Mary L. Chesney

Reimbursement realities of advanced nursing practice

Abstract Rising costs of health care require advanced practice nurses to be cost-effective and knowledgeable regarding reimbursement of their services within rapidly expanding managed care organizations. However, the rapid pace of change in reimbursement legislation, policies, and procedures makes this a daunting task.

Hepatitis A Screening for Internationally Adopted Children From Hepatitis A Endemic Countries

Screening for hepatitis A virus (HAV) infection is not currently routinely recommended in internationally adopted children. International adoptees seen at the University of Minnesota International Adoption Clinic from 2006 to 2010 were assessed for acute HAV infection (positive HAV immunoglobulin M). Thirty of the 656 children screened (4.6%) were acutely HAV infected. HAV-infected children emigrated from Ethiopia (16), Guatemala (4), China (2), Colombia (2), Haiti (2), Philippines (2), Liberia (1), and Nepal (1). Infection was most frequent among children younger than 2 years (6.7%). No symptoms distinguished children with acute HAV infection from uninfected children. HAV infection caused significant social disruption, including separation of children from their ill adoptive parents during the initial weeks postarrival, a period important for postadoption adjustment and attachment. All international adoptees arriving from countries with high or intermediate HAV endemicity should be screened for HAV infection on arrival to the United States.

Family-centered Health Care/Medical Home: APN Roles in Shaping New Care Models

www.jpedhc.org The Patient Protection and Affordable Care Act (PPACA) of 2010 is the legislation that created the foundation for reformof theU.S. health care system.The legislation established and funds diverse policies and projects to realign the financial incentives in the current health care insurance market. It encourages efficiency and quality and directs funds toward prevention and population health. Many regulations and rules from the legislation are currently being formulated to translate the law’s provisions into actual changes in health care practices and processes (Table 1). The law includes much for advanced practice nurses (APNs) to celebrate, such as funding for nursemanaged centers and increased nurse education loans and grants. Care innovations, a provision in the health care reform legislation, have significant potential for enhancing APN practice even though physician-exclusive language in the legislation resulted in nurse practitioners (NPs) not being fully included in key provisions of the care innovations reforms. This article focuses on one of the care innovations strongly supported in the PPACA, the health care/medical home. It provides background on the health care/medical home model, the importance of family-focused caremodels, and suggestions for possible partnership for APNs to forge with family advocacy groups to improve access and quality and to strengthen the position of NPs in the newmodels of health care delivery.

APRN Consensus Model Implementation: The Minnesota Experience

In 2015, more than 16 years of strategic work resulted in the removal of statutory barriers to Minnesota advanced practice registered nurse (APRN) practice. Keys to the passage of the legislation were the creation of a formal infrastructure (Minnesota APRN Coalition) to manage financial and communication strategies, cohesion among all four roles of APRNs, engagement of strong legislative authors and bipartisan support, and valuable partnerships among the coalition and external stakeholders, such as the Minnesota Board of Nursing. The rapid implementation of the law presented the board with distinct challenges. The purpose of this article is to present the experience of implementing the 2008 APRN Consensus Model to assist other states.

Differentiating Our Brand Highlights Our Value

The era of health care reform offers many possibilities for transforming our health care system and improving the health and well-being of our nation’s children. As noted in the report The Future of Nursing: Leading Change, Advancing Health by the Institute of Medicine (IOM, 2010), the nursing profession must lead the way if we are to transform the U.S. health care system. Nurses have expertise in advancing the health of populations, enhancing patients’ health care experiences, and controlling costs. Often the type of health care needed by people is actually advanced nursing care, not medical care. For this reason, one of the key messages of the IOM report is that nurses should be equal partners with physicians and others in the redesign of American health care. Sadly, I still see far too few pediatric nurse practitioners (PNPs) and other pediatric advanced practice nurses (APNs) in the boardrooms of children’s hospitals, clinics, health systems, and governmental agencies. As I begin my term as NAPNAP’s president, I take seri-