Advanced Practice Nurse Leader

RUBRIC:

 

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Application of course knowledge

20 ptsExceptional

The initial post thoughtfully considers and responds to the discussion questions using well documented, sound logic, and is clearly and succinctly written. The post fosters ongoing dialog in a professional and scholarly manner.

 

Scholarly Synthesis and Referencing

20 pts

Exceptional

Initial post is supported by evidence from scholarly sources. The initial post is approximately 200-300 words in length and includes relevant citations from the course readings and/or professional literature. In-text citations and full references are utilized.

 

 

Clarity, Relevance and Organization

20 pts

Exceptional

All discussion posts are relevant to the topic and are presented logically and clearly. This includes initial posts and posts to peers. Direct course applications and synthesis of scholarly information is easily discernable.

 

 

 

Scenario

Put yourself in the role of an advanced practice nurse leader working in an urban emergency department (ED) in your state. You just received a report of a patient death. The patient was recently discharged to home from the ED after being diagnosed with a complicated urinary tract infection. The patient died two days later in presumed septic shock. As the advanced practice nurse leader, you examine the case and find that multiple issues contributed to this event.

· The patient presented during peak hours in the ED. The ED is currently under pressure from administration to keep wait times down. Patient discharge is sometimes hurried to allow for additional patients to be seen.

· Two nurses and a nurse practitioner called in sick during the shift, which likely contributed to staffing issues that day.

· A serum lactic acid level was drawn, but the results did not return until after the patient was discharged home. The elevated level was likely never seen by a nurse or medical provider.

· The patient was discharged with a 10-day course of ciprofloxacin and advised to follow up with their primary care provider (PCP) in 2 days. The patient was uninsured and did not follow up with their PCP as recommended.

Discussion Questions

1. Analyze the complex practice, organizational, and system issues presented in this scenario. Include at least 2 examples of each in your response.

2. Based on your findings from question one, consider the resources available in urban areas at the state and national level. Also consider the disparities in care that the the uninsured can experience. Using this information and other scholarly resources, formulate potential solutions. Discuss two solutions that would address the factor(s) that contributed to the patient death. Address cost, feasibility, policy and other resources, including staffing. Include rationale for your solutions.

3. Select one of the solutions from question two. Identify one policy change needed to implement your solution. What quality improvement measure(s) would need to be evaluated in order to demonstrate an improvement in patient safety and care?

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