W7- : Discussion: Safe Prescribing

In 1915, the Drug Enforcement Administration was formed, known then as the Bureau of Internal Revenue. Recognizing the variance in state laws and the process for completing applications for prescriptive authority and DEA registration is essential to the role of the NP as a prescriber. Within the last decade, safe prescribing of opioids has also become a national concern. For this 

Discussion, you will: 

1. focus on the process for obtaining prescriptive authority after successfully completing your program of study and passing a National Certification Exam. 2. 

2. You also will explore safe prescribing.

To prepare:

· 3. Review your (TEXAS) state’s process for obtaining prescriptive authority and associated fees

· 4. Review the DEA website and review the process for obtaining a DEA number and associated fees.

· 5. Review and select the following case studies and 6. analyze the provider information:

o  

o Case Study One: Lori, FNP-BC, is a new graduate and has recently passed her certification exam. She has just been hired to work for a Primary Care Clinic in a small town. She will be working with one physician at one site.

Post a

1.  brief summary of your case study and

2.  an explanation of the appropriate prescriptive authority and 

3. DEA registration process needed for the above case study you selected. 

4. Then, explain the safe prescribing practices that these providers should use for these settings.

WRITE 1 PAGE

NP PLAGIRIS

USE provided references

Due tomorrow 1.07.2018

References/ 

Required Readings

Buppert, C. (2018). Nurse practitioner’s business  practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones  Learning.
Chapter 5, “Prescribing” (pp. 203-207)This chapter covers prescribing as an advanced practice nurse.

U.S. Department of Justice (n.d.). Drug Enforcement Administration: Office of Diversion Control. Retrieved from http://https://www.dea.gov/ops/diversion.shtml
This resource guides you on a federal level to enforce safe prescribing of controlled drugs.

Required Media

Fisher, A. S. (2015, June 5). Medical Records: What Must Be Included from a Legal Standpoint? [Video file]. Retrieved from https://www.youtube.com/watch?v=euhoL62YsSk

Note: The approximate length of this media piece is 7 minutes.

Optional Resources

Hagan, P. C., & Ransdell, M. (2015). “Do not fill until”…… Not a legal solution! KBN Connection, Spring(43), 8-10. Retrieved from http://kbn.ky.gov/online-forms/Documents/Spr15_0116.pdf

Discussion Board:  Minimum 250 words, APA Style, Time New Roman, Font 12, 

(3 references- in text citations) not older than (2012-2017). No Plagiarism please.

Discussion Topic 1: Policy Implications of Patient Safety Standards and Practices

Read the case study number one, Moving to a Common Core Interprofessional Patient Safety Curriculum on page 254 in Health Policy and Politics: A Nurse’s Guide, by Milstead. Why is it important that health professionals share a common understanding of patient safety standards and practices? What are the policy implications from accepting that “mistakes are normal and all human err”? How would you approach health care systems leaders or employers about changing employment policies related to punitive actions when errors occur?

Case Study 1

You see a 1-week-old Asian infant for a weight check. The infant is back to his birth weight and is breastfeeding for 10 minutes every 2 hours with one 3-hour stretch a day. He is alert, has bowel movements with each feeding, and wets 8–10 diapers a day. His blood type is A+ and his mother’s blood type is A+. Coombs’ testing at birth was negative. You note slight scleral and skin jaundice.

Case Study 2

Jimmy is a 3-year-old “picky” eater according to his mother. He refuses to eat anything but waffles for breakfast and macaroni and cheese or chicken nuggets for lunch and dinner. He will eat apples and bananas but refuses all vegetables except corn. After a normal physical examination, you obtained blood testing that revealed the hemoglobin is 11.4 mg/dl and his hematocrit is 30% (both obtained by venipuncture). The CBC revealed microcytic hypochromic RBCs.

Case Study 3

Melissa is a 13-year-old who presents to your office for a well-child check. Physical examination reveals a thin child who is short of stature. Breast Tanner stage is II and pubic hair development is Tanner I. Neurologic, skin, heart, lung, abdominal, and HEENT examinations are normal.

To prepare:

• Review “Endocrine and Metabolic Disorders” and “Hematologic Disorders” in the Burns et al. text.
• Review and select one of the three provided case studies. Analyze the patient information.
• Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
• Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
• Consider strategies for educating patients and families on the treatment and management of the hematologic or metabolic disorder.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the hematologic or metabolic disorder.

Read a selection of your colleagues’ responses.

Alma Faulkenberger is an 85-year-old female outpatient sitting in the waiting room awaiting an invasive pelvic procedure. The health care professional who will assist in her procedure enters the room and calls “Alma.” There is no reply so the professional retreats to the work area. Fifteen minutes later the professional returns and calls “Alma Frankenberg.” Still no reply, so he leaves again. Another 15 minutes pass and the professional approaches Alma and shouts in her ear, “Are you Alma Frankenberg?” She replies, “No I am not, and I am not deaf either, and when you get my name correct I will answer you.”

Using the topic 1 materials, develop a plan to help Alma be compliant with the procedure and post-treatment medication. Also, describe the approach you would take to patient education in this case.

 Week 8 Discussion

The posts/references must be in APA format. 

Please review the clinical case study below and answer the questions that follow:

 Clinical Case Scenario

An 11-month-old girl, well-known to your clinic since birth, arrives for a well-child visit. The parents report that their baby drags her legs rather than crawling on both hands and legs. They are concerned that this is abnormal. The father says that the child only recently began crawling and she does not pull to a stand. You noted at her 6-month visit that she was not rolling over or sitting; previous visits were unremarkable as was the mother’s pregnancy and vaginal delivery. While examining the baby, you note that when she is held by the axillae her legs are extended and crossed (i.e. the “scissoring” posture).

1: What is the most likely diagnosis? Why?

2: What would be three differentials in this case? Why?

3: What developmental milestones are expected at this age?

4: What do you believe is your best course of action/treatment plan for this appointment? Why?