Appendix A Course Signature Assignment NP PRACTICE PLAN

Date Completed:

Are you a BSN/PM/Post-Doc student?

Justification

Include population foci and role; does it match the Musco School of Nursing’s?

State your ideal vision for practice to include your population, mission, vision and scope of practice within your ideals.  Discuss if you will have an independent practice (if allowed in your state) or with a group, etc.

Begin with your first year after graduation or specialty completion.

Include:

What type of Community do you want to serve:

·       Describe community of practice setting e.g.; rural, suburban, urban, poverty level, population mix, crime statistics etc.

·       Place here whatever defines the needs of your practice and what you must do to be prepared to meet the community needs through this practice.

Identify the certifying body and requirements (including costs) to sit for the exam.  If there is more than one option, please identify them both and talk about which one you will take and why.

Also provide the link to the application website(s)’ url(s).

Identify your State Board of Nursing (or the state that you intend to practice in) requirements (including costs) for application for advance practice licensure or to add an additional specialty.

Include any special considerations for prescriptive authority (e.g., the CA BRN requires that each applicant take a Schedule II medication course) and how you will meet those requirements (e.g., CANP provides a CA BRN approved course included in their membership fee).

Include any other State Requirements for practice:

(e.g.; Practice Protocol, Collaborative Practice Contract and provide an example of these.

Also provide the link to the application website(s)’ url(s).

Provide a summary of the federal application requirements (including costs) for each of the following as needed in your practice:

·        National Provider Identifier (NPI)

·        Prescribing Authority: Drug Enforcement Agency (DEA) and Controlled

·        Dangerous Substance (CDS) numbers.

·        MAT identifier

Also provide the link to the application website(s)’ urls.

Outline requirements and where to obtain coverage:

A)   General:

·        Professional liability

·        Health/Life Insurance

·        Umbrella policy

·        “Tail” insurance

B)    Individual Malpractice Insurance:

·        Additional coverage for self

Also provide the insurance companies’ website(s)’ urls.

List possible opportunities in your selected region or city, state appropriate to specialty, degree, role, locale etc.

Also provide the job search website(s)’ urls

If you have identified where you want to practice, consider your personal and professional practice needs and if the selected environment supports your practice and security for the following:

•   Safety, lit parking lots, escorts if needed, security

·     Is it organized?

·      Clean rest rooms, access to meals/meal prep, conference rooms, play area for children, exam rooms, waiting area, laboratory, utility room, offices, storage, and quiet room.

•   Will you need to take call?

•   How flexible are they with your work schedule and hours?

·     How flexible are they with vacation, sick leave, maternity leave

•   Do you have to supply your own coverage if you are out?

•   Who makes those decisions?  Is it an office manager? Medical director? Supervising physician?

·     Other?

Consider these aspects of initial career launch. e.g.;

·        Is a relocation or separate apartment needed?

·        What are the projected costs in time and resources (“ball parking” this set of costs is sufficient)

•   Identify what you feel must be measured to practice safely

•   Does the practice manage QA in a manner agreeable to your philosophy?

·     Consultants (lawyer, etc. if starting a private practice)

•  Skills needed to document to apply for hospital privileges

•  Additional certifications, training or education needed for owning your own practice and understanding the billing

·     Additional staffing needs (receptionist, billing specialist, other providers, etc.)

•  Will you need to speak a foreign language or have a translator for your desired position

Create a list reflecting local to broader contacts which may include the following:

·       Local list-serves of specialty referral sources

·       Local List for consultation contacts – who will you call for advice?

·       Local organizations of specialty/role

·       Major and essential professional organizations/ membership in specialty

·       Membership fees/benefits

Also provide specialty and organization website(s)’ urls

Provide url’s for at least one national and one local organization

State what you will require in your practice (self /private or group:

Software, such as :

•   Billing software/printer

•   EHR; compatible with Medicare/Medicaid systems

•   E-Prescribing

•   Data entry forms

•   HIPAA compliance programs

•   Email/patient and referral options

•   Transcription services

•   Apps for your mobile device such as Guidelines for your practice

·        Other

Hardware, such as:

·        Desktop computers or

·        iPad or other mobile device

·        On-line printer

·        Credit card Processor

·        Other

Review current or practice needs and forms essential to practice. Ask if these are present, if not, be ready to locate/create forms, state where they are found or retrieved to provide structure and continuity to encounters (e.g., a PMHNP will need a template for a Diagnostic Evaluation on hand, AIMS and other scales, etc.)

Other forms (per eChart or paper):

•   Intake (name, address, telephone, insurance company, phone number, birth date etc.)

•   History & Physical

•   Evaluation/consultation

•   Tracking of healthcare maintenance/screening

•   Patient Instructions forms

•   Common screening forms

•   CHDP or other routine physical form templates

•   Other

Create a list identifying texts, books and on-line, virtual resources that are indispensable for your specialty and any other “must have” materials needed nearby for day to day practice.  Are they available to you?

·        ePocrates

·        NEI app

·        Up-to-Date

·        DSM-V

·        Professional library access

·        Other per specialty

Inquire:

•   Does position or your practice require/support evidence-based research? Do you plan to include this in practice?

•   Is there access to a medical library for references?

·     Provide at least 3 website(s)’ urls for medication costs (e.g., Costco, Target, Walmart, Good Rx) for cost comparison for commonly used drugs

State your plan for annual updating of your skills (e.g., consult specific evidence-based texts, attendance at a minimum, one conference annually in addition to state Board of Nursing continuing education (CEU) mandated or other procedure protocols (if any).

·       What conferences will you attend (costs)

·       What journals will you subscribe to (costs)?

Also provide conference and journal website(s)’ urls

•   Outline your plan to remain current, compliant and engaged in emerging legislative policies, actions, and debates impacting practice

•   Identify the state representatives that are responsible for

your physical practice area and give their contact

Information – addresses, phone numbers

·        List any current legislative issue that may impact your current of near future practice as an APRN

Also provide legislative website(s)’ urls for at least one national nursing organization’s PAC page and the information pages for your representative(s)

·       Provide three first year of practice goals in a desired action plan with timeline of completion as identified above (e.g., date of program completion, date for passing national certification exam, date for completion of APRN licensure in your practice state, etc.)

·       Identify required professional and personal “life” changes that include projected cost(s)

·       How will you sell yourself to a new employer – create a personal cover letter in writing for employers, insurance companies, other providers for marketing purposes

4

3

2

1

0

35 points

(140/300)

logical justification for not applicable

Resources/

Website url(s)

20 points (80/300)

20 points

(80/300)