Medicolegal Considerations

Week 1 discussion

Discussion Part I: Medicolegal Considerations

Note: In this course, all Discussions will have two parts:

Part I will consist of a specific topic related to the Week’s content.

Part II will consist of a pharmacology review of approximately 250 words. Please submit each posting separately but within the same Discussion thread.

You will be assessed on your posting and responses to both parts.

As an advanced practice nurse (APN), it is essential to understand your medicolegal responsibilities as they relate to coding the services you provide to patients. Improper coding, undercoding, or overcoding can have serious implications for patients, providers, and the provider’s care setting. For this Discussion, you examine potential coding issues in case studies and consider the medicolegal responsibilities of the advanced practice nurse.

Case Study 1:

Sally Jones, an acute care advanced practice nurse, is making hospital rounds on the same patients her colleague nurse practitioner saw yesterday. Sally had five history and physicals to complete on admissions that came in overnight. At the beginning of her shift, she had to complete two emergency admissions and was then called to intensive care, where she spent most of the afternoon. She had to leave work early because of her husband’s retirement party. Because she knew most of the patients on her rounding list, she decided to visit each patient’s room quickly for about 10 minutes. She coded all of the visits the same way she had done the day before, with codes 99231 and 99232.

Case Study 2:

Lisa Smith, an acute care advanced practice nurse, is making hospital rounds on the same patients her colleague nurse practitioner saw yesterday. It took her 50 minutes to see 10 of her patients and 30 minutes to see each of the remaining patients on her list. She used the same code for all visits—99233.

To prepare:

Select one of the provided case studies.

Review the patient documentation given for the case. Think about medicolegal considerations and the responsibilities of the advanced practice nurse.

Consider the medical codes selected by the advanced practice nurse. Reflect on how the selections might impact clinical practice and billing. Think about how the impact might differ from primary to acute care settings.

Post on or before Day 3 a brief description of the patient documentation given for the case study you selected. Explain any medicolegal considerations, including the role and responsibilities of the advanced practice nurse. Then, explain how medical coding might impact clinical practice and billing, as well as how implications might differ from primary to acute care settings.

Read a selection of your colleagues’ responses.

Respond on or before Day 6 to at least two of your colleagues on two different days who selected a different case study than you. Share additional insights or alternative perspectives.

Discussion Part II: Pharmacology

Read the following articles to enhance your knowledge on commonly prescribed medications:

River-Bou, W. & Brown, D. (2014). Thrombolytic Therapy. Retrieved from http://emedicine.medscape.com/article/811234-overview

Thrombolytics are used for AMI, DVT, acute peripheral arterial occlusion, occlusion of indwelling catheters, pulmonary embolism, and stroke.

All of the following groups of medications are commonly prescribed in the acute care setting. Choose one of the topics below to discuss. If it is a medication group, select a specific drug within that group. (This is a good way to prepare for clinical practice, because you will get to know the drugs you will prescribe for patients.). Focus your discussion on the hospital or ICU setting and IV usage.

Activase

Retavase

Urokinase

Streptokinase

TNKase

Anistreplase.

Note: When sharing your initial post, select a topic that has not yet been discussed. If all topics have been discussed, then you may select that topic again, but select a different drug within the medication group.

For this Discussion, address 1 of the following options. Post by day 3:

Option 1: Post a description of a patient you have taken care of (inpatient as an RN, or as an NP student) who has been prescribed the medication you selected. Include the scenario, indication, dosing, complications, and outcome. Then explain whether or not you would have ordered the same drug and same dose.

Option 2: Conduct an evidence-based drug search on the drug you selected and post an explanation of any possible issues. Are there any drug interactions? Any black box warnings? To what type of patient would you prescribe this medication?

Option 3: Post an explanation of the properties of the drug you selected, including usages and dosing in the hospital or ICU. Describe a patient to whom you would prescribe this medication.

Note: To be considered as one of your required responses, your pharmacology rationale must include a supporting reference.

Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

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