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Table of Contents APN Capstone Portfolio Part 2 1 Background 4 Exemplar #1: NR503 Population Health, Epidemiology & Statistical Principles 5 Chamberlain Program Outcomes 7 AACN MSN Essentials 7 NONPF Core Competencies 7 Connect 8 Reflection 8 References 8 Exemplar #2: NR505 Advance Research Methods: Evidence-Based Practice) 9 (Week 4; Research Literature, Design Approach and Sampling Guidelines) 9 Chamberlain Program Outcomes 10 MSN Essentials 10 NONPF Competencies 11 Connection 11 Reflection 11 References 12 Exemplar #3: NR507 Advanced Pathophysiology 12 Chamberlain Program Outcomes 14 AACN MSN Essentials 14 NONPF Core Competencies 14 Connect 15 Reflection 15 References 16 Exemplar #4: NR508 Advanced Pharmacology 16 Chamberlain Program Outcomes 17 AACN MSN Essentials 18 NONPF Core Competencies 18 Connect 18 Reflection 18 References 19 Exemplar #5: NR509 Advanced Physical Assessments 20 Chamberlain Program Outcomes 21 AACN MSN Essentials 21 NONPF Core Competencies 21 Connect 22 Reflection 22 References 22 Exemplar #6: NR510: Leadership and Role of the Advanced Practice Nurse 23 Chamberlain Program Outcomes 24 AACN MSN Essentials 24 NONPF Core Competencies 25 Connect 25 Reflection 25 Reference 26 Exemplar #7: NR 511 Differential Diagnoses and Primary Care 27 Chamberlain Program Outcomes 28 AACN MSN Essentials 28 NONPF Core Competencies 28 Connect 29 Reflection 29 References 30 Exemplar #8: NR601 Primary Care of the Maturing and Ageing Family 30 Chamberlain Program Outcomes 31 AACN MSN Essentials 32 NONPF Core Competencies 32 Connect 32 Reflection 33 References 33 Exemplar #9: NR 602 Primary Care of the Childbearing and Childbearing Family 34 Chamberlain Program Outcomes 35 AACN MSN Essentials 35 NONPF Core Competencies 35 Connect 36 Reflection 36 References 37 Exemplar #10: NR 602 Advanced Clinical Care and Practice Across the Lifespan Practinum 37 Chamberlain Program Outcomes 38 AACN MSN Essentials 39 NONPF Core Competencies 39 Connect 40 Reflection 40 References 41 References 42 Appendix 1: Tabulation of achieved program 0utcome, MSN Essentials and NONPF Competencies 45

Background
On account of the intense and comprehensive nursing education program that I have undergone at Chamberlain College of Nursing, resulting into an award of Masters of Science in Nursing, here is a compilation of a reflection through the journey. The reflection entails the Program Outcomes, Master’s Education Essentials and the Core Competencies of the National Organization of Nurse Practitioners Faculties with the abbreviations as PO, MSN Essentials, and NONPF. Further, this documentation also covers ten exemplars with an assessment on views of the right argument that all of the above requirements have been covered.

Exemplar #1: NR503 Population Health, Epidemiology & Statistical Principles
In #Week 6 of this course we conducted an Evaluation of Epidemiological Problem. This assignment enabled the students to meet different course outcomes. The assignment required defining key terms in community health, epidemiology, and population-based research. We also gained the knowledge and skills to compare study designs used for obtaining population health information from observation, surveillance, community, and control trial-based research. The assignment also enabled us to commonly used measures of health risk and identify appropriate outcome measures and study designs applicable to epidemiological subfields, for instance chronic disease, infectious disease, reproductive health, environmental exposures, and genetics. We were able to identify important sources of epidemiological data and evaluate a public health problem as regards to place, person, magnitude, and person.

The task was to discuss HIV/AIDS and give its background information. The assignment was able to realize that HIV/AIDS is both an infectious disease and an epidemic disease. Learning that, since its onset, HIV/AIDS has claimed over 35 million lives was very scaring. HIV is considered infectious because it causes a severe impairment of the immune system, which then leads to AIDS (Moyer, 2015). With a weak immune system, AIDS patients become susceptible to other cancers, diseases and infections – often called opportunistic infections since their causal organisms only take advantage of the weakened immune system (Maartens, Celum & Lewin, 2014).

I was able to learn about the worrying prevalence statistics of AIDS with 23,304 people estimated to be living with HIV in Houston Texas (Maartens, et al., 2014). I also established the current surveillance techniques and strategies of HIV in the US and a clear descriptive epidemiological analysis. Finally, I was able to understand the screening and diagnosis methods of HIV. I was then able to develop and action plan for dealing with the disease or infection when I finished my MSN.

Chamberlain Program Outcomes
This assignment enabled me to meet course outcome PO #1: Provide high quality, safe, patient-centered care grounded in holistic health principles (Holistic Health & Patient-Centered Care). The course was able to realize Program Outcome #1 by calculating HIV prevalence in Houston Texas and breaking it down to address particular interests of the populations. The assignment discussed the surveillance methods for HIV, which is one of the techniques that support community intervention plan. I was able to successfully suggest an intervention plan of increasing health awareness on HIV to help in its prevention.

AACN MSN Essentials
This assignment met the AACN MSN Essential I: Background for Practice from Sciences and Humanities. This MSN Essential captures the importance of obtaining an understanding of a disease and using an informed background for practice to manage its prevalence. As demonstrated in the assignment, in identifying HIV’s prevalence and designing an intervention for Houston Texas, I relied on nursing scientific findings to advocate for quality and improved health outcomes.

NONPF Core Competencies
The NONPF that I was able to demonstrate with this assignment were Practice Inquiry, Scientific Foundation and Technology and Information Literacy Competencies. I was able to think critically while compiling data on HIV and being able to apply evidence-based practice to design the intervention plan. I also included research outcomes for practice improvement and improving patient outcomes. I also had to include knowledge from other disciplines as a way of practice inquiry. Using spreadsheet application demonstrated technology and information competency.

Connect
The concepts that I can connect with from the exemplar are screening and surveillance. In nursing context, screening is used to refer to a test conducted to determine a health condition prior to manifestation of symptoms. Screening helps to detect diseases and conditions in their early periods to improve treatment outcomes. This makes screening an essential part of preventive care (Moyer, 2015).

On the other hand, disease surveillance refers to information-oriented activity encompassing gathering, analyzing and interpreting relevant health data from varied and different sources (Houston Health Department. 2015). This requires the use of informatics and technology to enhance surveillance and enable real time analysis. Surveillance leads to effective disease management and enhances preventive measures (Moyer, 2015).

Reflection
This course was very insightful. It enables accomplishments of Program Outcome #, which is to promote safe and high-quality patient-driven care anchored in holistic health tenets. To produce the document of HIV program, I had gone through several scientific studies on HIV prevalence in Houston to understand the disease’s status in the target population. I also had to compare different studies to conclude on the prevalence and determine the incident rate. Understanding the epidemiological perspective of the disease enabled proper identification of the intervention plan. I was also able to apply evidence-based practice in the work.

References
Houston Health Department. (2015). HIV Surveillance Program. HIV Infection in Houston: An Epidemiologic Profile 2010-2014. Houston, Texas; 2015.

Maartens, G., Celum, C., & Lewin, S. R. (2014). HIV infection: epidemiology, pathogenesis, treatment, and prevention. The Lancet, 384(9939), 258-271.

Moyer, V. A. (2015). Screening for HIV: US preventive services task force recommendation statement. Annals of internal medicine, 159(1), 51-60.

Exemplar #2: NR505 Advance Research Methods: Evidence-Based Practice)
(Week 4; Research Literature, Design Approach and Sampling Guidelines)
In NR505 the assignment was Research methods and evidence-based practice. In week #4 of about Research Literature, Design Approach and Sampling Guidelines. I chose obesity in children and adolescents as the phenomenon of interest in the evidence-based practice project. The selected nursing issue for the project was prevention of adolescent and childhood obesity, with the overall aim being to prevent obesity’s co-morbidities. Child and teenage obesity has become a key problem in our society today. I was able to discuss the literature support research of the research, as well as identify the appropriate theoretical framework, research design and methodology including sampling method procedure.

Literature support generated three key pieces of information. The reviewed CDC (2017) document recommended the need for multi-disciplinary research to help develop proper behavioral interventions to prevent childhood obesity. The CDC document also gave a conclusive perspective of diet and exercise as the proper initiatives for obesity control. In a longitudinal study, Cunningham, Kramer & Narayan (2014) agreed with the CDC recommendation and suggestions. Kliegman, et al (2016) suggested the Nelson Textbook of Pediatrics as the key resource for approaches that can help pediatric care including obesity. Lobstein, et al (2015) study concluded an improved governance of food markets and food supply can help address the challenge of obesity. However, it would be impractical to govern food markets and supply, thus instead education should be improved.

The theoretical framework suggested for the study was Henderson’s Needs Theory. The argument was that although the theory works well with inpatients, it can support the problem of helping obesity patients (Ahtisham & Jacoline, 2015). The suggested research approach and design of the study would be qualitative study with a non-experimental (descriptive) inquiry-based design based on the Grounded Theory (GT). The research, as suggested, use interviews and existing documents as its primary data collection tools.

Chamberlain Program Outcomes
The assignment enabled realization of program outcome (PO) #5: Advocates for positive health outcomes through compassionate, evidence-based, collaborative advanced nursing practice (Extraordinary nursing). This is because, evidence-based practice is one of the ways through which nurses can advocate for desirable health outcomes. The assignment enabled the application of the ability to design an evidence-based research. The process involves selecting an appropriate research article, summarizing and reviewing its relevance and information, research design, methodology, sampling and presentation of research findings.

MSN Essentials
This assignment met MSN Essential VI: Health Policy and Advocacy. I was able to engage in advanced research method, and research critique, to inform health advocacy and policy as to attain MSN Essential VI. It is evident that an MSN prepared nurse can apply research outcomes, become a change agent, resolve a nursing practice issues, and help disseminate research findings. I concluded that being able to translate findings of a nursing research is an important.

NONPF Competencies
To achieve the assignment outcome, I needed such NONPF Competencies as policy, scientific foundation and health delivery systems. Policy and health delivery systems competencies enabled me to use health informatics for determining the best guidelines for managing critical health issues. Through scientific foundation I was able to critique different study findings to generate appropriate information for the research. Through health delivery systems competency I was able to synthesize nursing practice methods that would improve patient outcomes.

Connection
I was able to connect with two concepts from this exemplar – research gap and research limitations. Research gaps are the areas with inadequate information, which constraints the research’s effective conclusion. A research gap often leads to recommendation of a new research to further the information. One can conclude there’s a research gap only after a comprehensive literature review.

Research Limitation are the research aspects that inhibit a researcher from attaining the full potential of the research outcomes. It is assumed that every research has a given limitation level such as resources, scope or knowledge. Limitations are the conditions, which an investigator cannot fully manage and will constraint the research’s conclusions and methodology.

Reflection
I thank this course for giving me insight on conducting scientific research and critique. Through program Outcome #5 I am now able for advocating for the realization of a positive health outcome through engaging evidence-based compassionate and collaborative advanced nursing practices that are evidence-based. Having gone through this course, it is evident that nurses could experience challenges in research critiques and general research conduct. Nurses should therefore exhibit NONPF Core Competencies particularly the scientific foundation competencies.

References
Centers for Disease Control and Prevention. (2017). Childhood Obesity Facts. Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion.

Kliegman, R. M., Schor, N. F., St Geme III, J. M., & Behrman, R. E. (2016). Nelson Textbook of Pediatrics. Philadelphia: Elsevier.

Lobstein, T., Jackson-Leach, R., Moodie, M. L., Hall, K. D., Gortmaker, S. L., Swinburn, B. A., . . . Mc Pherson, K. (2015). Childhood and adolescent obesity: Part of a bigger picture. The Lancet, 2510-2520.

National Collaborative on Childhood Obesity Research. (2012). Childhood Obesity in the United States. NCCOR.

Exemplar #3: NR507 Advanced Pathophysiology
The NR507 Course of Advance Pathophysiology was key in realizing the Chamberlin trained nurse practitioner’s program outcomes, master’s essentials, and core competencies. Pathophysiology focuses on the symptoms and function of diseased organs, to enable diagnosis and effective patient care. The different between pathophysiology and pathology, is that pathology studies all aspects of a disease, and not just the organic function. The question that NR507 sought to answer is how the study of pathophysiology help nurses in their practice. Nurse practitioners must have the right information coupled with practice knowledge and skills to be able to achieve the best evidence-based, comprehensive quality patient outcomes.

Pathophysiology entails Disease and etiology, signs and symptoms, investigation and diagnosis, treatment and prognosis. Pathophysiology puts together all of these steps. Nurse practitioners are expected to have a clear understanding of the process from the etiology and symptoms, through to medical testing, investigation, diagnosis and finally prognosis. It is clear that pathophysiology works closely with evidence-based practice. Thus, nurse can conduct more effective treatments through pathophysiology especially in such situations where anxious, scared patients don’t really understand their conditions. Nurses can educate the patients and calm them down.

There are cases where, through pathophysiology, nurses can help generate a valuable discovery for a patient’s healthcare team. Acting – in their usual crucial role – as their patients’ advocates, it is possible that nurses could catch some overlooked signs or and make them know to the doctor. The course sheds the light of pathophysiology as a way of facilitating the nurses’ knowledge to enable them to comfortably walk their patients through the process of disease etiology, testing, diagnosing, treating and prognosis. Nurses become effective in their work when they clearly understand the different ways biological processes and human organs behave in the presence of a disease. This experience and practice skills is gained through. effective research.

Chamberlain Program Outcomes
I found this course highly critical since it concerns understanding a disease, correct diagnosis, treatment and its prognosis for effective and quality patient care through proper professional identity. Thus, this course met two program outcomes. It met PO #2: Create a caring environment for achieving quality health outcomes (Care-Focused) and PO #4: Integrate professional values through scholarship and service in health care (Professional identity). Pathophysiology ensures that the patient’s care environment is perfect for achieving quality treatment outcomes.

AACN MSN Essentials
The course managed to achieve MSN Essential IV: Translating and Integrating Scholarship into Practice and MSN Essential VIII: Clinical Prevention and Population Health for Improving Health. These two essentials are connected to PO #4, which this course was also able to meet. An MSN prepared nurse must be able to integrate broad, effective patient-centered, culturally competent and organizational concepts to assess, manage and deliver proper clinical care to the patient. As an MSN prepared nurse, I can use pathophysiology to manage a patient and the disease following through all the necessary steps learned throughout the nursing course with appropriate understanding to achieve quality health outcome for the patient.

NONPF Core Competencies
To effectively achieve this course, it was imperative to have such NONPF competencies as quality, independent practice and health delivery systems Competencies. To be able to apply pathophysiology, an MSN trained nurse must exhibit independent practice competencies. It is only through independent practice that the nurse can bring to the doctor’s attention certain aspects of the disease that were overlooked. This competency is supported by quality-oriented practice and having a clear knowledge of the health delivery systems.

Connect
The Autonomic Nervous System, controls the body’s internal organs functions. It controls body muscles and is also an integral part of the peripheral nervous system (Tappen, 2016). The renal system is comprised of body organs, which filter out excess fluid and other substances from the bloodstream. It is responsible for the production, storage and elimination of urine is done. The kidneys, being key part of the renal system, help to excrete excess fluid waste. Further, the kidney filters waste and extra blood from the blood system (Tappen, 2016).

Reflection
One among the many useful and important courses in MSN, this this NR507 Advanced Pathophysiology course sought to answer the question of how the study of pathophysiology help nurses in their practice. It is now clear to me that through this course the nurse can conduct more effective treatments especially in such situations where anxious, scared patients don’t really understand their conditions. I even learned that there are cases where, through pathophysiology, nurses can help generate a valuable discovery for a patient’s healthcare team. This course was important in realizing two program outcomes: PO #2: Create a caring environment for achieving quality health outcomes (Care-Focused) and PO #4: Integrate professional values through scholarship and service in health care (Professional identity). Understanding pathophysiology is an important aspect of nurse evidence-based treatment.

References
American Association of Colleges of Nursing. The Essentials of Masters Education for Nursing (2011). Retrieved from http://www.aacn.nche.edu/education-resources/MastersEssentials11.pdf

Robinson, B. K., & Dearmon, V. (2013). Evidence-based nursing education: Effective use of instructional design and simulated learning environments to enhance knowledge transfer in undergraduate nursing students. Journal of Professional Nursing, 29(4), 203-209. doi: 10.1016/j.profnurs.2012.04.022

Tappen, R. M. (2016). Advanced nursing research: From theory to practice. Jones & Bartlett Publishers.

Exemplar #4: NR508 Advanced Pharmacology
The focus of this course is on advanced knowledge base and practice skills of pharmacology across in different clinical settings. It discusses the principles of clinical pharmacology, pharmacokinetics, therapeutics, and drug metabolism. Being a dynamic science, advanced Pharmacology as explained in NR508, built upon the previous knowledge to augment our understanding of treatment complexities with pharmacological interventions. The whole of this course expands knowledge of the principles of pharmacology specific to the APN’s role. As a student I was able to explore, analyze, evaluate, and apply common drugs used for treatment of chronic diseases and some self-limiting acute conditions and apply evidence-based practice for prescriptive intervention.

In reflection, through this course, and as an MSN trained nurse, I can now compile patients’ information to provide appropriate evidence-based diagnosis and treatment. I can boast of better understanding of the integration and application of appropriate and quality care to patients while also focusing on organizational standards, and considering distinct and dynamic individual and family populations. I have learned this important aspect of treatment through pharmacokinetics and giving patients appropriate drug choices it is possible to achieve quality treatment.

Through completion of NR 508, I can discuss the principles and concepts of pharmacokinetics, pharmacotherapeutics and pharmacodynamics. I can also now demonstrate an understanding of the key drug classifications with regards to rationale, risks, indications, and efficacy for the pharmacotherapeutic agents regularly prescribed in acute and primary care settings. I also gained the knowledge to evaluate relevant and current research findings to come up with prudent and quality pharmacological interventions. This course has also enabled me to be able to design suitable pharmacologic interventions. This class was one of those that are both enlightening and challenging. I gained the knowledge necessary to arrive at definitive patient diagnosis and establish an apt a treatment plan.

Chamberlain Program Outcomes
I believe this course me program outcome (PO) #5: Advocates for positive health outcomes through compassionate, evidence-based, collaborative advanced nursing practice (Extraordinary nursing). It is important that nurses communicate effectively to patients on the drugs given and treatment plan offered. It is possible that NR508 MET PO #5 because it is the only outcome that champions for desirable health outcomes through compassionate and evidence-based encompassed with collaboration

AACN MSN Essentials
The course attained AACN MSN Essential VII: Interprofessional Collaboration for Improving Patient and Population Health Outcomes. MSN Essential VII addresses interprofessional collaboration that enhances patient outcomes and quality of population health. As an MSN prepared nurse, I now understand that to attain quality care, it is important to collaborate with other healthcare professionals so as manage and coordinate the care.

NONPF Core Competencies
Through this course (NR508) it is evident that one needs to show Health Delivery Systems Competencies and practice competencies. These two competencies impact the operationalization of public health and community programs. Using these competencies, a nurse can engage inquiry to come up with appropriate diagnosis, treatment plan and drug prescription. You also need to eb culturally competent to deliver appropriate healthcare and work with others in the healthcare field for effective patient outcomes.

Connect
Through this course, can connect with two terms – allergy and NSAIDs. In the context of pharmacology an allergy is used to refer to the immune system’s response – unnecessary – to a harmless foreign substance (Lilley, Shelly & Snyder, 2019). NSAIDs, on the other hand are non-steroidal anti-inflammatory drugs, which work by obstructing prostaglandins. prostaglandins are the chemicals that trigger the inflammation and pain signal. NSAIDs then help to relieve the inflammation from pain (Lilley, Shelly & Snyder, 2019).

Reflection
This course has benefitted me a lot. Other than knowing the essentials and specific applications of advanced pharmacology, I managed to attain PO #5, which advocates for desirable health outcomes through compassionate and evidence-based approach to nursing practice while elevating collaboration. It is understandable that you cannot work alone when you are a nurse practitioner and that you have to engage other practitioners in the healthcare field to attain quality healthcare outcomes. The course is also aligned to MSN Essential VII, which addresses interprofessional collaboration for enhanced patient outcomes. Thus, while conducting evidence-based and compassionate care, elevating interprofessional collaboration also leads to enhanced patient outcomes.

References
Chamberlain College of Nursing. (2016). Graduate Program Outcomes. Retrieved from http://www.chamberlain.edu

Chamberlain College of Nursing. (2017). Pharmacokinetics, Pharmacodynamics, Art of Pharmacotherapeutics, Reproductive System Medications and Drug-OTC-Herbal Interactions. Week 1 lesson. Retrieved from http://www.chamberlain.edu

Lilley, L. L., Shelly Rainforth Collins, P., & Snyder, J. S. (2019). Pharmacology and the nursing process. Mosby.

Exemplar #5: NR509 Advanced Physical Assessments
The name and expectation of the NR509 course is far much different from time one needs to successfully complete the course. I never expected that this course would involve that much activity and time. There is much study and practical application in this course than any other MSN course. I was even overwhelmed with the amount of documentation and information involved with the patients.

This course is best for those planning to undertaking autonomous practice. An FNP is an example of an autonomous practicing nurse. They have the knowledge for emergency nursing, primary care, night-nurse practitioners, community matrons, critical care, occupational therapists, physiotherapists, and working in different pre-surgical clinics, and day surgery, among other places. The course aims to enable one, as a practitioner, to develop advanced physical assessment skills and apply them in a clinical context, including when working as an autonomous practitioner.

Immersion weekend – the lab component of NR-509: Advanced Physical Assessment – gave me a great experience while also being nerve wracking. Occurring in week 7 of NR-509, the Immersion Weekend offered me an opportunity to demonstrate competence and engage critical thinking in my health assessment skills. The course has designed the Immersion Weekend to teach us appropriate assessment techniques on various general medical complaints, which help prepare us for practicum experiences in NR-511. This means, one has to do well in NR509 so as to understand NR511.

Even after all the preparations, study and documentations, NR509 was still difficult to pass. I still had low scores in the NR509 APEA exams in three areas – Neurology, Gastroenterology, and Respiratory. I had to put a lot of work to ensure that I performed well in these three areas so that I would succeed in NR511. Also, to succeed in NR509, one has to be well versed with the previous MSN courses that come before 509, and take keen consideration of pharmacology and pathophysiology.

Chamberlain Program Outcomes
The content and information of this course meets those of Chamberlain MSN PO #1: Provide high quality, safe, patient-centered care grounded in holistic health principles (Holistic Health & Patient-Centered Care). Through this course I have become keener on screening and diagnostics both of which exemplify Program Outcome #1 for provision of safe, patient-centered and high-quality care. Conducting advanced physical assessments require not only clear and informed background in nursing, but critical thinking and evidence-based practice.

AACN MSN Essentials
The course met the conditions for arriving at Essential IX: Master’s-Level Nursing Practice. Clearly, advanced physical assessments highly impact individuals’ healthcare outcomes. Its achievement requires clear and well-defined background in nursing which provokes the essentials of master’s level nursing practice. It is a clear demonstration of advanced level of understanding and comprehension of advanced nursing and its relevant fields.

NONPF Core Competencies
The course also needs a demonstration of NONPF Independent Practice Core competencies. It gives an opportunity to work autonomously exhibiting independent practice as a competency. It also involved independently analyzing the given case studies with stellar profession and distinguished care to provide accurate diagnosis and establish quality outcome. A competent MSN prepared nurse should distinguish between normal and abnormal health results, which is supported by this course.

Connect
I can connect with two terms in this course – shadow-health and gastroenterology. Gastroenterology, as a field of medicine, is involved with interrogating, diagnosing, and suggesting treatment that also encompasses listing preventive care for gastrointestinal and hepatological tissues and organs (Tappen, 2016). Shadow health, on the other hand, is a software that gives healthcare students a virtual learning opportunity through simulations (Foronda et al., 2019). Thus, it enables students to test their nursing knowledge and skills and hence build their confidence.

Reflection
The name and expectation of the NR509 course is far much different from time one needs to successfully complete the course. I never expected that this course would involve that much activity and time. There is much study and practical application in this course than any other MSN course. I was even overwhelmed with the amount of documentation and information involved with the patients. The sensitivity is on its screening and diagnostic processes, which both inform the treatment plan making any mistake – if any – at this stage costly and fatal and costly. I discovered that conducting advanced physical assessments needs stellar background in nursing information and proper develop critical thinking. Students can use Shadow Health and case studies to test their physical assessment’s skills and knowledge.

References
Codina, L. M. T. (2007). Adult nurse practitioner intensive review: Fast facts & practice questions. New York: Springer Pub. Co.

Foronda, C. L., Alfes, C. M., Dev, P., Kleinheksel, A. J., Nelson Jr, D. A., O'donnell, J. M., & Samosky, J. T. (2017). Virtually nursing: Emerging technologies in nursing education. Nurse educator, 42(1), 14-17.

Tappen, R. M. (2016). Advanced nursing research: From theory to practice. Jones & Bartlett Publishers.

Exemplar #6: NR510: Leadership and Role of the Advanced Practice Nurse
This course was not only important but also practice assuring. Id defined the leadership and role of an APNs practitioners in a wide range of possible careers and employment opportunities. Holding either MSN or a doctorate in nursing, APNs are considered to be the most highly trained category of all registered nurses. They conduct certain functions previously reserved for medical doctors such as diagnosing condition, requesting and/or interpreting laboratory tests, and prescribing medications among others. They have a wide scope of practice and lots of duties to perform either as practitioners or leaders.

APNs apply technical, cognitive and integrative abilities to carry out their practice in ethical and safe approaches for quality outcome of patients. APN must also have the capability of peer and patient education, research and inquiry, mentorship and accountability in interpreting and utilizing research to advance and improve nursing practice. There are two main themes identified in the role of an ANP – organization and system‐focused leadership and Patient‐focused leadership. These are the main leadership orientations of APNs as they seek to contribute to and improve the clinical care environment for patients and their families, other nurses including other healthcare providers, and the entire healthcare system.

Being an APN requires a one to have an MSN. Other MSN’s proceed to earn a doctoral degree to become Clinical Nurse Specialists. With an MSN one also has to obtain a certification after sitting an exam to become an APN. (“Advanced Practice Nursing Fact Sheet”, 2017). It is also important to consider the federal and state Licensure and Regulatory Requirements to practice as an MSN trained APN. With an additional certification, degree and license, being an MSN prepared APN means having a higher responsibility. Further, a complex job title, higher knowledge, more skills and authority give APN new challenges and equal opportunities. Nevertheless, regardless of having higher roles or authority, an APN must always keep in mind that providing quality and safe healthcare is paramount.

Chamberlain Program Outcomes
This course meets the needs of program outcome (PO) #3: Engage in lifelong personal and professional growth through reflective practice and appreciation of cultural diversity (Cultural Humility). Nurses are generally leaders both to patients and to their lower ranking colleagues. By pursuing an APN level nursing career, one is aligning with Program Outcome #3 that urges continuous personal and professional growth through reflective practice and appreciation of cultural diversity.

AACN MSN Essentials
This course realizes AACN MSN Essential II: Organizational and Systems Leadership. APN’s are naturally leaders because of their skill levels and associated responsibility, roles and authority. Thus, they must demonstrate both organizational and systems leadership to promote safe and quality care. They must also engage critical thinking in their decision making and engage systems-wide view.

NONPF Core Competencies
The accurate and obvious competency that this course instill is the Leadership Competency. As an MSN APN I have to build on leadership competencies (Hickey & Brosnan, 2012). This is because you will have more responsibilities, key roles and authority, which put you in a leadership position. As a leader you have to act on the best interest of all the stakeholders involved in the care process including patients, junior colleagues and other health sector practitioners. You must also exercise effective communication skills and participate in professional organizations to enhance your leadership competences.

Connect
Systems-wide view: seeks consider the organization’s entire units or departments in a bid to accomplish a practical approach to leadership. The systems-wide concept views an organization from a cause-effect view which supports implementation of corrective measures (Cherry & Jacob, 2016).

Nursing leadership is a dynamic concept of nursing that, simply stated involves mentoring (or coaching) and building of supportive relationships to maximize individual potential and enhance professional growth. Mentorship involves a nurse leader sharing their knowledge, behaviors, skills, and attitudes with other nurses (Cherry & Jacob, 2016).

Reflection
APNs are trained to be leaders and demonstrate leadership competencies. This course not only teaches leadership but also gives leadership opportunities for APNs in care environment. While nursing leaders provide higher level leadership, individual nurses are always engaged in leadership, for instance when assigned students or nursing interns. This course is aligned with Program Outcome #3, which urges nurses and APNs to indulge in continuous personal and professional growth while considering cultural diversity

Reference
Advanced Practice Nursing Fact Sheet | 2017 NurseJournal.org. (2017). Retrieved from http://nursejournal.org/advanced-practice/advanced-practice-nursing-fact-sheet/

About Boards of Nursing | NCSBN. (2017). Retrieved from https://www.ncsbn.org/about-boards-of-nursing.htm

Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.

Hickey, J. V., & Brosnan, C. A. (2012). Evaluation of health care quality in advanced practice nursing. New York: Springer Pub. Co.

Exemplar #7: NR 511 Differential Diagnoses and Primary Care
Through Differential Diagnosis and Primary Care nurse practitioners systematically approach treatment symptoms and signs with careful approach as they see them practice. NR 511 was the key test of my education and learning as an MSN prepared nurse. Organized into categories different categories such as mass, pain, bloody and non-bloody discharge, abnormal laboratory results, and functional changes, this course offers a clinical reference for diagnosis and taking appropriate steps in ensuring that the patient gets appropriate diagnosis. I had the opportunity to conduct my first FNP program clinical rotation. As an MSN, you are prepared to handle different aspect of care and diagnosis. In rotation, I realized that there is more that I need to learn as far as diagnosis and primary care is concerned. Primary care is intensive unlike ER, with the need for more follow up and abroad treatment for quality outcome. There is even more time needed to obtain lab results, hence diagnosis and treatment plan must be based on advanced physical test and the patient’s history.

There is also a key difference between primary care and ER when it comes to medication and treatments. In primary care, there are many protocols and many treatment options and sometimes patients have numerous comorbidities that that must be considered while choosing a plan of care. This often calls for differential diagnosis to ensure that the treatment plan addresses specific diseases and not comorbidities.

Primary care indulge different areas of clinical health and rotation exposes you to different patients in terms of age, gender, and disease infections. You have to be updated in treatment methods and ensure that you have the correct information going into treatment. As an MSN trained APN, you are a leader and perceived to be more knowledgeable and with more skills. Thus, it is only prudent to ensure that you follow the right procedures and ensure quality outcome.

Chamberlain Program Outcomes
NR 511 met PO #1: Provide high quality, safe, patient-centered care grounded in holistic health principles (Holistic Health & Patient-Centered Care). The differential diagnosis and primary course as it helps the MSN APN nurse determine the final diagnosis of the patient and subsequent treatment plan. Thus, it enables the realization of Program Outcome #1, which advocates for safe, high-quality, patient centered healthcare that is premised on holistic health principles. A critical element of the patient’s safety is ensuring that the patient is given correct of a medical condition or illness is a critical element of patient safety and quality attributes of a healthcare system. The treatment plan should be supported with an evidence-based information.

AACN MSN Essentials
The course helped in the realization of two AACN MSN Essentials – Essential V: Informatics and Healthcare Technologies and Essential IX: Master’s-Level Nursing Practice. The realization of these essentials is demonstrated through the achievement of PO #1. Differential diagnosis and Primary care have a direct impact on patient’s healthcare outcomes as addressed by Essential IX addresses. This is because any nursing aspect that directly impacts healthcare outcomes encompass MSN practice due to their requirement of detailed, keener and more informed with high accountability demands.

NONPF Core Competencies
This course managed to demonstrate the need for Quality CompetenciesThrough this course, MSN-APN trained nurses develop NONPF’s quality competencies to enable them operationalize all the other important competencies. One can achieve this trough applying the current and best research study findings and results to clinical practice. Nurse practitioners should also consider the complex relationships between quality, safety, and cost in healthcare delivery. This competency has many other aspects that an MSN-APN nurse must demonstrate.

Connect
Differential Diagnoses – when a patient has a condition that is difficult to understand, clinicians and nurse practitioners use differential diagnosis to distinguish one condition, disorder or disease from others, especially when these conditions present close or similar clinical features (Gorenstein & Comer, 2015). This makes differential diagnosis a systematic diagnostic method that can identify a particular disease where there is a possibility of multiple alternatives.

Test sensitivity – In medical diagnosis, clinicians use test sensitivity to describe a test’s ability “to correctly identify those with the disease (true positive rate)” (Cummings et al., 2015). This is the exact opposite of test specificity which describe the test’s ability to correctly identify those without the disease (true negative rate) (Cummings et al., 2015).

Reflection
I can categorically say that this course was very critical in MSN because it directly addresses the healthcare’s sensitive stages. It informs the patient’s final diagnosis and all the subsequent treatment plan that the nurse will give. By meeting the requirements of PO #1 this course also directly advocates for f safe, high-quality and patient-centered healthcare that is premised on key holistic health principles. It emphasizes quality outcome and patient safety, which are salient element of healthcare provision. It also encourages evidence-based practice for better outcome.

References
Cummings, J., Soomans, D., O'laughlin, J., Snapp, V., Jodoin, A., Proco, H., ... & Rood, D. (2015). Sensitivity and specificity of a nurse dysphagia screen in stroke patients. MedSurg Nursing, 24(4), 219-224.

Gorenstein, E. & Comer, R. (2015). Case studies in abnormal psychology. New York, NY: Worth Publishers, a Macmillan Higher Education Company.

National Organization of Nurse Practitioner Facilities. (2013). Nurse practitioner population focused competencies. http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/Competencies/CompilationPopFocusComps2013.pdf

Exemplar #8: NR601 Primary Care of the Maturing and Ageing Family
Part of nursing is being able to provide primary care from pediatrics to the aged population. This course was an opportunity to learn and practice about providing primary care for the maturing and ageing population. This is a very delicate population and one that needs intensive care. Primary care for this category of this population is more intense during prognosis and managing them after treatment (Boeckxstaens & De Graaf, 2011). As an MSN trained APN practitioner, it is important to not only demonstrate leadership but also advocate for the well-being of the patients after treatment.

During this course, I was able to learn that primary care doesn’t mean a fixed organizational structure or style but a blend of functional and variable characteristics to the needs – present and emerging – of the older persons (Boeckxstaens & De Graaf, 2011). Clearly, multimorbidity, disability, dependence and frailty play out often and differently in the aging persons; making a key challenge for primary care to be able to provide an adaptable response to these individuals’ needs. Indeed, caring for the elderly needs involving them in the care decisions since, contrary to what’s believed, the elderly consider their life quality as high (Boeckxstaens & De Graaf, 2011). Furthermore, providing care for the elderly requires coordination and continuity with other specialist care programs.

The central theme of primary care for the old and ageing is delivering seamless integrated care. I learned that instead of disease management, primary care prefers case management approach. This involves proactive geriatric assessment to know the individual’s functional, medical, and social needs, including isolation, and loneliness. We also need clinical or MSN practice guidelines for multimorbidity to avoid costly uncoordinated and multiple prescriptions. Importantly, primary care is a teamwork, and coordinated healthcare provision, and nurses have a significant role in ensuring quality care and alignment with home (family) care and social services

Chamberlain Program Outcomes
This provisions and lessons in this course meet Chamberlain’s PO #5: Advocates for positive health outcomes through compassionate, evidence-based, collaborative advanced nursing practice (Extraordinary nursing). For example, when I helped an elderly patient get a referral by coordination and liaising her service with the relevant office, I operationalized PO #5, which advocates for positive outcomes through collaborative, evidence-based and compassionate practice. The mere fact that coordination and delivering of seamless integrated care in primary care for the ageing is a fulfilment of the PO #5.

AACN MSN Essentials
This course realized the fulfillment of MSN Essential VII, which advocates for Interprofessional Collaboration for Improving Patient and Population Health Outcomes. This essential is in line with PO #5 on the issue of coordinated and integrated care delivery. As an MSN NP you need to be working with different hospital/care departments to support the patient’s and a referral quality result. It is important that a NP consult and coordinate care with other health professionals as provided in essential VII.

NONPF Core Competencies
This course and the achievement of the practical outcomes that I managed to achieve shoed the need for Ethics Competencies as the NONPF core competencies. Dealing with elderly patients needs not only need compassion but also ethics both in their diagnosis and prognosis. I discovered that the elderly person’s families need to be helped to understand the situation including the patient’s prognosis. This is only possible when you infuse ethical principles in decision making.

Connect
Geriatrics: refers to the branch of social science or medicine that deals with the health and care of old people (Zaccagnini & White, 2015). This is basically what this course entailed.

Orthopaedic: is a special branch of medicine that deals with the correction of the body’s deformities of bones and muscles. It addresses the diagnosis, corrections, preventing, and treatment of individuals with their skeletal deformities (Zaccagnini & White, 2015). Most old people need to undergo orthopaedic treatment.

Reflection
In summary, I learned that the central theme of primary care for the old and ageing is delivering seamless integrated care. I learned that instead of disease management, primary care prefers case management approach. This involves proactive geriatric assessment to know the individual’s functional, medical, and social needs, including isolation, and loneliness. Nurses also need clinical or MSN practice guidelines for multimorbidity to avoid costly uncoordinated and multiple prescriptions. Importantly, primary care is a teamwork, and coordinated healthcare provision, and nurses have a significant role in ensuring quality care and alignment with home (family) care and social services

Primary care for the old have complex demands. Fortunately, nurses have adequate training to navigate through these complex demands for positive and quality patient outcome. It also needs ethics as a competency to be able to deal with the old and aging population. Further, dealing with this population needs interprofessional collaboration to enhance population and patient health outcomes.

References
Berry, S., Kiel, D. P., Schmader, K. E., & Sullivan, D. J. (2017). Falls: Prevention in nursing care facilities and the hospital setting. Uptodate. com.

Boeckxstaens, P., & De Graaf, P. (2011). Primary care and care for older persons: position paper of the European Forum for Primary Care. Quality in primary care, 19(6), 369.

Zaccagnini, M., & White, K. (2015). The doctor of nursing practice essentials. Jones & Bartlett Learning

Exemplar #9: NR 602 Primary Care of the Childbearing and Childbearing Family
This course course provides an NP student with the essential knowledge, information and experience to be able to diagnose and manage a childbearing/childrearing family and provide them with primary care as well as manage their common health problems. The course placed emphasis on assisting childrearing families to maintain or reach the highest level of functioning and health, focusing on health maintenance, health promotion. I am glad that this course prepared me to meet the MSN PO #1, MSN Essential VII, and the NP Core Competencies #8.

This course is focused on the primary care for low risk of a childbearing woman and her newborn. It is important for an FNP because it applies developmental theoretical perspective, for achieving primary care for during childbearing in a family practice setting. Also, the given clinical component gives the opportunity fo the MSN-FNP’s to integrate the learned theoretical content from their prior courses and use them in clinical gynecologic and obstetrical family practice. It gives the FNP-student nurse practitioner (SNP) skills needed for a quality holistic, primary care of the woman obstetrical client in ambulatory and family practice care.

This course also offers the practice and principles of care for the childbearing woman and family throughout the ante- and post-partum stages. The course explains this process through different ethnicities, ages, and social circumstances and also involves advanced physical assessment (NR509) and management of both normal pregnancy and different pregnancy complications. On top of the different pregnancy’s physiological changes, the course also helps to examine the psychological issues that are commonly encountered during the pregnancy’s prenatal and post-partum care provision.

Furthermore, the builds on human development and growth to focus on support knowledge of assessment and management of chronic and acute health care problems that practitioners encounter in primary care of family, and sometimes pediatric, settings. It analyzes the medical problems and conditions of expectant women, unborn and born infants, as well as children and adolescents within the context of a FNP framework.

Chamberlain Program Outcomes
Program outcome #1 advocates for providing high quality, safe, patient-centered care grounded in holistic health principles (summarized as holistic health & patient-centered care). The significance of holistic care was first emphasized by Florence Nightingale. Holistic care gives a patient satisfaction in the provided healthcare, which is also their right (Andrus, 2014). Through this course, and by meeting MSN PO #1 I am able to address childbearing patients and families’ social, physical, emotional, and spiritual needs, and support them in dealing with their illnesses, to improve their lives.

AACN MSN Essentials
The course achieved MSN Essential VII: Interprofessional Collaboration for Improving Patient and Population Health Outcomes. Achievement of this essential recognizes that an APN MSN-prepared nurse, being a leader and member of interprofessional teams, collaborates, consults, and communicates with other professionals in the healthcare field to coordinate and manage care (Andrus, 2014). As an MSN, you coordinate and lead interdisciplinary care teams across different care environment to improve health outcomes. This professional identity is achieved through MSN Essential VII.

NONPF Core Competencies
This course demonstrates the Nurse Practitioner Core Competency # 8: Ethics Competencies. This is because it ensures integration of ethical principles in care decision making, ensures evaluation of the ethical consequences of care decisions. It also applies ethically sound solutions to complex issues related to individuals, populations and systems of care. As an FNP this course has prepared me to promote patient-centered, comprehensive holistic care (Sohi, Champagne & Shidler, 2015). Thus, I know that, ethically it is the patients’ right to choose the type of care they feel comfortable with and can refuse care when they are not comfortable with a given care. This means that the nurse – an MSN-APN prepared FNP – has a responsibility to provide patients with enough information about the treatment and care so that they can make informed decision.

Connect
Postnatal depression: is the form of depression, which a parent can undergo after childbirth. The major victims are mothers but it can also affect fathers. The signs of postnatal depression include difficulty bonding with the new baby, insomnia or intense irritability. If untreated it can go for a long time and can lead to a major depression (Agrawal, 2015).

Postpartum hemorrhage entails excessive bleeding after childbirth. The hemorrhage often takes place after the delivery of the placenta. Its causes include uterine muscles’ loss of tone, or a bleeding disorder or sometimes when the placenta fails to be delivered completely or when it’s tone (Agrawal, 2015).

Reflection
This is one of the courses that is suitable for an FNP because it offers a lot of ways that help the FNP on addressing the social, emotional, spiritual, and physiological needs of parents after childbirth. In essence it helps to the student to operationalize Program Outcome # 1, which urges nurses and care givers to offer safe, high quality and patient-oriented care while considering holistic healthcare tenets. Also, it provides for collaboration and coordination while handling patients enhance desired quality health outcomes. For example, through Essential VII, this course helps you to learn to appreciate other professionals in your team and appreciate the significance of collaboration.

References
Agrawal, P. (2015). Maternal mortality and morbidity in the United States of America.

Andrus, V. L. (2014). Person-Centered Care: Enhancing Patient (Person) Engagement. Beginnings, 34(1), 18-21.

Sohi, J., Champagne, M., & Shidler, S. (2015). Improving health care professionals' collaboration to facilitate patient participation in decisions regarding life-prolonging care: An action research project. Journal of Interprofessional Care, 29(5), 409-414.

Exemplar #10: NR 602 Advanced Clinical Care and Practice Across the Lifespan Practinum
As an MSN-FNP this course is very essential for my practice. This course has helped me achieve MSN-FNP Program Outcome #4: professional identity (Integrate professional values through scholarship and service in health care). This course offered an opportunity for practical experience in nursing scholarship. As described by the American Association of Colleges of Nursing (2011), scholarship includes the activities, which systematically advance the practice, research and teaching of nursing through a rigorous inquiry. The course also supports other MSN qualities such as leadership, advanced practice, coordination, collaboration and authority in advocating and providing quality care.

This enabled attainment of course MSN Essential IV: Translating and Integrating Scholarship into Practice. This essential recognizes that the MSN-prepared nurse must apply research outcomes in the practice to make informed decisions and solve practice problems through evidence-based practice. The MSN-prepared nurse also works as a leader and change agent in healthcare setting. Utilizing the guidelines of clinical practice to recognize, plan, manage and treat diseases satisfies this essential.

This course – being an important APN course – continues to provide expanded the practical and theoretical knowledge of diagnostic and disease management principles specific to the MSN-FNP’s, for healthcare needs of all individuals across all ages. It enables students to further their skills in diagnosis, health promotion, prevention of illness, and general care management of complex chronic and acute conditions, as well as behavioral health. This course leads the student to develop and maintain such care strategies as patient education, follow-up, referral, and protocol development through an experience in clinical practicum in an advanced practice setting.

This course solidifies the FNP’s clinical experience, which involves developing knowledge and skills that supports provision of quality healthcare outcome through best research and evidence-based care. Achievement of the course leads to attainment of numerous Nurse Practitioner Core Competencies, key among them being competency # 7: Health Delivery System Competencies. This cluster of competencies (#7) refer to the design, planning, and implementation of community and public health programs for quality healthcare outcome and encompass such skills as effective communication, leadership, compassion, coordination, research and evidence-based practice in care provision (AACN, 2011).

Chamberlain Program Outcomes
This course has helped me achieve MSN-FNP Program Outcome #4: professional identity (Integrate professional values through scholarship and service in health care). This program outcome is especially important for aspiring FNPs in the clinical practice. For example, I have learned to provide primary care to patients of different ages, class and identities, which is important in FNP practice. As an MSN-FNP prepared nurse you’re expected to become a leader and have more skills in different care settings that will make you stand out among other practitioners. Thus, this course has offered important insights on not only MSN requirements but also cultural diversity and behavioral health concerns.

AACN MSN Essentials
The meeting of PO #4 enabled attainment of MSN Essential IV: Translating and Integrating Scholarship into Practice. Also, MSN essential III: quality improvement and safety comes close to this course. Expectedly, conducting advanced primary care to different age groups of patients and conduction differential diagnosis requires reliance on both Essential III and IV. As an FNP, attaining MSN level of practice required covering numerous theories, practical, simulations, laboratory sessions and case studies and being able to apply them in real-world.

NONPF Core Competencies
This course solidifies the FNP’s clinical experience, which involves developing knowledge and skills that supports provision of quality healthcare outcome through best research and evidence-based care. Achievement of the course leads to attainment of numerous Nurse Practitioner Core Competencies, key among them being competency # 7: Health Delivery System Competencies. This cluster of competencies (#7) refer to the design, planning, and implementation of community and public health programs for quality healthcare outcome and encompass such skills as effective communication, leadership, compassion, coordination, research and evidence-based practice in care provision (AACN, 2011).

Connect
Cryotherapy: is a form of therapy treatment that involves using freezing temperatures. It is also known as cold therapy, and used to cool body temperature and bring it down at the cellular and tissue level for therapeutic benefits (Song et al., 2016). It is a relatively new concept.

Immunization: often confused vaccination, and sometimes referred to as inoculation. Vaccination involves administering a vaccine (a mild form an infectious agent) in to your body (usually by injection). Immunization is the result of vaccination. The vaccine helps to stimulate the body’s immune system so that the body can recognize the disease and gradually build defenses against the pathogen to protect the body from future infection (Wilder-Smith et al., 2017).

Reflection
This course is an essential course for every MSN-FNP nurse because it forms the core of nursing care. Through this course one gets the opportunity to identify with all MSN Program Outcomes especially PO #4, which requires a nurse practitioner to incorporate scholarship and professional values in healthcare service. This course solidifies the FNP’s clinical experience, which involves developing knowledge and skills that supports provision of quality healthcare outcome through best research and evidence-based care. Achievement of the course leads to attainment of numerous Nurse Practitioner Core Competencies, key among them being competency # 7: Health Delivery System Competencies. This cluster of competencies (#7) refer to the design, planning, and implementation of community and public health programs for quality healthcare outcome and encompass such skills as effective communication, leadership, compassion, coordination, research and evidence-based practice in care provision (AACN, 2011).

References
American Association of Colleges of Nursing (AACN). (2011). Defining Scholarship for the Discipline of Nursing. Retrieved from http://www.aacnnursing.org/News-Information/Position-Statements-White-Papers/Defining-Scholarship.

Curtis, K., Fry, M., Shaban, R. Z., & Considine, J. (2016). Translating research findings to clinical nursing practice. Journal of Clinical Nursing, 26(5-6), 862-872.

Goroll, A., & Mulley, A. (2014). Primary care medicine: Office evaluation and management of the adult patient (7th ed.). China: Wolters Kluwer Health.

Wilder-Smith, A., Longini, I., Zuber, P. L., Bärnighausen, T., Edmunds, W. J., Dean, N., ... & Gessner, B. D. (2017). The public health value of vaccines beyond efficacy: methods, measures and outcomes. BMC medicine, 15(1), 138.

References
American Association of Colleges of Nursing (AACN). (2011). Defining Scholarship for the Discipline of Nursing. Retrieved from http://www.aacnnursing.org/News-Information/Position-Statements-White-Papers/Defining-Scholarship.

Advanced Practice Nursing Fact Sheet | 2017 NurseJournal.org. (2017). Retrieved from http://nursejournal.org/advanced-practice/advanced-practice-nursing-fact-sheet/

About Boards of Nursing | NCSBN. (2017). Retrieved from https://www.ncsbn.org/about-boards-of-nursing.htm

Agrawal, P. (2015). Maternal mortality and morbidity in the United States of America.

Andrus, V. L. (2014). Person-Centered Care: Enhancing Patient (Person) Engagement. Beginnings, 34(1), 18-21.

Berry, S., Kiel, D. P., Schmader, K. E., & Sullivan, D. J. (2017). Falls: Prevention in nursing care facilities and the hospital setting. Uptodate. com.

Boeckxstaens, P., & De Graaf, P. (2011). Primary care and care for older persons: position paper of the European Forum for Primary Care. Quality in primary care, 19(6), 369.

Centers for Disease Control and Prevention. (2017). Childhood Obesity Facts. Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion.

Chamberlain College of Nursing. (2016). Graduate Program Outcomes. Retrieved from http://www.chamberlain.edu

Chamberlain College of Nursing. (2017). Pharmacokinetics, Pharmacodynamics, Art of Pharmacotherapeutics, Reproductive System Medications and Drug-OTC-Herbal Interactions. Week 1 lesson. Retrieved from http://www.chamberlain.edu

Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.

Codina, L. M. T. (2007). Adult nurse practitioner intensive review: Fast facts & practice questions. New York: Springer Pub. Co.

Cummings, J., Soomans, D., O'laughlin, J., Snapp, V., Jodoin, A., Proco, H., ... & Rood, D. (2015). Sensitivity and specificity of a nurse dysphagia screen in stroke patients. MedSurg Nursing, 24(4), 219-224.

Curtis, K., Fry, M., Shaban, R. Z., & Considine, J. (2016). Translating research findings to clinical nursing practice. Journal of Clinical Nursing, 26(5-6), 862-872.

Gorenstein, E. & Comer, R. (2015). Case studies in abnormal psychology. New York, NY: Worth Publishers, a Macmillan Higher Education Company.

Goroll, A., & Mulley, A. (2014). Primary care medicine: Office evaluation and management of the adult patient (7th ed.). China: Wolters Kluwer Health.

Foronda, C. L., Alfes, C. M., Dev, P., Kleinheksel, A. J., Nelson Jr, D. A., O'donnell, J. M., & Samosky, J. T. (2017). Virtually nursing: Emerging technologies in nursing education. Nurse educator, 42(1), 14-17.

Hickey, J. V., & Brosnan, C. A. (2012). Evaluation of health care quality in advanced practice nursing. New York: Springer Pub. Co.American Association of Colleges of Nursing. The Essentials of Masters Education for Nursing (2011). Retrieved from http://www.aacn.nche.edu/education-resources/MastersEssentials11.pdf

Houston Health Department. (2015). HIV Surveillance Program. HIV Infection in Houston: An Epidemiologic Profile 2010-2014. Houston, Texas; 2015.

Kliegman, R. M., Schor, N. F., St Geme III, J. M., & Behrman, R. E. (2016). Nelson Textbook of Pediatrics. Philadelphia: Elsevier.

Lilley, L. L., Shelly Rainforth Collins, P., & Snyder, J. S. (2019). Pharmacology and the nursing process. Mosby.

Lobstein, T., Jackson-Leach, R., Moodie, M. L., Hall, K. D., Gortmaker, S. L., Swinburn, B. A., . . . Mc Pherson, K. (2015). Childhood and adolescent obesity: Part of a bigger picture. The Lancet, 2510-2520.

Maartens, G., Celum, C., & Lewin, S. R. (2014). HIV infection: epidemiology, pathogenesis, treatment, and prevention. The Lancet, 384(9939), 258-271.

Moyer, V. A. (2015). Screening for HIV: US preventive services task force recommendation statement. Annals of internal medicine, 159(1), 51-60.

National Collaborative on Childhood Obesity Research. (2012). Childhood Obesity in the United States. NCCOR.

National Organization of Nurse Practitioner Facilities. (2013). Nurse practitioner population focused competencies. http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/Competencies/CompilationPopFocusComps2013.pdf

Robinson, B. K., & Dearmon, V. (2013). Evidence-based nursing education: Effective use of instructional design and simulated learning environments to enhance knowledge transfer in undergraduate nursing students. Journal of Professional Nursing, 29(4), 203-209. doi: 10.1016/j.profnurs.2012.04.022

Sohi, J., Champagne, M., & Shidler, S. (2015). Improving health care professionals' collaboration to facilitate patient participation in decisions regarding life-prolonging care: An action research project. Journal of Interprofessional Care, 29(5), 409-414.

Tappen, R. M. (2016). Advanced nursing research: From theory to practice. Jones & Bartlett Publishers.

Wilder-Smith, A., Longini, I., Zuber, P. L., Bärnighausen, T., Edmunds, W. J., Dean, N., ... & Gessner, B. D. (2017). The public health value of vaccines beyond efficacy: methods, measures and outcomes. BMC medicine, 15(1), 138.

Zaccagnini, M., & White, K. (2015). The doctor of nursing practice essentials. Jones & Bartlett Learning

Appendix 1: Tabulation of achieved program 0utcome, MSN Essentials and NONPF Competencies
Exemplar# Title

Program outcome

MSN Essentials Met

NONPF Core Competencies Met

Exemplar I: NR503 Population Health, Epidemiology & Statistical Principles

PO #1: Provide high quality, safe, patient-centred care grounded in holistic health principles (Holistic Health & Patient-Cantered Care)

Essential I: Background for Practice from Sciences and Humanities

Scientific Foundation Competencies.

Technology and Information Literacy Competencies

Exemplar II: NR 505 Advance Research Methods Week 3

PO #5: Advocates for positive health outcomes through compassionate, evidence-based, collaborative advanced nursing practice (Extraordinary nursing)

Essential VI: Health Policy and Advocacy

Scientific Foundation Competencies

Policy Competencies

Exemplar III: NR 507 Advanced Pathophysiology

PO #2: Create a caring environment for achieving quality health outcomes (Care-Focused)

PO #4: Integrate professional values through scholarship and service in health care (Professional identity)

Essential VIII: Clinical Prevention and Population Health for Improving Health

Independent Practice Competencies.

Policy Competencies.

Exemplar IV: NR 508 Advanced Pharmacology

PO #5: Advocates for positive health outcomes through compassionate, evidence-based, collaborative advanced nursing practice (Extraordinary nursing)

Essential VII: Interprofessional Collaboration for Improving Patient and

Population Health Outcomes.

Health Delivery Systems Competencies

Exemplar V: NR 509 Advanced Physical Assessments

PO #1: Provide high quality, safe, patient-centered care grounded in holistic health principles (Holistic Health & Patient-Centered Care).

Essential IX: Master’s-Level Nursing Practice

Independent Practice Competencies

Exemplar VI: NR510: Leadership and Role of the Advanced Practice Nurse

PO #3: Engage in lifelong personal and professional growth through reflective practice and appreciation of cultural diversity (Cultural Humility))

Essential IX: Master’s-Level Nursing Practice

Leadership Competencies

Exemplar VII NR 511 Differential Diagnoses and Primary Care

PO #1: Provide high quality, safe, patient-centered care grounded in holistic health principles (Holistic Health & Patient-Centered Care)

Essential V: Informatics and Healthcare Technologies

Essential IX: Master’s-Level Nursing Practice

Quality Competencies

Exemplar VIII: NR 601 Primary Care of the Maturing and Ageing Family

PO #5: Advocates for positive health outcomes through compassionate, evidence-based, collaborative advanced nursing practice (Extraordinary nursing))

Essential VII: Interprofessional Collaboration for Improving Patient and Population Health Outcomes

Ethics Competencies

Exemplar IX: NR 602 Primary Care of the Childbearing and Childbearing Family

PO #1: Provide high quality, safe, patient-centered care grounded in holistic health principles (Holistic Health & Patient-Centered Care)

Essential VII: Interprofessional Collaboration for Improving Patient and Population Health Outcomes.

Ethics Competencies

Exemplar X: NR 602 Advanced Clinical Care and Practice Across the Lifespan of Practinum

PO #4: Integrate professional values through scholarship and service in health care (Professional identity)

Essential III: Quality Improvement and Safety

Essential IV: Translating and Integrating Scholarship into Practice

Health Delivery Systems Competencies