Apr 29, | Health Medical
Add and comment to these two posts with journal article reference
Each post with 200 words
Post One:
What is the goal of the CMS Emergency Preparedness Rule?
The goal of the CMS Emergency Preparedness Rule is to establish baseline consistencies for preparedness, response, and recovery of manmade and natural disasters which allows for better coordination with federal, state, tribal, regional, and local emergency preparedness systems. The rule addresses four core elements: Risk Assessment and Emergency Planning, Communication Plan, Polices and Procedures and Training and Testing.
How does it impact you as a healthcare emergency manager?
Prior to this November 2017, there was not a hard fast rule, but recommendations and best practices. A huge impact of this rule is job opportunities. Many facilities have safety officer rolls, but few, even today, have emergency preparedness officers. (And many try to combine the responsibilities of safety and compliance with emergency preparedness.) The shift from best practice to require also increases responsibilities, especially around documentation of plans, procedures, and drills.
How does the Emergency Preparedness Rule strengthen community emergency preparedness?
Increased coordination between local, state, tribal, and federal emergency preparedness agencies greatly strengthens community emergency preparedness. By requiring compliance, emergency managers and healthcare facilities are forced to reach out to their local partners in order to create plans, policies, procedures and drills. Additionally, the burden of preparedness, response and recovery is shared amongst the communities thus increasing the strength and durability of the response.
What other credentialing/regulatory agencies influence healthcare emergency management? How?
The Joint Commission (TJC), another regulatory agency, also impacts healthcare emergency management. For example, there are 21 specific performance elements related to hospitals including COOP, documentation requirements, and annual training requirements.
Cascardo, D. (2017). Preparing to Meet the New CMS Emergency Preparedness Rule (pp. 301-303, Rep.). New York: Greenbra;nch Publishing LLC.
CMS Emergency Preparedness Rule: What You Need to Know Now. (2018, October 19). Retrieved fromhttps://www.liveprocess.com/blog-cms-emergency-preparedness-regulations-what-you-need-to-know
Joint commission issues updated emergency management requirements for hospital, ambulatory, home health, hospice settings. (2017, ). Targeted News Service.
News briefs. (2018). AORN Journal, 107(1), P5-P6. doi:10.1002/aorn.12027
Post Two :
The goal of the CMS Emergency preparedness rule
This 190-page rule that was issued on September 2016 was meant for Medicare and Medicaid Partaking Providers and Suppliers, and it generally seeks to establish consistent national standards to be followed in emergency preparation and mitigation (Federal Register, 2016). Through this rule, Medicare and Medicaid providers are supposed to adhere to set guidelines in order to ensure the improvement of patient safety at the period when natural, and man-made disasters strike. In order for this to happen, stakeholders including hospitals and other health care organizations are proposed to implement assessment and planning for risks, ensure proper communication plans are in place, guarantee compliance with relevant policies and laws and conduct training and testing (CMS.gov, 2019).
How rule affects me as a healthcare emergency manager
As a healthcare emergency manager, this rule provides me with the tools to be an effective responder to emergency situations by informing me of the right preparation strategies. It also helps to provide a guideline on what standards are expected to be met in emergency response, and this provides a clear picture of what resources and capabilities I should advocate for to aid in preparation for emergencies. I will be expected to document most of the activities conducted during emergency drills and exercises, policies and risk assessments and be part of the development of new training programs.
How the Emergency Preparedness Rule strengthens community emergency preparedness
The framework is an advocate of targeted training exercises aimed at simulation of real emergency situations at the community level and then prioritizing and availing financial and related resources necessary to mitigate the risks presented by such emergencies. It also calls for partnerships between the relevant agencies in ensuring the strengthening of integrated initiatives and action towards emergency preparedness which spreads the cost of such efforts among the different agencies involved as opposed to one (Abdalla & Esmail, 2018).
What other credentialing/regulatory agencies influence healthcare emergency management? How?
Health care emergency management has been the forte of several regulatory and accreditation organizations and one of the major one is the Joint Commission which has established standards for evaluation, assessment, and improvement of performance in this area. This includes the six critical areas of emergency management, including staff responsibilities, communication, resources and assets, utility management, safety and security, patient clinical and support and staff responsibilities which articulate what procedures and policies to prioritize and follow during a disaster (Rose, Murthy, Brooks, & Bryant, 2017). The National Committee for Quality Assurance (NCQA) is also another major accreditation agency that aims to harmonize the process of emergency preparedness and management through partnerships with policymakers and health care stakeholders through establishing evidence-based programs, standards and measures in compliance auditing and vendor and software certification (Abdalla & Esmail, 2018). Others include the Healthcare Quality Association on Accreditation (HQAA), Accreditation Commission for Healthcare (ACHC) and Utilization Review Accreditation Commission (URAC) among many more. With the CMS Emergency Preparedness rule in force, these agencies will have to incorporate its detailed requirements into their standards, thus improving emergency preparedness and management in health care within the country.
References,
Abdalla, R., & Esmail, M. (2018). WebGIS for Disaster Management and Emergency Response. Basingstoke, England: Springer.
CMS.gov. (2019, February 6). Emergency Preparedness Rule – Centers for Medicare & Medicaid Services. Retrieved from https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertEmergPrep/Emergency-Prep-Rule.html
Federal Register. (2016, September 16). Medicare and Medicaid Programs; Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers. Retrieved from https://www.federalregister.gov/documents/2016/09/16/2016-21404/medicare-and-medicaid-programs-emergency-preparedness-requirements-for-medicare-and-medicaid
Rose, D. A., Murthy, S., Brooks, J., & Bryant, J. (2017). The Evolution of Public Health Emergency Management as a Field of Practice. American Journal of Public Health, 107(S2), S126-S133. doi:10.2105/ajph.2017.303947
Apr 29, | Health Medical
I need this ppt revise to make it visually appealing with picture as vision aide for the various APN role for the audience . See professor feedback below. Please review the PPT Presentation template and revise it. However, you are on the right track. Recommendations for your group: 1. only bullet points are in the slides with citations. 2. include visual illustrations in your audience to capture the audience. The ppt is attached
Amanda Batista
Anderson Taylor
Janna Gambino-Cataldo
Perry David
Sandra Chapman
Health promotion
Core Competencies
Role of the Advance Practice Nurse
South University
Tracey Swanson
January 30, 2019
❑ “TFL is characterized by the ability to stimulate, inspire, and motivate followers.
Transformational leaders focus on building relationships with people and creating
change by emphasizing values. Most TLF literature in nursing focuses on clinical
practice with very little representation from academic nursing leadership” (Giddens,
2017).
❑ This quote applies to our category of Health Promotion by inspiring and motivating
followers. It is imperative to communicate effectively and build trusting relationships
to inspire change in others. In our journey to pursue an Advanced Nursing Practice
degree there is a focus on Transformational Leadership as evidenced by this very
project.
INTRODUCTION
➢ Metabolic Syndrome is a major health
concern
➢ We present what it takes as an NP to
organize a Health Fair that will address
health promotion
➢ The specific health problem is specifically
Diabetes Mellitus (DM)
➢ AP roles, core competencies, and support
are highlighted and explained
INTRODUCTION
❖ Explain the meaning of health, health promotion, and
the concepts involved in attaining a healthy lifestyle.
❖ Discuss the purpose of health and wellness.
❖ List health promotion goals.
❖ Processes for changing health behavior.
❖ Discuss major activities for health promotion.
❖ Identify the consideration of the nurse who is involved
in health promotion.
SEVEN CORE COMPETENCIES
❑Evidence based Practice
o Critically analyzing data and evidence
o Integrating knowledge from sciences and
humanities
❑Leadership Competencies:
o Allows assumptions on complex as well as
advanced leadership roles
o To both initiate and guide changes
o Allows leadership to adoptive collaboration with
various stakeholders
CORE COMPETENCIES
❑ Direct Clinical practice Competencies:
o Allows the utilization of the best available evidence to
uninterruptedly improve the quality of AP’s clinical
practices.
o Facilitate the evaluation of the relationships among
factors like access, cost, quality, and safety
❑ Consultation Competencies:
o Allows the provision of leadership in translating new
knowledge and putting it to practice.
o Help generate knowledge in clinical practice to advance
practice as well as patient outcomes.
CORE COMPETENCIES
❑ Collaboration Competencies:
o Facilitate teambuilding in clinical practice
o Reliance on each other when handling projects.
❑ Ethical Decision-Making Competencies:
o Demonstrate knowledge of the relationship between policy and
practice
o Advocate for ethical policies, which promote quality, access,
equity, and cost.
❑ Guidance and Coaching Competencies:
o Apply knowledge of organizational practices as well as
complex systems in the improvement of health care delivery.
o Effect health care change through broad based guidance skills.
ROLE OF NURSE MANAGERS
▪ Evaluates staff nurses
▪ They provide feedback and mentoring
programs
▪ They develop educational programs
▪ They also contribute to the professional
development of staff
▪ They interview and hire nurses
▪ They develop departmental budgets
CONTINUATION
▪ A nurse manager is involved in patient
care indirectly and directly.
▪ Role: staff support
▪ Role: administrative liaison
▪ Role: guideline or policy adherence
CORE COMPETENCIES CONTINUES
▪ Guida nce & Coa ching : Guidance can apply to team members
during consultation or it can apply to patient education delivery.
As a nurse manager they would guide their employees to make
the correct choices and take the correct action. Then they
would coach them through doing just that in the future
▪ Consulta tion: This requires understanding the patient’s needs,
your own scope of practice, and community or facility
resources. The nurse manager applies this same principal to the
team. When the team is in need of different things the nurse
manager can consult bringing in different people to increase
their environment.
CORE COMPETENCIES CONTINUES
▪ E B P : This keeps treatment regimes, procedures and
policies to be the most forward thinking based on
research (Hamric, 2014). A nurse manager can
constantly stay up to date with evidenced base
practice to set the standards for the unit and to help
administration keep their policies up to date with the
newest research.
▪ L ea dership: Teams are only as good as their leader.
In healthcare everyone is a team looking to make a
difference. Nurse managers shape and lead their
teams.
CORE COMPETENCIES CONTINUES
▪ Colla bora tion: Teamwork is essential in healthcare. Many providers and
ancillary staff must come together to reach goals of patient care.
▪ E thica l Decision M a king : When caring for patient’s indirectly or directly
ethics will come into play. It is important in conjunction with the other core
competencies the best choice will be made. A nurse manager can apply this
principle to either staff members or patient care.
▪ Direct Clinica l P ra ctice: This competency can be termed as the
competency that dictates all others. It affects all others because in order to
complete any of the other competencies one must possess clinical practice
knowledge (Hamric, 2014). APN’s specifically nurse managers are able to
manage and shape the clinical practices of all nurses they supervise. This
allows them to have a large impact on multiple nurses and their practice
delivered to patients.
FOUR COMPETENCIES- HEALTH PROMOTION
• Profession of Nursing
• This has an overall impact on patient
care improvement (Karami , 2017).
• Clinical Practice Arena
• This has impact on the care patient’s
have within their lifetime. This includes
proper referrals, medications, follow ups
and collaborations.
• Health Policy Arena
• This will impact your patient populations
ability to afford care, have different levels
of care, and receive quality EBP care
continuously.
• Systems Level
• This is the bigger picture, How do
studies, technology, laws, and staffing
shortages effect patients today and what
will that look like in the future.
HEALTH PROMOTION: DM HEALTH FAIR
▪ Roles: FNP, NI, CNS
▪ Core Competencies: guidance & coaching,
consultation, EBP, collaboration, direct clinical
practice
CORE COMPETENCIES EXPANDED
▪ Know the audience & understand what needs to be
available in education
▪ Know community resources available to help
implement the knowledge given
▪ Best place and time to hold fair
▪ Be current on your knowledge of DM regarding EBP
▪ Know your own scope of practice
▪ Consultations required due to scope of practice
▪ Collaborations best to better the overall picture
ROLES EXPANDED
▪ F NP : Can use knowledge of current practice to
understand general areas of patient knowledge that
are lacking, This will be extremely helpful in knowing
treatment options, treatment outcomes, cost of
treatments, etc.
▪ NI: Can follow up after the health fair to continue to
keep in touch with the participants and keep them
educated on updated EBP. This will also allow for any
unforeseen client issues to be assisted with after the
initial session.
▪ CNS : Can contribute different information to
different patient populations based on who they
currently serve in their clinical practice.
ROLE OF CLINICAL NURSE SPECIALIST
▪ They provide direct care to patients
▪ Work as consultants in health care
▪ They assist other professionals to improve
the outcomes of patients
▪ Observe the conditions of patients and
provide diagnosis
▪ Provides orders on medical tests and then
evaluates medical results.
NP ROLE
▪ NP roles depend on specialty
▪ Primarily, NPs provide general care and
preventive care
▪ They do check-ups
▪ They treat patients
▪ They order medical tests
▪ They prescribe medicine
ROLE OF NE
▪ Roles are mainly in the nurse education setting
▪ They teach aspiring nurses on patient care
▪ They develop nursing curriculum
▪ They may conduct medical care research
▪ They analyze data
▪ They present the results at nursing conferences
AP SUPPORT
Support programs are necessary for AP
Educational support programs are important
They help improve skills
They enable career development program
implementations
▪ AP also needs social support
▪ Personal support and work collaboration
programs are also necessary for Aps
▪
▪
▪
▪
CORE COMPETENCIES
The Core Competencies discussed in
Health and Wellness and Nursing
Considerations
TRANSFORMATIONAL LEADERSHIP
▪ Transformational leadership enables the leader and
follower to be unified with a collective purpose.
▪ Transformational Leadership can lead to a trusting
relationship between clinician and patient. This
relationship can lead to changes in values, attitudes,
perceptions, and or behaviors
▪ Transformational Leadership can lay the groundwork
for further positive changes through effective
communication.
TRANSFORMATIONAL LEADERSHIP
▪ Transformational Leadership can “inspire higher levels
of motivation and it satisfies the needs of the leader
and the follower”(Hamric, p. 272).
▪ According to Hamric, the leadership style of
Transformational Leadership is associated with
effective changes.
▪ It would seem that this may be the most effective style
of leadership for change due to education, trust, and
open communication. Understanding what the patient
wants, needs, understands and is willing to do may lead
to positive influence and changes in bad habits.
TRANSFORMATIONAL LEADERSHIP
▪ Transformational Leadership was
demonstrated by increasing understanding of
risk factors and modifications of lifestyle
changes to produce better patient outcomes.
DIRECT CLINICAL PRACTICE
▪ Advanced Practice RNs are providing direct health
care services that positively affect the health and
outcomes of the patients they serve.
▪ The value of services provided in direct clinical
practice are valued by the public and costeffective(South).
▪ Direct clinical practice could be demonstrated in the
PowerPoint presentation by providing accurate
information in clear language to patients and their
family member.
GUIDANCE AND COACHING
▪ Guidance and coaching “have been conceptualized as a
complex, dynamic, collaborative, and holistic” (South)
process between the Advanced Practice Nurse and
patient.
▪ The model for guidance and coaching include patient
education and guidance from the Advanced Practice
Nurse.
▪ Guidance and Coaching has been demonstrated in the
PowerPoint presentation by providing accurate and up
to date information. In doing so, it may be beneficial
to patient outcomes by providing information to make
good health care choices.
COLLABORATION
▪ The presence or absence of collaboration can affect
quality and cost of patient care.
▪ The use of collaboration in the instance of this
PowerPoint could be use of expert advise. These
could include:
Nutritionist – Healthier Eating Choices
Diabetes Educator –Glucose Control
Pharmacist – Medication Management
Gym Teacher – Healthy ways to exercise
WHAT IS HEALTH?
❖ The complete state of physical and mental wellbeing.
❖ It also entails the spiritual and social state of the individual
that contributes to his or her wellbeing.
❖ A healthy person is not only someone without disease or
infirmity but one who enjoy emotional, physical, social, and
spiritual growth and development (Eldredge et al., 2016).
❖ Therefore, the engagement of people in activities that ensure
a balance of these components of their health is important
WHAT IS HEALTH PROMOTION?
❖ It is the process that is used for empowering people in ways
that increase their control over the methods for improving
their health.
❖ The process for promoting the health of people involves the
participation of skilled practitioners.
❖ Also, health promotion entails changes in the environmental
factors that could adversely affect the health of the people
(Eldredge et al., 2016).
❖ Hence, health promotion is considered an important
business for all humans.
CONCEPT OF HEALTH PROMOTION
❖ Political actions to change public health policies.
❖ Patient education to help them identify the basics of healthy
living.
❖ Community engagement and partnerships.
❖ Social advocacy and support for members of the
communities. Sustainable resources for ensuring education
and housing (Mittelmark & Bull, 2013).
❖ Environmental factors that support food income and social
equity.
HEALTH PROMOTION GOALS
❖ Provide the right education and information for people to
make healthy choices.
❖ Allow access to multiple choices and ensure people and
communities understand the potential contributions of each
to their health and wellbeing (Mittelmark et al., 2013).
❖ Empower people with the necessary skills to make informed
decisions regarding their health and wellbeing
❖ Finally, the provide the resources for preventing illnesses and
making lifestyle changes.
PROCESSES FOR CHANGING HEALTH BEHAVIOR
❖ The initial phase is known as the pre-contemplation and entails the
level of illiteracy of the people regarding the actions and changes
that are needed to improve their health.
❖ The next process is referred to as the contemplation stage and
involves the actions that are used to motivate people towards the
positive changes to make them healthy.
❖ According to Hollands, Marteau, and Fletcher (2016), people are
ready to accept the changes that are recommended for their health
status, then processes for ensuring commitment are initiated.
❖ Then, the actions that are required for the changes are
implemented,
CONTINUATION
❖ Continuous actions are required for maintaining the
outcomes from the changes since there is a high tendency
for people to experience difficulty with the new methods for
healthy living.
❖ It is important to help people that achieved progress to
continue on the part since the chances of returning to the
old habits are very high (Hollands et al., 2016).
❖ Finally, resources are provided to the individual to make the
new health behavior a permanent aspect of their lives
HEALTH AND WELLNESS
❖ While health is described as the complete mental and physical state of an individual
and absence of disease and infirmity, wellness is considered the optimal emotional
and physical health of the person.
❖ Also, wellness is considered as the decision to take proactive measures and
responsibility for the entire wellbeing of the person.
❖ The dimensions of wellness include physical, intellectual, spiritual, emotional, and
interpersonal wellness (Eldredge et al.,2016).
❖ Therefore, wellness resources are designed to provide the person with information
about the methods for controlling the risk factors that result in illness.
HEALTH PROMOTIONAL EDUCATION
“Health promotion is the process of enabling
people to increase control over, and to
improve, their health. It moves beyond a focus
on individual behavior towards a wide range of
social and environmental interventions.”
HEALTHY DIET AND NUTRITION
http://www.choosemyplate.gov
ONE DEFINITION FOR HEALTH IS THE MANNER WHICH A PERSON ADEQUATELY
MANAGES DEMANDS OF HIS OR HER DAY TO DAY LIFE.
(SARTORIUS, 2016)
Take stairs when available
INCREASE
PHYSICAL
ACTIVITY
Gardening
Park in the outer parking lot at
grocery stores and walk
Clean the house regularly
CLINICAL NURSE
SPECIALIST
GOA L : using evidence-based research and practice
to focus on providing education and health
promotion to those that suffer from diabetes
mellitus.
EVIDENCE-BASED RESEARCH
In order to educa te our community, collaborate with other members of the
health care team, and provide evidence based practice, one must first research the
topic.
• H ea lthy People 2020: 1 in 3 adults have prediabetes, totaling more than 84 million
people.
• CDC: Diabetes prevalence is approximately 17% higher in rural areas than urban areas.
• World H ea lth Org a niz a tion: The number of people with diabetes has risen from 108
million in 1980 to 422 million in 2014.
• Diabetes is the major cause of blindness, kidney failure, stroke, heart attacks and lower
limb amputations.
• In 2016, an estimated 1.6 million deaths were directly caused by diabetes.
PROVIDING EDUCATION TO COMMUNITY
…..THROUGH THIS HEALTH PROMOTION BROCHURE
• CDC: Prediabetes can be reversed, while Diabetes can be treated and its consequences avoided or delayed
with…
• Stop frying your food.
Instead, use methods
of baking, grilling, or
steaming
• Drink more water
• Eat vegetables and
fruits
• Avoid sugar and
sodium
• Read labels on
packages
Get at least 2.5
hours of moderately
intense activity every
week. Example: Take
20 minute walks 5
days per week.
cdc.gov
Losing just 5-7%
of your body
weight can make
a difference in
reducing your
risk for type 2
diabetes.
cdc.gov
LEADERSHIP
• Using lea dership to colla bora te with other members of healthcare in order to come up with
ideas and formulate a plan that could result in the decrease of diabetes in the community.
• Working with ca se m a nag em ent, in order to coordinate and try to provide healthcare for all
people with or at risk for diabetes.
• Working with RN’s, Nurse M a nag ers a nd Nurse P ra ctitioners, to create a community event
to check glycemic levels for members in the community.
• Using Tra nsform a tiona l L ea dership as the guide to your practice and the purpose for helping
out in the community. Knowing that there is unity between all health care member (each with a
specific task) and patients all for a collective purpose-to improve diabetes in the community.
Rootedts.com
EVIDENCE-BASED PRACTICE
Implement diet and physical activity intervention programs such as (for example)
• Community Zumba: Free community event to promote exercise.
• Diabetes Prevention Walk: Free community event to prevent sedentary lifestyle.
• Healthy Eating Guides 101: Tips and Recipes for healthy meals.
The CDC provides Dia betes F riendly E a ting P la n for Ga m e Day and Ga m e Day H ea lthy
Recipes.
HEALTH PROMOTION ACTIVITIES
❖ Target all age, ethnic, and social groups to ensure healthy
population.
❖ Provide culturally relevant information and consider the
differences in the needs of patients across socioeconomic
and demographic categories.
❖ Implement approaches that contribute to healthy lifestyles
by providing resources and information on various health
options (Mittelmark et al., 2013).
❖ Establish and support environmental conditions that
contribute to the good health of the population.
NURSING CONSIDERATION DURING HEALTH
PROMOTION
❖ Develop and implement models and interventions for
culturally relevant education of the people.
❖ Support patient-centered opportunities for making healthy
behavioral changes.
❖ Provide resources and information for all categories of the
population that seek medical advise for their health and
wellbeing (Kemppainen,Tossavainen, & Turunen, 2013).
❖ Facilitate community initiatives for preventive medicine such
as immunization, physical activities, diet and nutrition,
infectious disease prevention, and reproductive health
programs.
CONTINUATION
❖ Conduct epidemiological studies for target populations.
❖ Participate in programs for disease detection in the
communities and within the target population.
❖ Administer interventions for the maintenance of the health
of individuals with chronic health conditions to improve
their quality of life (Kemppainen et al., 2013).
❖ Advocate for public health policies that promote equity and
justice for vulnerable groups in the society.
CONSULTATION
▪ Consultation offers clinical expertise to other
clinicians or to seek additional information to develop
their own practice.
▪ Obtaining and gathering relevant information was used
in this PowerPoint presentation.
CONCLUSION
❖ Health promotion is important for increasing the wellbeing
of the population through disease prevention and control.
❖ Patient education and awareness is an integral element of
the processes that are required for accomplishing the goals
of health promotion activities.
❖ Nurses are part of the major stakeholders that contribute
to the development and implementation of all the activities
that are necessary for promoting the health and wellbeing of
the members of any community.
REFERENCES:
American Association of Colleges of Nursing. (2006). The Essentials of Doctoral Education for
Advanced
Nursing Practice. Retrieved on January 28, 2019 from
http://www.aacn.nche.edu/dnp/pdf/essentials.pd
f
Centers for Disease Control and Prevention.” Centers for Disease Control and Prevention,
Centers for Disease Control and Prevention, www.cdc.gov/
Eldredge, L. K. B., Markham, C. M., Ruiter, R. A., Kok, G., Fernandez, M. E., & Parcel, G. S.
(2016). Planning health promotion programs: An intervention mapping approach. John
Wiley & Sons.
Hamric, A., Hanson, C., Tracy, M.F., & O’ Grady, E. (2014). Advanced Practice Nursing: An
Integrative Approach, 5th Edition. [South University]. Retrieved
from https://digitalbookshelf.southuniversity.edu/#/books/undefined/
Hollands, G. J., Marteau, T. M., & Fletcher, P. C. (2016). Non-conscious processes in changing
health-related behaviour: a conceptual analysis and framework. Health Psychology
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Institute of Medicine. (2001). Crossing the Quality Chasm: A new health system for the 21st
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Karami A, Farokhzadian J, Foroughameri G. Nurses’ professional competency and
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One. 2017;12(11):e0187863. Published 2017 Nov 8.
doi:10.1371/journal.pone.0187863
Kemppainen, V., Tossavainen, K., & Turunen, H. (2013). Nurses’ roles in health promotion
practice: an integrative review. Health Promotion International, 28(4), 490-501.
Mittelmark, M. B., & Bull, T. (2013). The salutogenic model of health in health promotion
research. Global Health Promotion, 20(2), 30-38.
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NP%20NP%20competenciesApril2006. pdf
NONPF & National Panel for NP Practice Doctorate
Organic Facts. (2018). www.organicfacts.net
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Leadership—A Meta-ethnography From the Nurse Leaderʼs Perspective. Nursing
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Tracy, M. F., Hanson, C. M., O Grady, E. T., & Hanric, A. B. (2014). Advanced practice
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