Seth Fuller, MSN, RN, FNP-BC
Nursing Instructor
Outcome Mastery
Samples of work during my graduate studies are included below for your review. Relevancy will be listed in the 9 outcome mastery questions provided by Auburn University at Montgomery's program. Research was based on library of texts recommended by the university (list may be provided upon request) and listed specifically with each sample work.
1. Initiate communication and collaboration with patient, patients’ support networks and healthcare
(Essential II and VII met through clinical and work experience)
I have accomplished this outcome through clinical and work experiences. Working full-time as an RN while simultaneously as a NP student has provided me the knowledge to work from "both sides of the coin" to understand what drives patient care. These experiences have also allowed me to work with patients from numerous backgrounds, cultures, and beliefs. It truly takes a team to provide the ultimate care for a patient. I have collaborated with patients, their family members, physicians, case managers, pharmacists, home health agencies, insurances, and many more members of the interdisciplinary team that has allowed me to demonstrate my knowledge in the coordination of care.
2. Utilize informatics and communication technologies to enhance patient education, expand accessibility of
care, analyze performance measures and improve outcomes. (Essential III, V, and VIII met through Typhon logs and EHR systems for documentation)
Throughout my NP journey, I have had the opportunity to utilize many tech systems that improve patient care. One of the systems include AthenaHealth which is an EHR that allows for patient communication, educational resources, statistical information of patient population, and monitors due dates for next due treatments or vaccines that are expiring, i.e. Another such system used during my graduate program was Typhon. This program would allow for the logging of patient information to review patient statistics, ranking of most common ICD-10 codes seen, etc. The information provided by the variety of software utilized provided valuable insight into patient needs, feedback, and what exposures needed by student prior to graduation. These systems can also provide infection monitoring, QA reports, and gaps in care.
3. Apply advanced concepts in the care of diverse populations through systemic assessment of actual and
potential risks in multiple care environments. (Essential I, II, and VIII met through EBP projects and
SOAP notes)
Coursework during graduate study provided the experience necessary to apply appropriate concepts to diverse populations. The project cited below was evidence-based research on the LGBTQ population and potential gaps in care due to lack of cultural sensitivity. It is important that providers are able to at least appreciate differences among patients and customize care to those needs. I can also relate to this need for application through the current increase in immigrants and non-English speaking patients with my job. Patients with different backgrounds must have the same needs met and culture should never be a barrier. Education level is also seen as a risk for compromised care. Providers must work to ensure patients understand teaching, educational material, and plan of care.
4. Influence health care policies to improve access, equity, efficiency, and social justice by utilizing clinical
judgment, evidence-based findings and theory in delivery of healthcare. (Essential I, IV, VIII, and IX met through Advocacy Paper)
Through study and experience it is evident that there are problems with the healthcare delivery system. Providers must work with lobbyists, professional organizations, peers, and other advocacy groups to improve accessibility to care, equality, and in providing care that is evidence-based. I have observed that healthcare is turning into a "experience" rather than a necessary service. While patient satisfaction is important, what the patient needs to improve their clinical condition should not be dampened to accommodate "regulation and reimbursement." It is important that the power to treat remains with providers and researchers versus third-parties and payers. An example of this during my graduate studies would be joining the professional organization, American Association of Nurse Practitioners. This organization is to keep me abreast of current issues and to provide support to those advocating for my profession. Other tools would include the use of Up-To-Date, UCentral, Epocrates, and others to fact-check and ensure that treatment plans were evidence-based.
5. Develop strategies for lifelong learning and interprofessional collaboration that integrate professional
standards, guidelines, statues, regulations, and accountability in coordination of care. (Essential V, VI,
VII, and IX met through medical advisory for local church)
It is important for providers to serve as advocates for health in their communities and reachable surroundings. Providers should be the experts in the area that keep community populations up-to-date with health needs, goals, and concerns. Additional ways this outcome was met is through the study of the Nurse Practice Act set by the State of Alabama Board of Nursing, review of our Buppert text, and participating in the Fitzgerald review course.
6. Recognize global factors to intervene and advocate for health promotion, clinical prevention, and disease
management (Essential I, VI, VIII, and IX met through Health Promotion project)
I have accomplished this outcome through sharing my knowledge-base with patients during clinical rotation, friends, family, and co-workers regarding my vision on lifestyle change (see "Practice Philosophy") and with advocacy for disease prevention. I volunteered through my adjunct position to provide health screenings for community members to identify care needs for the underserved place them in contact with affordable resources.
7. Provide ethical, culturally sensitive, patient centered care based on epidemiological, social and
environment data to improve health status. (Essential VI, VIII, and IX met through personal philosophy tab)
With each and every patient encounter I have seen them as a person in need of medical care rather than through a microscope based on identifiers. However, I appreciate and recognize these identifiers as what place the patient at risk for certain diseases, how care is delivered, and how culture influences expectations and approach. As mentioned previously, I have personally seen an influx of Latino and Asian patients through the COVID-19 pandemic and have mastered providing culturally sensitive care for these persons.
8. Apply healthcare economics and leadership skills, managing micro-, meso-, and macro-systems for
continuous quality improvement processes. (Essential II, III, VI met through EBP project and advocacy paper)
During the graduate program I recall two specific examples that include quality management and fiscal responsibility. Through a facility's transition to electronic medical record from paper and the implementation of new intake forms to expedite patient encounter times.
9. Apply scientific and ethical principles of emerging and current technology in delivery of direct and indirect
care to promote safe practice environments. (Essential I, IV, V, and IX met through Health Promotion project and utilization of current tech at clinical rotations)
Several of the university's resources and texts utilized digital content. Having information available in this format made easy to have necessary resources in the clinical setting and on-demand during regular work. Another important aspect of current technology is that it can provide a wealth of information at a touch. For example, rather than having to physically store and access paper records, all patient encounters are easily accessible for review to include HPI, labs, outside providers, etc. Another benefit of technology is allowing providers to see treatment provided by others so that harmful outcomes can be greatly limited. An example from my clinical experience is before writing a new narcotic information, the DEA database was reviewed to ensure the patient was not "doc-hopping & shopping", written a similar drug recently, or had potential interaction with any drugs being filled by the patient.
