ANCC Adult-Gerontology Acute Care
Nurse Practitioner (AGACNP-BC) 2024
Exam Review
Scope of Practice - ANS Based on legal allowances in each state, individual state nurse practice acts
providing guidelines for nursing practice
Key elements of the NP role include - ANS integration of care across the acute illness continuum with
collaboration and coordination of care; research based clinical practices, clinical leadership, family
assessment, and discharge planning
Standards of Advanced Practice are delineated by... - ANS American Nurses Association which measure
quality of practice, service, or education
State Practice Acts - ANS Authorize Boards of Nursing in each state to establish statutory authority for
licensure of RNs
State Practice Acts - authority includes: - ANS use of title, authorization for scope of practice including
prescriptive authority, and disciplinary grounds
States vary in practice requirements, such as - ANS certification
Prescriptive authority - ANS Ability and extent of NPs ability to prescribe meds
DEA has ruled that nurses in advanced practice may obtain.. - ANS registration numbers, state practice
acts dictate level of prescriptive authority allowed
Credentials encompass... - ANS required education, licensure and certification to practice as an NP
,Credentials establish... - ANS minimal levels of acceptable performance
Credentialing is necessary to: - ANS ensure that safe healthcare is provided by qualified individuals;
comply with federal and state laws r/t APN
Credentials also... - ANS acknowledges the scope of practice of NP, mandates accountability, enforces
professional standards for practice
Licensure - ANS establishes that a person is qualified to perform in a particular professional role
Licensure is granted as defined by rules and regulations set forth by - ANS a governmental regulatory
body (ie. state board of nursing)
Certification - ANS Person has met certain standards that signify mastery of specialized knowledge
Certification is granted by nongovernmental agencies such as - ANS ANCC, AANP
Admitting privileges to hospitals (non physican) were granted - ANS 1983 by JC
Credentialing and privileging - ANS process which an NP is granted permission to practice in an inpt
setting
Credentialing with hospital privileges is granted by a - ANS Hospital Credentialing Committee
Pt Medical Abandoment - ANS When caregiver-pt relationship is terminated w/o making reasonable
arrangements w an appropriate person so that care can be continued
,Determination of pt abandonment depends on factors such as: - ANS Whether NP accepted pt
assignment, whether NP provided reasonable notice before termination, whether reasonable
arrangements could have been made
Following do not constitute pt abandonment - ANS NP refuses to accept responsibility for pt assignment
when NP has given reasonable notice to proper authority that NP lacks competence to carry out
assignment; NP refuses assignment of a double shift or addtl hrs beyond posted work schedule when
proper notification has been given..latter phrase can be controversial
Risk Mgmt - ANS Systematic effort to reduce risk begins w formal written risk mgmt plan that includes:
organizations goals, delineation of program's scope, components, methods; delegating responsibility for
implementation and enforcement; demonstrating commitment by the board; confidentiality and
immunity from retaliation for those who report sensitive info
Most common method of documentation for risk mgmt - ANS incident reports
Policies regarding incident reports should address: - ANS ppl authorized to complete report; ppl
responsible for review of a report, immediate actions needed to minimize the effects of the event; ppl
responsible for follow up; plan for monitoring aftermath; security/storage of completed report
Risk mgmt - Satisfaction surveys - ANS Important for identifying problems before they develop into
incidents or claims; for pts and employees
Risk mgmt - Complaints: Risk mgmt plan should delineate tracking, analyzing, and managing complaints
by clearly identifying: - ANS ppl notified after receiving complaint; ppl responsible for responding; ppl
responsible for monitoring follow up
Action taking initiatives: - ANS Prevention, correction (corrective steps must be monitored and audited),
documentation, education, departmental coordination
, Medical Futility - ANS Interventions that are unlikely to produce significant benefit for pt - "Does the
intervention have any reasonable prospect of helping this pt?"
Two kind of medical futility: - ANS Quantitative futility: likelihood that intervention will benefit pt is
extremely poor
Qualitative futility: quality of benefit an intervention will produce is extremely poor
Informed consent - competence (decisional capability) - ANS state that pt is able to make personal
decisions about their care
competence implies that ability to: - ANS understand, reason, differentiate good and bad, and
communicate
informed consent - ANS pt has received adequate instruction or info regarding aspects of care to make
prudent, personal choice regarding such tx
Informed consent includes: - ANS discussing benefits and risk
consent is assumed if... - ANS pt's condition is life threatening
Danforth Amendment 1991 - ANS pts are informed at time of admission to federally funded institution
(such as hospital, nursing home, hospice, HMO, etc) that they have the right to refuse care as long as the
pt has decisional capability (competence)
Ethics - ANS study of moral conduct and behavior protecting the rights of an individual
1st priority is the - ANS most salvagable pts. Most critically injured cared for last.
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