Question 1

Which element would be important to address to promote professional ambulatory practice?&#10;A)Emphasizing nursing's contribution to the practice&#10;B)Having leaders who stress rules and tasks&#10;C)Using a practice model from outside the organization&#10;D)Employing a hierarchical decision-making framework

Accepted Answer

The infrastructures that support professional ambulatory nursing practice include the professional practice environment (PPE) guided by a Professional Practice Model (PPM) and shared governance along with the reinforcement of ambulatory nursing practice by the Ambulatory Medical Record (AMR) and professional development including the role of nurse residencies. A professional practice environment is promoted through the use of transformational leaders, not leaders who lead from a transactional framework of emphasizing rules and tasks. A PPM should be developed from within the organization. Professional nursing governance is key and reflects a nonhierarchical framework for decision-making and nursing practice.

Question 2

An ambulatory care setting is implementing a professional practice model (PPM). When describing this model to the nursing staff, which information would the nurse manager include as being addressed? Select all that apply.

A)View of how nursing is practiced
B)Contributions of other clinicians to individual care
C)Nurse relationship to populations served
D)Relationships within the organization
E)Nursing and organizational leadership

View of how nursing is practiced
Contributions of other clinicians to individual care
Relationships within the organization
Nursing and organizational leadership

Accepted Answer

A PPM is a structure that describes the contributions of nursing practice within a specific organization or practice area. The structure most often describes the context of the nurse relationship to the individual, to their own practice, to the roles of other clinicians in contributing to the individual care plan, and to the organization. Most practice models are based on a theory and are designed to evolve as an essential description of how nursing is practiced and individual care provided, the nursing and organizational relationships, and the organizational concepts. The model also grounds and aligns nurses with the purpose they serve.

Question 3

An ambulatory care nurse works in an ambulatory care setting that employs professional governance. The nurse would likely demonstrate which characteristic to promote the success of this concept? Select all that apply.

A)Accountability
B)Professional obligation
C)Discipline-specific knowledge
D)Decision-making
E)Individual relationships

Accountability
Professional obligation
Discipline-specific knowledge
Decision-making

Accepted Answer

Professional governance builds on the conceptual foundation of shared governance and is characterized by the attributes of accountability, professional obligation, collateral relationships, and decision-making. All members collaterally participate with the expectation that all are clear about the role, contribution, and value that each brings. The disciplines must specifically define their roles, relationships, and distinct contributions as part of an aggregated professional team. Individuals must demonstrate this professional status behaviorally through the discipline-specific ownership of practice, quality, competence, and management of the requisite knowledge of nursing.

Question 4

A nurse, who previously worked in an acute care setting, is being oriented to an ambulatory care setting. As part of the orientation, the nurse manager is explaining the Ambulatory Medical Record (AMR) used in this setting and how it compares to the electronic medical record (EMR) the nurse has been using in acute care. The nurse manager determines that the explanation has been successful based on which statement by the nurse?

A)"The AMR and EMR are basically the same documentation method."
B)"The AMR lacks information about care outside the acute care setting."
C)"Clinical as well as nonclinical staff can make entries into the AMR."
D)"The AMR is a standard format regardless of the type of ambulatory setting."

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Accepted Answer

The differences between EMRs and AMRs relate not just to the volume of information they contain but the number of clinicians who contribute to the record and the workflows that support information as well. In acute care settings, physicians and nurses dominate the provider and clinician types that add data to EMRs. While they also make entries onto AMRs, several additional types of clinical staff, including medical assistants, LPNs, and Advanced Practice Providers, as well as nonclinical staff update AMRs. Unlike EMRs, the AMR captures information about care given in nonhospital settings such as urgent care clinics, physicians' offices, and telephonic or in-home care. Another major difference between an EMR and an AMR focuses on location-specific workflows-that is, the way information moves through the type of setting where individual care is delivered.

Question 5

An advanced practice nurse working in an ambulatory care setting is conducting a presentation for a group of ambulatory care nurses in the community. When describing the concept of a professional practice environment, which element would the nurse identify as key?

A)Organizational structure expertise
B)Flexibility with the organization
C)High-level leadership skills
D)Ongoing professional development

Accepted Answer

Although knowledge of organizational structure, flexibility, and leadership can contribute to a professional practice environment, a key structural element of a professional practice environment is professional development. Within ambulatory care settings, the practice model relies on nurses to function at the top of their licensure for delivery of cost-effective, high-quality healthcare. In order for nurses to maintain evidence-based practice and prepare for expanded roles, ongoing professional development is key.

Deck 12: Ambulatory Nursing Practice: Support and Infrastructures