Advanced nursing roles in healthcare administration and legal consulting

¶ … roles available to nurse administrators.

Include at least one nurse administrator role in a health care agency.

Complete each cell of this grid with concise descriptions. Bulleted words and phrases are preferred to complete sentences.

Cite a minimum of 4 peer-reviewed resources, and include a reference page formatted according to APA guidelines.

Patient Advocate

Healthcare IT (HIT)

Utilization Reviewer

Legal Nurse Consultant

Two related responsibilities

Medical navigational assistance

Home health assistance

Nursing Informatics:

Electronic coding and billing systems

Electronic medical records (EMR)

- Networks for digital imaging such as PACS

- Making sure health care services are being used appropriately.

- Ensuring high quality care is administered as economically as possible.

-- Case management (utilization review plus discharge)

Analyze complex medical information

2 - Render informed opinions to attorneys in medical-legal matters

Identify the practice environment where this role may be applied

Clinics: Accompany a patient to appointments

Hospital: Monitor the patient at the bedside in a hospital

Cross-environmental: Act as a healthcare proxy

Hospitals

Clinics

Specialty Medical Centers

Laboratories

Hospitals

Home health companies Health insurance companies

Includes coordination with quality improvement team, social work team, discharge planning team, and the clinical staff caring for the patient.

About half of all legal nurse consultants are employed in law firms, insurance companies and other private institutions, while the other half work as independent consultants.

Education and experience required

Not all patient navigators have a healthcare background, although many do. Some have assisted relatives or friends through difficult medical circumstances. Or navigated the healthcare system on their own.

1 - Certificate Granting Programs in Patient Advocacy and Navigation

2 - Patient Advocacy Programs for Hospital Patient Advocates

3 - Specialized-Focus Patient Advocate and Navigator Programs

4 - Patient Advocacy Degree Programs (Bachelors or Masters Level)

Two ways to break into healthcare IT:

1 - From the clinical side, moving into a health IT role

2 -- From the IT side, moving from an IT professional role, without healthcare experience, making the transition into a healthcare IT role.

Registered nurse degree

Masters level RN

Doctoral level RN

Hospital administration experience

Issues or opportunities role might face

Most patient advocates or navigators work as individuals, running their own navigation consultancies or businesses. This means there are self-employment challenges, so it is important to have an entrepreneurial mindset.

Clinical knowledge is very valuable in the Health IT field. Clinicians who transfer into health IT may come from a background as a nurse.

Careers in nursing informatics, clinical process improvement, and service line analysts are a common careers for former clinical nurses.

Making sure patients get the care they need, administered via proven methods, provided by an appropriate health care provider, and delivered in an appropriate setting. Utilization review is a form of practice audit, which means it is often met with resistance from stakeholders.

Experience and clinical expertise that enables legal consulting nurse to:

1 - Locate and interview medical experts

2 - Serve as a liaison between law firms, medical experts and other parties

3 - Formulate medical-legal case theories; identify deviations from nursing standards of care

4 - Research medical literature

5 - Coordinate independent medical examinations

Appropriate theory to address