenges the Advanced Nurse Practitioner  encounter in their Scope of practice (SOP), include them on this week first peer response due.

Scope of practice (SOP) is a cornerstone for professional regulation used by nurse practitioner (NP) licensing boards across the country, usually a state’s Board of Nursing (BON). This concept defines the procedures, actions, and processes that NPs can perform as part of their professional licensure. Regulations are handled by each state and can vary from state to state.

By definition, the SOP for family NPs (FNPs) is broad, with FNPs caring for a wide spectrum of patients (from pediatrics to geriatrics) and domains (private practices to hospital clinics and other outpatient settings, both urban and rural). In some rural or remote settings, FNPs may be the only health care provider available to patients.

The SOP for FNPs could include providing mental health care services, and FNPs in primary care settings often are the first to see patients with common mental illnesses, such as depression and anxiety. In fact, FNPs are increasingly providing mental health care as demand from patients has increased. According to the National Institute of Mental Health, nearly 1 in 5 adults in the United States suffers from a mental illness (44.7 million in 2016). Among adolescents, an estimated 49.5% of young people aged 13 to 18 have had a mental disorder.

Among mental illnesses, major depression is common, with approximately 16.2 million adults (6.7% of all US adults) having had at least 1 major depressive episode. Anxiety disorders also greatly affect US adults, with more than 31% having had an anxiety disorder sometime in their lives. Furthermore, this increase in patient demand has been exacerbated in recent years by a growing shortage of mental health care practitioners, including psychiatrists, whose numbers declined by 10% from 2003 to 2013.7

Although a legal or regulatory concept, the importance of SOP cannot be overstated. FNPs need to be familiar with their state’s SOP to ensure patient safety as well as to protect their professional license, because acting outside of their recognized SOP in any patient care setting could expose them to civil liability and disciplinary actions brought by their BON, with the potential of having their professional licenses revoked.8 This is especially true when treating patients with mental illness or working with behavioral health issues, where an FNP may be trained and have the skills to diagnosis and initially treat mental illness but may be restricted by his or her SOP on the breadth and depth of care permitted.

With that in mind, this article will outline several important SOP issues for FNPs working with patients with mental health issues and provide recommendations to help them ensure best practices and patient safety. The recommendations also will help them avoid blurring the boundaries delineated by their SOPs and protect their professional licenses.

References

American Association of Nurse Practitioners. Scope of Practice. https://www.aanp.org/images/documents/publications/scopeofpractice.pdf. Updated 2015. Accessed August 15, 2018.

Nurse Journal. Role & Scope of Practice of a Family Nurse Practitioner. https://nursejournal.org/family-practice/role-scope-of-practice-of-a-family-nurse-practitioner/

Date accessed: August 15, 2018

Comment 1

Concerning the different methods argued in the “Visual Learner: Statistics,” it is important to abide on the statistical hypothesis. There are two chief types of analysis. They are null hypothesis in which samples apparent result as a result of chance and alternative hypothesis where sample observation is predisposed mainly by non-random causes. There are a total of five sampling techniques that have been discussed with systematic sampling, simple random sampling, cluster sampling, convenience sampling and stratified sampling. Systematic sampling is a type of probability sampling method where the sample members coming from the larger inhabitants are designated based on a preparatory point random as well as a fixed periodic interval. 

An example includes when a researcher wants to create a systematic sample in a university of about 90,000 enrolled students, they should consider every 100th student. A simple random sample denotes a set of data where every person has an equivalent probability of being chosen. An example includes selecting 50 members from a set of 400 employees to represent a company in an individual event. Cluster sampling is a sampling method where the population is divided into groups referred to as clusters.

An example would include getting the level of educational performance of high schools in the entire nation. A convenience sample can be categorized among the non-probability sampling methods. It is made up of people who can be reached speedily like business operators in a center and family members. An example includes an interview by a pollster to a purchaser who functions at a local mall. Finally, Stratified sampling refers to a method of sampling where the population effects to be distributed into minor groups that are called strata. The layers are therefore, formed basing the arguments on the shared characteristics and attributes of the members.

Comment 2

The visual learner statistics page includes five different samplings which include cluster sampling, simple random sampling, systematic sampling, convenience sampling, and stratified sampling.

Cluster sampling is dividing the population into sections. The cluster sampling is chosen randomly and it includes all the individuals of that particular cluster that was chosen. An
example where cluster sampling could be used is at area high schools. Many towns have several high schools within a descent range where it could be easy to pick a grade and randomly select a high school.

Simple random sampling allows every member of the study population to have an equal opportunity to be chosen as a study subject. Random sampling is known to eliminate bias by giving the population an equal chance to be chosen. An example where simple random sampling could be at a hospital and involve all register nurses.

Systematic sampling is choosing a larger population and selecting the individuals at a random starting point and a fixed periodic interval, for example picking the every fifth person (Business Dictionary, 2018).  Systematic sampling could be used in a large city of businesses and every fourth street in the district could be selected.

Convenience sampling is just that the convenience of selecting the individuals. Convenience sampling be simply your closet friends or coworkers.

Stratified sampling is choosing a general population that share the same qualities and features and separated them into different groups. An example of using stratified sampling is choosing a group of men and a group of women and dividing them into different groups.

Write a 1- 2 page essay addressing the discussion questions posed for the one you selected.  Be sure to clearly identify the news clipping you selected.

Adhere to APA formatting and cite all sources. Review the rubric for further information on how your assignment will be graded.

Find Out More: You may use these and other outside sources to frame your discussion.

• The Pain of Wrong Site Surgery
• Judgment Upheld in Arkansas Brain Surgery Lawsuit
• National Quality Forum

Assignment Discussion Questions

1. Discuss the issues of integrity in this case.

2. Should criminal charges be considered in this case, if accurately reported? Discuss your answer. 

3. Why did you choose to respond to this story?

4. How is integrity displayed in your clinical setting?

Video transcript

 #1 Wrong Operation Doctor (ethics and integrity) Hospitals find it hard to protect patients from wrong-site surgery. Last year a jury returned a $20 million negligence verdict against Arkansas Children’s Hospital for surgery performed on the wrong side of the brain of a 15-year-old boy who was left psychotic and severely brain damaged. Testimony showed that the error was not disclosed to his parents for more than a year. The hospital issued a statement saying it deeply regretted the error and had “redoubled our efforts to prevent” a recurrence. So, what happened? “Health care has far too little accountability for results … . All the pressures are on the side of production; that’s how you get paid,” said Peter Pronovost, a prominent safety expert and medical director of the Johns Hopkins Center for Innovation in Quality Patient Care. He added that increased pressure to quickly turn over operating rooms has trumped patient safety, increasing the chance of error. Kenneth W. Kizer, who coined the term “never event” nearly a decade ago when he headed the National Quality Forum, a leading patient safety organization, said he believes reducing the number of errors will require tougher reporting rules and increased transparency.  

 For the middle-aged adult, exercise can reduce the risk of various health problems. Choose two at-risk health issues that regular physical exercise and activity can help prevent and manage. Discuss the prevalence of each of these health problems in society today. Describe measures that you would take as a nurse to assist clients with health promotion measures to incorporate exercise and physical activity into their lives. Include the kind of activities you would recommend, the amount of exercise, and the approach you would use to gain cooperation from the client. Support your response with evidence-based literature