FNP NR-506 ANCC-Non-Clinical
ANCC Non-Clinical Information
Level of Evidence Hierarchy: Ms. Reccee:
1. Meta-analysis
2. Systemic review
3. Randomized Controlled Trial (RCT)
4. Experiment
5. Cohort Study
6. Case Reports/Series
7. Expert Opinions/Editorials
Types of Research
• Meta-analysis
• Systemic review
• Randomized Controlled Trial (RCT)
• Experiment (Classic Research)
• Cross-Section
• Longitudinal Design
• Case Study (Report/ series)
• Field study or Naturalistic study
• Survey study
• Cohort research
Statute of Limitations:
• The time limit of when a lawsuit can be filed or action against a nursing licensee for
alleged violation can occur. Most states are 2-3 years.
• A period of limitation for the bringing of certain kinds of legal action.
Standards of Practice
• Authoritative statements of the duties that all registered nurses, regardless of role,
population, or specialty are expected to perform
• It is developed by professional societies (ANA) and specialty organizations (AANP)
Emancipated Minor
• Can sign own legal documents
• Legally married or divorce
• Active duty in the armed forces
• These are people under the age of 18 y/o but do not require an adult for consent.
• Legal court document
HITECH
1
,FNP NR-506 ANCC-Non-Clinical
• Heath Information Technology or Economic and Clinical Health Act
• Promotes adoption and meaningful use of health information technology
• ACT approved in 2009 for the use of electronic health information.
• Protection of PHI enacted in 2009. PHI must be encrypted prior to sending.
• Patients must be informed if their PHI has been disclosed inappropriately even if the
disclosure was accidental.
• Providers will be offered financial incentives for demonstrating meaningful use of EHR
until 2015 then penalties.
• HITECH- signed by President Obama to transition to electronic health records. No more
paper charting. The 2009 Health Information Technology for Economic and Clinical
Health (HITECH) Act was signed into law with the explicit intention of accelerating the
adoption and promoting the “meaningful use (MU)” of electronic health records (EHRs)
by US physicians.
Patient in EOL (end of life) stage ask of hospice:
• The patient is already end stage so beneficence is not correct unless you are educating
about smoking cessation or vaccination. This is to promote good. Utilitarianism is the
greater good for a population of patients. Justice is to be fair. Which leaves us to
autonomy. This is allowing the patient to make his own choice after giving him all the
information to make a good informed decision.
• AFTT (adult failure to thrive). This is a secondary diagnosis for hospice eligibility. So
when you consult hospice for weight loss and not eating with no other major diagnoses,
this is not a good referral. Hospice is no longer able to use this as a primary diagnosis.
Prescriptive Authority
• The majority of states require NPs to have a collaborative agreement with a physician in
order to prescribe.
• All states now allow NPs to prescribe certain controlled drugs, but with limitations
DEA
• Drug Enforcement Administration
• NP must obtain prescriptive authority before getting a DEA number to prescribed
controlled substances.
• Allows advanced practice nurses to obtain registration numbers for prescribing controlled
medication
• Though DEA is federal, prescriptive authority is managed by the state board
Certification
• Generally a "voluntary" process and is done through a nongovernmental entity such as
professional nursing association or specialty organization.
• Many states mandate certification as a condition to obtain licensure
Licensure
2
,FNP NR-506 ANCC-Non-Clinical
• Legal requirement to practice as an NP
• Obtained through a governmental entity, the SBON
• Must meet minimal educational and clinical requirements in order to become licensed
Incidence
• Conveys information about the risk of contracting a disease
• Measure of disease that allows us to determine a person's probability of being diagnosed
with a disease during a given period of time.
• Rate of new cases of the disease
Prevalence
• How widespread the disease is
• Measure of disease that allows us to determine a person's likelihood of having a disease,
number of alive cases with the disease
What are the 4 ethical principles? (and define)
• Beneficence (promoting well-being for pt. and society)
• Nonmaleficence - "above all, do no harm"
• Autonomy (person acts intentionally after being given informed consent)
• Justice (equitable distribution of social benefits)
Beneficence
• To do good. The obligation to help the patient; to remove harm, prevent harm, and
promote good
• Acting in the patient's best interest
• Compassionate patient care
• The core principle in patient advocacy.
• Encourage a patient to stop drinking and enroll in AA program.
• Education on a new prescription about how to take the medication, health promotion,
education, smoking cessation.
Nonmaleficence
• Obligation to do no harm; protecting a patient from harm
• Your patient has asthma. She brown bags her medication on this visit and you notice a
beta-blocker. You educate her that she is not a good candidate for these drugs
• Example: Discussing risks vs. benefits of a treatment; working within SOP (standard
operating procedures).
Utilitarianism
• The outcome of the action is what matters with utilitarianism. It also means to use a
resource for the benefit of most (e.g., tax money). It may resemble justice, but it is not the
same concept
3
, FNP NR-506 ANCC-Non-Clinical
• The Women, Infants, and Children food (WIC) program is only for pregnant women and
children.
• Outcome of the action is what matter with utilitarianism.
• It also means to use a resource for the benefit of most.
• It may resemble justice, but it is not the same concept.
• Example: WIC program is only for pregnant women and children. It is not open to adults
and elderly males. The reason maybe that it would cost society more if women (and their
fetuses), infants, and children are harmed by inadequate food intake (affects the brain
growth).
• Obligation to act in a way that is useful to or benefits the majority
Justice
• The quality of being fair and acting with a lack of bias
• The fair and equitable distribution of societal resources
• Example: Low income individuals do not pay some types of taxes to the government but
still have equal access to the public services supported by taxes.
Informed consent
• Research subjects must be informed that they have the right to withdraw at any time
without consequences or penalty
• All information must be presented on what to expect, risks, benefits, alternatives,
compensation, and confidentiality
• Permission granted in the knowledge of the possible consequences, typically that which
is given by a patient to a doctor for treatment with full knowledge of the possible risks
and benefits.
Durable Power of Attorney
• A legal document that gives someone you choose the power to act in you place.
Advance Directive
• A written statement of a person's wishes regarding medical treatment, often including a
living will, made to ensure those wishes are carried out should be the person be unable to
communicate them to a doctor.
Living Will
• A written statement detailing a person's desire regarding their medical treatment in
circumstances in which they are no longer able to express informed consent, especially an
advance directive.
CPOE
4
ANCC Non-Clinical Information
Level of Evidence Hierarchy: Ms. Reccee:
1. Meta-analysis
2. Systemic review
3. Randomized Controlled Trial (RCT)
4. Experiment
5. Cohort Study
6. Case Reports/Series
7. Expert Opinions/Editorials
Types of Research
• Meta-analysis
• Systemic review
• Randomized Controlled Trial (RCT)
• Experiment (Classic Research)
• Cross-Section
• Longitudinal Design
• Case Study (Report/ series)
• Field study or Naturalistic study
• Survey study
• Cohort research
Statute of Limitations:
• The time limit of when a lawsuit can be filed or action against a nursing licensee for
alleged violation can occur. Most states are 2-3 years.
• A period of limitation for the bringing of certain kinds of legal action.
Standards of Practice
• Authoritative statements of the duties that all registered nurses, regardless of role,
population, or specialty are expected to perform
• It is developed by professional societies (ANA) and specialty organizations (AANP)
Emancipated Minor
• Can sign own legal documents
• Legally married or divorce
• Active duty in the armed forces
• These are people under the age of 18 y/o but do not require an adult for consent.
• Legal court document
HITECH
1
,FNP NR-506 ANCC-Non-Clinical
• Heath Information Technology or Economic and Clinical Health Act
• Promotes adoption and meaningful use of health information technology
• ACT approved in 2009 for the use of electronic health information.
• Protection of PHI enacted in 2009. PHI must be encrypted prior to sending.
• Patients must be informed if their PHI has been disclosed inappropriately even if the
disclosure was accidental.
• Providers will be offered financial incentives for demonstrating meaningful use of EHR
until 2015 then penalties.
• HITECH- signed by President Obama to transition to electronic health records. No more
paper charting. The 2009 Health Information Technology for Economic and Clinical
Health (HITECH) Act was signed into law with the explicit intention of accelerating the
adoption and promoting the “meaningful use (MU)” of electronic health records (EHRs)
by US physicians.
Patient in EOL (end of life) stage ask of hospice:
• The patient is already end stage so beneficence is not correct unless you are educating
about smoking cessation or vaccination. This is to promote good. Utilitarianism is the
greater good for a population of patients. Justice is to be fair. Which leaves us to
autonomy. This is allowing the patient to make his own choice after giving him all the
information to make a good informed decision.
• AFTT (adult failure to thrive). This is a secondary diagnosis for hospice eligibility. So
when you consult hospice for weight loss and not eating with no other major diagnoses,
this is not a good referral. Hospice is no longer able to use this as a primary diagnosis.
Prescriptive Authority
• The majority of states require NPs to have a collaborative agreement with a physician in
order to prescribe.
• All states now allow NPs to prescribe certain controlled drugs, but with limitations
DEA
• Drug Enforcement Administration
• NP must obtain prescriptive authority before getting a DEA number to prescribed
controlled substances.
• Allows advanced practice nurses to obtain registration numbers for prescribing controlled
medication
• Though DEA is federal, prescriptive authority is managed by the state board
Certification
• Generally a "voluntary" process and is done through a nongovernmental entity such as
professional nursing association or specialty organization.
• Many states mandate certification as a condition to obtain licensure
Licensure
2
,FNP NR-506 ANCC-Non-Clinical
• Legal requirement to practice as an NP
• Obtained through a governmental entity, the SBON
• Must meet minimal educational and clinical requirements in order to become licensed
Incidence
• Conveys information about the risk of contracting a disease
• Measure of disease that allows us to determine a person's probability of being diagnosed
with a disease during a given period of time.
• Rate of new cases of the disease
Prevalence
• How widespread the disease is
• Measure of disease that allows us to determine a person's likelihood of having a disease,
number of alive cases with the disease
What are the 4 ethical principles? (and define)
• Beneficence (promoting well-being for pt. and society)
• Nonmaleficence - "above all, do no harm"
• Autonomy (person acts intentionally after being given informed consent)
• Justice (equitable distribution of social benefits)
Beneficence
• To do good. The obligation to help the patient; to remove harm, prevent harm, and
promote good
• Acting in the patient's best interest
• Compassionate patient care
• The core principle in patient advocacy.
• Encourage a patient to stop drinking and enroll in AA program.
• Education on a new prescription about how to take the medication, health promotion,
education, smoking cessation.
Nonmaleficence
• Obligation to do no harm; protecting a patient from harm
• Your patient has asthma. She brown bags her medication on this visit and you notice a
beta-blocker. You educate her that she is not a good candidate for these drugs
• Example: Discussing risks vs. benefits of a treatment; working within SOP (standard
operating procedures).
Utilitarianism
• The outcome of the action is what matters with utilitarianism. It also means to use a
resource for the benefit of most (e.g., tax money). It may resemble justice, but it is not the
same concept
3
, FNP NR-506 ANCC-Non-Clinical
• The Women, Infants, and Children food (WIC) program is only for pregnant women and
children.
• Outcome of the action is what matter with utilitarianism.
• It also means to use a resource for the benefit of most.
• It may resemble justice, but it is not the same concept.
• Example: WIC program is only for pregnant women and children. It is not open to adults
and elderly males. The reason maybe that it would cost society more if women (and their
fetuses), infants, and children are harmed by inadequate food intake (affects the brain
growth).
• Obligation to act in a way that is useful to or benefits the majority
Justice
• The quality of being fair and acting with a lack of bias
• The fair and equitable distribution of societal resources
• Example: Low income individuals do not pay some types of taxes to the government but
still have equal access to the public services supported by taxes.
Informed consent
• Research subjects must be informed that they have the right to withdraw at any time
without consequences or penalty
• All information must be presented on what to expect, risks, benefits, alternatives,
compensation, and confidentiality
• Permission granted in the knowledge of the possible consequences, typically that which
is given by a patient to a doctor for treatment with full knowledge of the possible risks
and benefits.
Durable Power of Attorney
• A legal document that gives someone you choose the power to act in you place.
Advance Directive
• A written statement of a person's wishes regarding medical treatment, often including a
living will, made to ensure those wishes are carried out should be the person be unable to
communicate them to a doctor.
Living Will
• A written statement detailing a person's desire regarding their medical treatment in
circumstances in which they are no longer able to express informed consent, especially an
advance directive.
CPOE
4
