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 Please answer the questions below.

1. What must be included in the result and discussion section of the research assignment?
2. Select a research result and state whether it includes the necessary elements. Why and why not?

Submission Instructions:

• Post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

 Please include a 200 words in two answers to peers 

 

1.The economic and human costs associated with Alzheimer’s disease have prompted various research studies into the matter. A key topic of research and evaluation is the family’s role or obligation in caring for Alzheimer’s patients, especially parents. Such studies need to incorporate ethical considerations as they involve human beings, sensitive and vulnerable medical and care information, and contribute to knowledge development of the matter; thus, they should be done in the right way to improve the credibility and reliability of the information in the research. Ethical considerations are guidelines and principles that guide research and ensure the research process does not violate any human rights or academic regulations.

Martinez et al. (2022) conducted a qualitative study to understand the dynamics of caregiving of patients with Alzheimer’s within the Latino community because of their emphasis on familism. The study conducted interviews as its primary data collection method, which mandated various ethical considerations. Therefore, Martinez et al. obtained approval from their university’s Institutional Review Board, and informed consent was obtained before the interview. In another study to understand the caregiver’s perception of the unmet palliative care needs in Iranian Alzheimer’s patients, Ashrafizadeh et al. (2021) conducted a qualitative study. In this study, the authors mention that they incorporated various ethical considerations, including approval by the respective university’s Ethics committee. Additionally, they incorporated the voluntary nature of participation, obtained informed written consent forms and anonymity of the participants, and informed them of their right to withdraw from the study at any point. Further, they ensured the confidentiality of the information provided by the participants and guaranteed of using the said information for the sole purpose of the research.

In a cross-sectional study that involved fifty formal caregivers and fifty informal caregivers of Alzheimer’s disease patients, Sołtys & Tyburski (2020) sought to understand the predictors of mental health problems among these caregivers. The authors ensured that all surveyed caregivers willingly agreed to participate, and an ethics committee approved the study. Also, participants provided informed consent. Ashrafizadeh et al. (2021) ethical approach was relatively different, as the key ethical considerations were approval and the participant’s rights. This is seen in how the study guaranteed anonymity by providing nicknames for the participants that also assured confidentiality of the information provided. The participants were also assured of the publication of the results. At the same time, the authors obtained both oral and written consent to ensure the participants understood their involvement, including their right to withdraw from the study. Ethical considerations are similar as long as they involve human participants, even through virtual communication. Rodríguez-Mora et al conducted their interviews virtually but also had to seek informed consent and approval, and in this case, ensure no harm came to the participants by upholding the containment measures as the study was conducted during the recent pandemic.

2. Ethical approaches in research studies entail setting principles that help achieve the goal of research designs and practices. The approaches help the researchers to achieve a code of conduct when interacting with people to collect data. The primary goals of any short or comprehensive research entail enhancing the research validity, maintaining scientific or academic integrity, and acknowledging researchers who performed various research earlier. These practices are mainly for the research conducted using printed or recorded data sources.

Human research entails comprehensive ethical considerations, with voluntary participation being one of them. There is no pressure or compulsion used on any research participants to participate. Everyone enrolled in the study can stop at any time without feeling obligated to continue (Newman et al., 2021). Participants cannot be coerced into justifying leaving the study. As a result, it is critical to make it evident to participants that declining to participate will not have any detrimental effects.

Another consideration is whether participants provided informed consent and where the data was collected. The prospective participants should be provided with and comprehend the information necessary for making a participation decision (Newman et al., 2021). This includes information about the study’s advantages, hazards, funding, and institutional endorsement. Participants should be given a text to read and asked if they have any questions before proceeding. They can initial or sign the consent form if they are willing to participate. When working with particularly vulnerable groups of people, remember that this might not be enough to obtain informed consent.

Further confidentiality must be integrated into research by granting all participants the right to privacy. The researchers must protect participants’ data for a long provided they hold it (Horton & Lucassen, 2023). this consideration should be maintained when the data is collected anonymously. Assumptions such as research process grant confidentiality automatically grants confidentiality should not be taken (Horton & Lucassen, 2023). Some research designs are not conducive to confidentiality, but it is essential to make all attempts and inform participants of the risks involved. Therefore, achieving confidentiality should be explicitly planned for and met by the researchers.

In conclusion, ethical approaches to conducting research should entail observing a code of conduct that enhances research validity when collecting, storing, and interpreting data. Academic integrity should be considered when dealing with records. In human research, participants should be allowed to provide data voluntarily. They should be informed of the research details before being subjected to the research participation. Confidentiality of personal information should be significantly upheld even when research designs do not appear to favor confidentiality. Thus, researchers must ensure that research validity is enhanced by taking the ideal measures of research ethics.

Respond to what he wrote, be argumentative with the answers, and polite. References, and at least 2 paragraphs.

 

 

In the last decade, there have been a lot of changes to the model of practice of advanced practice registered nurses (APRNs) in Northern America. During the pandemic, legislative changes enabled nurse practitioners (NPs) in some states to act in the role of medical doctors, thereby empowering them to work to their full scope of practice. This has resulted in a higher quality of care, decreased hospitalization rates, improved access to care, and the creation of an improved working environment for direct care providers (McGilton et al., 2023). For the purpose of this discussion post, the practice agreements, process of certification and licensure as an APRN in North Carolina, the scope of practice of nurse practitioners, how to get Drug Enforcement Administration (DEA) license, and controlled substance prescriptive authority for NPs will be summarized. Also, the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in North Carolina will be explained.

Summary of Findings

Certain criteria need to be met before an individual can be licensed as an Advanced Practice Registered Nurse (APRN) in the state of North Carolina. A lot of information on certification and licensure can be found on 
www.ncbon.com
Links to an external site.
, which is the North Carolina Board of Nursing (NCBON) website. One must hold a North Carolina Registered Nurse license or a compact state license that is valid to practice in North Carolina. A master’s or higher degree in nursing must be completed. Additionally, a national certification as a nurse practitioner must be obtained from one of the nationally accredited credentialling bodies, and a registration with the North Carolina Controlled Substance Reporting System (CSRS) is required for those that have prescriptive authority for controlled substances. The North Carolina CSRS exists through the North Carolina Department of Health and Human Services to collect information on dispensed controlled substance prescriptions and make this information available to prescribers and dispensers (North Carolina Department of Health and Human Services, n.d.).

The scope of practice of an APRN in North Carolina required being educationally prepared, nationally certified, and maintenance of competence. The APRN is required to promote and maintain health; prevent illness and disability; diagnose, treat, and manage acute and chronic illnesses; guide and counsel individuals and their families; prescribe, administer, and dispense therapeutic measures, tests, procedures, and drugs; plan for situations beyond the nurse practitioner's scope of practice and expertise by consulting with and referring to other health care providers as appropriate; and evaluate health outcomes (Office of Administrative Hearing, 2019). According to the North Carolina Board of Nursing (2022), nurse practitioners have the approval to prescribe legend drugs and Controlled Substance Schedules II – V, which is consistent with the scope of practice determined by their educational preparation and national certification. Professionals who prescribe controlled substances must fully comply with both North Carolina’s state and federal rules and regulations. A nurse practitioner who administers, dispenses, or prescribes any controlled substance, must be registered with the federal Drug Enforcement Administration (DEA). In North Carolina, this process requires applying for DEA registration, paying the required fees, completing, and submitting DEA for 106.

In North Carolina, an APRN requires a collaborative practice agreement with a licensed physician. Therefore, upon completing an advanced degree and obtaining licensure, an APRN needs to apply for an ‘Initial Approval to Practice’. What this application entails is an active North Carolina Registered Nurse license; the physician’s name, their license number, or email address; and the practice information. After all these have been submitted and approved, the APRN can begin practicing in North Carolina (North Carolina Board of Nursing, n.d.).

Types of Regulations that Exist and the Barriers that May Impact Nurse Practitioner Independent Practice

From the research findings, there are regulations, and some barriers exist that may impact nurse practitioner independent practice in North Carolina. For instance, the scope of practice laws defines the activities and responsibilities that healthcare professionals are allowed to engage in. In North Carolina, there is a need for physician oversight, and there is a need for physician collaboration. Also, we are required to have collaborative practice agreements with physicians. Collaborative Practice Agreement (CPA) is an agreement between the nurse practitioner (NP) and the primary supervising physician addressing how the NP operates the administrative code or rules in their practice (North Carolina Board of Nursing, 2023). These agreements outline the relationship and level of collaboration between the nurse practitioner and the physician. Components that are included in the collaborative practice agreement are the drugs, devices, medical treatments, tests, and procedures that may be prescribed, ordered, and performed by the nurse practitioner. Additionally, prescriptive authority is part of the nurse practitioner approval to practice. A nurse practitioner may prescribe controlled substances; however, the supervising physician must have a DEA registration equal to or greater than the DEA registration of the nurse practitioner that he or she supervises. Finally, regulatory bodies exist to set regulations for APRNs. These boards can influence the level of autonomy nurse practitioners have in their practice in North Carolina.

Some of these regulations pose a major barrier that may impact the nurse practitioner’s ability to practice independently. To begin with, the scope of practice restrictions can be very challenging because it limits the ability to provide care independently. Also, due to the collaborative practice agreements that are needed from a physician, we experience a lot of opposition from physician associations and groups. They cite that they have concerns about patient safety and the need for the role of physicians in the health care team. To add to these barriers, there are challenges as to how the public perceives the role and capabilities of nurse practitioners. Patient and public understanding of the role and capabilities of nurse practitioners can influence the acceptance of independent practice. Educating the public about the training and expertise of nurse practitioners is very crucial for acceptance. Nurse practitioners may also face challenges in being recognized by insurance providers and receiving reimbursement for their services at the same rate as physicians. According to Barnes et al. (2017), in a lot of states, nurse practitioners are reimbursed less than the physician rate, varying from 75% to 100% of physician rates. A lot of legislative processes are ongoing to have nurse practitioners receive 100% reimbursement from Medicare. Currently, reimbursement is only provided at about 85% of the physician rate in most states (Bischof & Greenberg, 2021).

All this information did not come as a surprise to me because during this program, we have been required to carry out research findings on related issues. This has enlightened me to the state regulations for the scope of practice of nurse practitioners in my state. I have educated myself on these requirements and learned a lot from my preceptors and senior colleagues in the field of psychiatric mental health. I believe that I am well prepared for all these upon completion of my degree.

Conclusion

The United States is experiencing shortages of primary care providers, and NPs offer the potential to moderate these shortages (Barnes et al., 2017). As advanced practice registered nurses, it is important to stay updated with the latest regulations and developments in our individual states regarding nurse practitioner practice. It is therefore advisable to consult the state Board of Nursing and other relevant authorities for the most current and accurate information for legal practice.

References

Barnes, H., Maier, C. B., Sarik, D. A., Germack, H. D., Aiken, L. H., & McHugh, M. D. (2017). Effects of regulation and payment policies on nurse practitioners’ clinical practices. Medical Care Research and Review, 74(4), 431–451. 
https://doi.org/10.1177/1077558716649109
Links to an external site.

Bischof, A., & Greenberg, S. A. (2021). Post COVID-19 reimbursement parity for nurse practitioners. Online Journal of Issues in Nursing, 26(2). 
https://doi.org/10.3912/ojin.vol26no02man03
Links to an external site.

McGilton, K. S., Haslam-Larmer, L., Wills, A., Krassikova, A., Babineau, J., Robert, B., Heer, C., McAiney, C., Dobell, G., Bethell, J., Kay, K., Keatings, M., Kaasalainen, S., Feldman, S., Sidani, S., & Martin-Misener, R. (2023). Nurse practitioner/physician collaborative models of care: a scoping review protocol. BMC Geriatrics, 23(1). 
https://doi.org/10.1186/s12877-023-03798-1
Links to an external site.

the North Carolina Board of Nursing. (2022). Prescribing. Retrieved August 29, 2023, from https://www.ncbon.com/practice-nurse-practitioner-prescribing#:~:text=Nurse%20Practitioner%20approval%20includes%20prescriptive,educational%20preparation%20and%20national%20certification.

North Carolina Board of Nursing. (2023). Collaborative practice guidelines. Retrieved August 29, 2023 from https://www.ncbon.com/practice-nurse-practitioner-collaborative-practice-guidelines#:~:text=Required%20components%20of%20the%20CPA,performed%20by%20the%20nurse%20practitioner.

North Carolina Board of Nursing. (n.d.). Advanced practice registered nurse. Retrieved August 27, 2023, from 
Advanced Practice Registered Nurse | North Carolina Board of Nursing (ncbon.com)
Links to an external site.

North Carolina Department of Health and Human Services. (n.d.). NC Controlled Substances Reporting System. Retrieved August 29, 2023, from https://www.ncdhhs.gov/divisions/mental-health-developmental-disabilities-and-substance-use-services/north-carolina-drug-control-unit/nc-controlled-substances-reporting-system

Office of Administrative Hearing. (2019). Scope of practice. Retrieved August 27, 2023, from 
http://reports.oah.state.nc.us/ncac/title%2021%20-%20occupational%20licensing%20boards%20and%20commissions/chapter%2036%20-%20nursing/21%20ncac%2036%20.0802.html
Links to an external site.